Fan Yu, He Lian, Zhou Yongjing, Man Changfeng
Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, China.
Front Nutr. 2021 Sep 29;8:736884. doi: 10.3389/fnut.2021.736884. eCollection 2021.
Low Geriatric Nutritional Risk Index has been identified as an index of impaired nutritional state. The objective of the meta-analysis was to assess the association of the Geriatric Nutritional Risk Index (GNRI) with adverse outcomes in patients with coronary artery disease (CAD). Relevant studies were identified by comprehensively searching PubMed and Embase databases in May 2021. Studies assessing the association of GNRI with all-cause mortality or major adverse cardiovascular events (MACEs) in patients with CAD were included. The predictive value of GNRI was summarized by pooling multivariable adjusted risk ratios (RR) with 95% confidence intervals (CI) per GNRI point decrease or the lowest vs. the highest GNRI group. A total of eight studies involving 9277 patients with CAD were analyzed. Meta-analysis showed that the lowest GNRI was associated with a higher risk of all-cause mortality (RR 2.10; 95% CI 1.68-2.63) and MACEs (RR 2.84; 95% CI 1.56-5.16), respectively. Furthermore, per point decrease in GNRI was associated with 8 and 10% additional risk of all-cause mortality and MACEs. Subgroup analysis indicated that the value of low GNRI in predicting all-cause mortality was not affected by subtype of patients or follow-up duration. Low GNRI score at baseline was associated with a higher risk of all-cause mortality and cardiovascular events in patients with CAD. The nutritional state estimated by the GNRI score could provide important predictive information in patients with CAD.
低老年营养风险指数已被确定为营养状态受损的指标。本荟萃分析的目的是评估老年营养风险指数（GNRI）与冠状动脉疾病（CAD）患者不良结局之间的关联。通过全面检索2021年5月的PubMed和Embase数据库来识别相关研究。纳入评估GNRI与CAD患者全因死亡率或主要不良心血管事件（MACE）之间关联的研究。通过汇总每降低一个GNRI点或GNRI最低组与最高组的多变量调整风险比（RR）及其95%置信区间（CI）来总结GNRI的预测价值。共分析了八项涉及9277例CAD患者的研究。荟萃分析表明，最低的GNRI分别与更高的全因死亡率风险（RR 2.10；95% CI 1.68 - 2.63）和MACE风险（RR 2.84；95% CI 1.56 - 5.16）相关。此外，GNRI每降低一个点与全因死亡率和MACE额外增加8%和10%的风险相关。亚组分析表明，低GNRI在预测全因死亡率方面的价值不受患者亚型或随访持续时间的影响。基线时低GNRI评分与CAD患者更高的全因死亡率和心血管事件风险相关。通过GNRI评分评估的营养状态可为CAD患者提供重要的预测信息。
