Matsui Masahiro, Asai Akira, Ushiro Kosuke, Onishi Saori, Nishikawa Tomohiro, Ohama Hideko, Tsuchimoto Yusuke, Kim Soo Ki, Nishikawa Hiroki
The Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan.
Liver Center, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan.
Diagnostics (Basel). 2023 Dec 25;14(1):49. doi: 10.3390/diagnostics14010049.
The Prognostic Nutritional Index (PNI) is widely recognized as a screening tool for nutrition. We retrospectively examined the impact of PNI in patients with chronic liver disease (CLD, = 319, median age = 71 years, 153 hepatocellular carcinoma (HCC) patients) as an observational study. Factors associated with PNI < 40 were also examined. The PNI correlated well with the albumin-bilirubin (ALBI) score and ALBI grade. The 1-year cumulative overall survival rates in patients with PNI ≥ 40 ( = 225) and PNI < 40 ( = 94) were 93.2% and 65.5%, respectively ( < 0.0001). In patients with ( < 0.0001) and without ( < 0.0001) HCC, similar tendencies were found. In the multivariate analysis, hemoglobin ( = 0.00178), the presence of HCC ( = 0.0426), and ALBI score ( < 0.0001) were independent factors linked to PNI < 40. Receiver operating characteristic (ROC) curve analysis based on survival for the PNI yielded an area under the ROC curve of 0.79, with sensitivity of 0.80, specificity of 0.70, and an optimal cutoff point of 42.35. In conclusion, PNI can be a predictor of nutritional status in CLD patients. A PNI of <40 can be useful in predicting the prognosis of patients with CLD.
预后营养指数（PNI）被广泛认为是一种营养筛查工具。作为一项观察性研究，我们回顾性研究了PNI对慢性肝病（CLD，n = 319，中位年龄 = 71岁，153例肝细胞癌（HCC）患者）患者的影响。还研究了与PNI < 40相关的因素。PNI与白蛋白-胆红素（ALBI）评分和ALBI分级密切相关。PNI≥40（n = 225）和PNI < 40（n = 94）患者的1年累积总生存率分别为93.2%和65.5%（P < 0.0001）。在有（P < 0.0001）和无（P < 0.0001）HCC的患者中也发现了类似趋势。在多变量分析中，血红蛋白（P = 0.00178）、HCC的存在（P = 0.0426）和ALBI评分（P < 0.0001）是与PNI < 40相关的独立因素。基于PNI生存情况的受试者工作特征（ROC）曲线分析得出ROC曲线下面积为0.79，灵敏度为0.80，特异性为0.70，最佳截断点为42.35。总之，PNI可作为CLD患者营养状况的预测指标。PNI < 40有助于预测CLD患者的预后。
