Liu Guodong, Zou Chen, Jie Yu, Wang Pei, Wang Xiaoyan, Fan Yu
Department of General Surgery, The Suqian Clinical College of Xuzhou Medical University, Suqian, China.
Cancer Institute, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, China.
Front Nutr. 2022 Jun 22;9:903293. doi: 10.3389/fnut.2022.903293. eCollection 2022.
Conflicting results have been reported on the value of the Geriatric Nutritional Risk Index (GNRI) in predicting adverse outcomes in patients with peripheral artery disease (PAD). The objective of this meta-analysis was to evaluate the association of GNRI with adverse outcomes in patients with lower extremity PAD.
Relevant studies were comprehensively searched in PubMed and Embase databases until December 31, 2021. Eligible studies should evaluate the value of GNRI in predicting major adverse cardiovascular and leg events (MACLEs), all-cause mortality, and amputation in patients with lower extremity PAD.
Eight studies reporting on 9 articles involving 5,541 patients were included. A fixed-effect model meta-analysis showed that patients with PAD with low GNRI had an increased risk of MACLEs [adjusted risk ratio (RR) 2.26; 95% confidence interval (CI) 1.54-3.31] and all-cause mortality (RR 2.38; 95% CI 1.71-3.31) compared with those with high GNRI. When analysis of GNRI is by continuous data, 10 units of GNRI decrease was associated with 36% and 44% higher risk of MACLEs and all-cause mortality, respectively. However, per 10 units GNRI score decrease was not significantly associated with a higher risk of amputation ( = 0.051).
Low GNRI may be an independent predictor of adverse outcomes in patients with lower extremity PAD. Routine screening of nutritional status using the GNRI may provide important prognostic information in patients with PAD.
关于老年营养风险指数（GNRI）在预测外周动脉疾病（PAD）患者不良结局方面的价值，已有相互矛盾的报道。本荟萃分析的目的是评估GNRI与下肢PAD患者不良结局之间的关联。
在PubMed和Embase数据库中全面检索相关研究，截至2021年12月31日。符合条件的研究应评估GNRI在预测下肢PAD患者主要不良心血管和腿部事件（MACLEs）、全因死亡率和截肢方面的价值。
纳入了8项研究，共9篇文章，涉及5541例患者。固定效应模型荟萃分析显示，与GNRI高的PAD患者相比，GNRI低的患者发生MACLEs的风险增加[调整风险比（RR）2.26；95%置信区间（CI）1.54 - 3.31]，全因死亡率增加（RR 2.38；95% CI 1.71 - 3.31）。当按连续数据分析GNRI时，GNRI每降低10个单位，发生MACLEs和全因死亡率的风险分别增加36%和44%。然而，GNRI评分每降低10个单位与截肢风险增加无显著相关性（P = 0.051）。
低GNRI可能是下肢PAD患者不良结局的独立预测因素。使用GNRI对营养状况进行常规筛查可能为PAD患者提供重要的预后信息。
