Department of Intensive Care Medicine, Xuanwu Hospital, Beijing, China.
Vascular Department, Xuanwu Hospital, Capital Medical University, Beijing, China.
BMJ Open Diabetes Res Care. 2023 Oct;11(5). doi: 10.1136/bmjdrc-2023-003564.
There is little bulk clinical evidence on nutritional status and mortality in patients with diabetes. The purpose of this study was to examine the relationship between prognostic nutritional index (PNI) and all-cause mortality and cardiovascular mortality in adults with diabetes.
This study included 5916 adult patients with diabetes from the National Health and Nutrition Examination Survey 1999-2018. Cox proportional risk models were used to estimate risk ratios (HRs) and 95% CIs for all-cause mortality, cardiovascular disease (CVD) mortality.
During a mean follow-up of 8.17 years, there were 1248 deaths from all causes and 370 deaths from CVD. After multivariate adjustment, the risk of all-cause mortality was reduced by 24%, 38%, and 28% in Q2 (49.0-52.99), Q3 (53.0-57.99), and Q4 (≥58.0), respectively, compared with Q1 (PNI<49.0). The risk of cardiovascular mortality was reduced by 30%, 27%, and 26%, respectively. Consistent results were observed in the subgroup analysis.
Lower serum PNI levels were significantly associated with higher all-cause and CVD mortality. These findings suggest that maintaining an appropriate range of serum PNI status may reduce the risk of death in patients with diabetes.
关于糖尿病患者的营养状况和死亡率，临床证据很少。本研究旨在探讨预后营养指数（PNI）与成人糖尿病患者全因死亡率和心血管死亡率之间的关系。
本研究纳入了 1999 年至 2018 年全国健康和营养调查（NHANES）中的 5916 名成年糖尿病患者。使用 Cox 比例风险模型估计全因死亡率、心血管疾病（CVD）死亡率的风险比（HR）和 95%置信区间。
在平均 8.17 年的随访期间，共有 1248 例患者死于各种原因，370 例死于 CVD。经过多变量调整后，与 Q1（PNI<49.0）相比，Q2（49.0-52.99）、Q3（53.0-57.99）和 Q4（≥58.0）的全因死亡率风险分别降低了 24%、38%和 28%。心血管死亡率的风险分别降低了 30%、27%和 26%。亚组分析也得到了一致的结果。
较低的血清 PNI 水平与全因和 CVD 死亡率的增加显著相关。这些发现表明，维持适当的血清 PNI 状态范围可能会降低糖尿病患者的死亡风险。
