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老年营养风险指数与肌少症的发生呈纵向相关:来自 5 年前瞻性队列研究的证据。

The geriatric nutrition risk index is longitudinally associated with incident Sarcopenia: evidence from a 5-year prospective cohort.

机构信息

Department of Geriatrics and National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, 37 GuoXue Lane, Chengdu, Sichuan, 610041, P.R. China.

出版信息

Aging Clin Exp Res. 2024 Mar 5;36(1):52. doi: 10.1007/s40520-024-02725-7.

Abstract

BACKGROUND

Previous studies investigating the association between the geriatric nutrition risk index (GNRI) and sarcopenia either lacked longitudinal evidence or narrowly focused on specific populations.

AIMS

We aimed to reveal longitudinal associations of GNRI with sarcopenia risk in community-dwelling Chinese. We also investigated interaction effects of potential factors on such associations.

METHODS

We included participants aged ≥ 50 years with sufficient data from the WCHAT study who did not have sarcopenia at baseline and completed sarcopenia assessment during follow-up. GNRI was calculated according to the formula based on serum albumin, height and weight. Sarcopenia was diagnosed according to the 2019 AWGS consensus. Longitudinal associations between GNRI and sarcopenia were estimated by logistic regression with GNRI as either a continuous or categorical variable by tertiles, using generalized estimating equations (GEE) as sensitivity analyses. Subgroup analyses by potential covariates were conducted to detect interaction effects.

RESULTS

A total of 1907 participants without baseline sarcopenia were finally included, of whom 327 (17.1%) developed incident sarcopenia during 5-year follow-up. After controlling for confounders, sarcopenia risk decreased with each one standard deviation increase in GNRI (OR=0.36, 95% CI 0.31-0.43), and it also decreased successively from the lowest (< 111.2) through middle (111.2-117.7) to the highest (≥ 117.8) tertile of the GNRI level (P for trend < 0.001). Similar results were yielded by GEE. Such associations generally remained robust across subgroups with distinct characteristics, while significant differences were observed between different age groups (≥ 65 vs. <65 years) (interaction P-value < 0.05).

CONCLUSION

GNRI is longitudinally associated with sarcopenia risk with possibly age-specific differences in association magnitude, which holds implications for policymakers to conduct population-based risk assessment.

摘要

背景

先前研究 GNRI(老年营养风险指数)与肌少症之间的关联,或是缺乏纵向证据,或是仅限于特定人群。

目的

我们旨在揭示 GNRI 与中国社区居住的老年人肌少症风险之间的纵向关联。我们还研究了潜在因素对这些关联的交互作用。

方法

我们纳入了 WCHAT 研究中年龄≥50 岁、基线时无肌少症且随访期间完成肌少症评估的、数据充足的参与者。根据血清白蛋白、身高和体重的公式计算 GNRI。根据 2019 年 AWGS 共识诊断肌少症。使用广义估计方程(GEE)作为敏感性分析,通过将 GNRI 作为连续或分类变量的三分位数,使用逻辑回归来估计 GNRI 与肌少症之间的纵向关联。通过潜在协变量进行亚组分析,以检测交互作用。

结果

共纳入 1907 名基线时无肌少症的参与者,其中 327 名(17.1%)在 5 年随访期间发生了肌少症。在控制混杂因素后,GNRI 每增加一个标准差,肌少症风险降低(OR=0.36,95%CI 0.31-0.43),并且随着 GNRI 水平从最低(<111.2)到中间(111.2-117.7)再到最高(≥117.8)三分位数依次降低(趋势 P<0.001)。GEE 也得出了类似的结果。这些关联在具有不同特征的亚组中基本保持稳健,而在不同年龄组(≥65 岁与<65 岁)之间观察到显著差异(交互 P 值<0.05)。

结论

GNRI 与肌少症风险呈纵向相关,其关联程度可能具有年龄特异性,这对政策制定者进行基于人群的风险评估具有启示意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63bd/10912133/9d07cbea387b/40520_2024_2725_Fig1_HTML.jpg

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