Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan; Division of Research, ARCE Inc., Sagamihara, Japan.
Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Japan; Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Japan.
Nutr Metab Cardiovasc Dis. 2023 Oct;33(10):1914-1922. doi: 10.1016/j.numecd.2023.06.005. Epub 2023 Jun 17.
This study was conducted to verify whether serum cholinesterase (ChE) is useful in predicting prognosis and discriminating undernutrition status compared to existing low-nutrition indices of blood chemical tests in patients with heart failure (HF).
A total of 1617 patients (1204 older patients) with HF who evaluated ChE during hospitalization were recruited for this study. The primary outcome was all-cause death, and multivariate survival analysis was performed. We drew a receiver operating characteristic curve for all-cause death, some undernutrition status, such as low body mass index, thin mid-upper arm circumference, low grip strength, and slow gait speed. The area under the curve was used to compare the predictive ability of ChE with some existing nutritional parameters, such as blood biochemical tests, controlling nutritional status (CONUT), and the geriatric nutritional risk index (GNRI). After adjusting for 29 variables, higher ChE significantly decreased the risk of all-cause death (per 10 increase, hazard ratio: 0.975, 95% confidence interval: 0.952-0.998), and this trend was maintained for older patients (per 10 increase, hazard ratio: 0.972, 95% confidence interval: 0.947-0.997). ChE was moderately correlated with CONUT and GNRI, but the predictive ability for all-cause death was higher for ChE relative to both scores. ChE tended to have an almost consistently high predictive ability compared with other blood biochemical tests.
ChE was associated with all-cause death and an almost consistently higher predictive ability for all-cause death and undernutrition status in comparison to existing blood chemical tests and nutritional scores.
本研究旨在验证血清胆碱酯酶（ChE）在预测心力衰竭（HF）患者预后和区分营养不良状态方面是否优于现有血液化学检测的低营养指数。
共纳入 1617 例（1204 例老年患者）住院期间评估 ChE 的 HF 患者进行本研究。主要结局为全因死亡，进行多变量生存分析。我们为全因死亡、低体重指数、消瘦中上臂围、握力低和步态缓慢等一些营养不良状态绘制了全因死亡的受试者工作特征曲线。使用曲线下面积来比较 ChE 与一些现有营养参数（如血液生化检测、控制营养状况（CONUT）和老年营养风险指数（GNRI））的预测能力。调整 29 个变量后，较高的 ChE 显著降低了全因死亡的风险（每增加 10，风险比：0.975，95%置信区间：0.952-0.998），这一趋势在老年患者中也保持不变（每增加 10，风险比：0.972，95%置信区间：0.947-0.997）。ChE 与 CONUT 和 GNRI 中度相关，但与这两个评分相比，ChE 对全因死亡的预测能力更高。与其他血液生化检测相比，ChE 具有更高的预测全因死亡和营养不良状态的能力。
与现有血液化学检测和营养评分相比，ChE 与全因死亡相关，并且对全因死亡和营养不良状态具有几乎一致的更高预测能力。
