Miao ShuYing, Bao ChunXiang, Zhang YuanFeng, Wang LiJuan, Jin XiaoDong, Huang BiWu, Zhang Zheng, Wang Wei
Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Urology, Shantou Central Hospital, Guangdong Province, Shantou, China.
Nutrition. 2023 Nov;115:112164. doi: 10.1016/j.nut.2023.112164. Epub 2023 Jul 17.
The geriatric Nutritional Risk Index (GNRI) is an effective tool to assess the nutritional status of the elderly. However, the relationship between the GNRI and the risk for prostate cancer (PCa) remains uncertain in middle-aged and older men. The aim of this study was to investigate the association between the GNRI and the risk for PCa by analyzing the serum total (tPSA) and free prostate-specific antigen (fPSA) levels (including percent fPSA [%fPSA]).
Data for this study were obtained from 7396 men ≥40 y of age from the 2001-2010 National Health and Nutrition Survey (NHANES). We obtained the tPSA and fPSA and calculated the %fPSA and the GNRI. Participants with %fPSA >25% and tPSA <4 ng/mL were defined as high PCa risk. The relationship between the GNRI and serum PSA levels was investigated using a linear regression model. The odds ratios (ORs) and 95% confidence intervals (CIs) for the association between the GNRI and PCa risk were estimated by a logistic regression model. The non-linear relationship was also characterized by a restricted cubic spline regression model.
The median of tPSA, fPSA, and %fPSA was 0.90, 0.26, and 29%, respectively. The mean of the GNRI was 29. The proportion of participants in the low PCa- and high PCa-risk groups was 93% and 7%, respectively. There was a negative and linear correlation between the GNRI and serum tPSA and fPSA levels in all models. However, no association between the GNRI and the %fPSA was observed. In the adjusted model, lower GNRI was associated with higher PCa risk (OR, 0.570; 95% CI, 0.415-0.784; P = 0.001). The restricted cubic spline regression model showed a non-linear and negative association between the GNRI and PCa risk (P = 0.020), with inflection points of 109.148.
The results of this study suggest that nutritional status, as represented by the GNRI, is associated with the risk for PCa.
老年营养风险指数（GNRI）是评估老年人营养状况的有效工具。然而，在中老年男性中，GNRI与前列腺癌（PCa）风险之间的关系仍不明确。本研究的目的是通过分析血清总前列腺特异性抗原（tPSA）和游离前列腺特异性抗原（fPSA）水平（包括fPSA百分比[%fPSA]）来探讨GNRI与PCa风险之间的关联。
本研究的数据来自2001 - 2010年美国国家健康与营养检查调查（NHANES）中7396名年龄≥40岁的男性。我们获取了tPSA和fPSA，并计算了%fPSA和GNRI。%fPSA>25%且tPSA<4 ng/mL的参与者被定义为高PCa风险。使用线性回归模型研究GNRI与血清PSA水平之间的关系。通过逻辑回归模型估计GNRI与PCa风险之间关联的比值比（OR）和95%置信区间（CI）。还通过受限立方样条回归模型描述了非线性关系。
tPSA、fPSA和%fPSA的中位数分别为0.90、0.26和29%。GNRI均值为29。低PCa风险组和高PCa风险组参与者的比例分别为93%和7%。在所有模型中，GNRI与血清tPSA和fPSA水平之间均呈负线性相关。然而，未观察到GNRI与%fPSA之间存在关联。在调整模型中，较低的GNRI与较高的PCa风险相关（OR，0.570；95%CI，0.415 - 0.784；P = 0.001）。受限立方样条回归模型显示GNRI与PCa风险之间呈非线性负相关（P = 0.020），拐点为109.148。
本研究结果表明，以GNRI表示的营养状况与PCa风险相关。
