Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China.
Cognitive Center, Department of Neurology, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China.
Nutr Neurosci. 2024 Nov;27(11):1330-1340. doi: 10.1080/1028415X.2024.2330786. Epub 2024 Apr 2.
The Prognostic Nutritional Index (PNI) has been described as a useful screening tool for patient prognosis in several diseases. As a potential diagnostic index, it has attracted the interest of many physicians. However, the correlation between the PNI and post-stroke cognitive impairment (PSCI) remains unclear.
A total of 285 patients with acute ischemic stroke were included. PNI was assessed as serum albumin (g/L) + 5× lymphocyte count (10/L) and was dichotomized according to the prespecified cut-off points 48.43 for the high and low groups. PSCI was defined as Mini-Mental State Examination (MMSE) < 27 at the 6-10 months follow-up. Multiple logistic regression and linear regression analyses were performed to examine the association between PNI and cognitive outcomes.
A low PNI was independently associated with PSCI after adjusting for age, sex, education, National Institutes of Health Stroke Scale (NIHSS), deep white matter hyperintensity (DWMH), and stroke history (odds ratio [OR]: 2.158; 95% confidence interval [CI]: 1.205-3.863). The PNI scores were significantly associated with MMSE and attention domain ( = 0.113, = 0.006; = 0.109, = 0.041, respectively). The PNI improved the model's discrimination when added to the model with other clinical risk factors.
A low PNI was independently associated with the occurrence of PSCI and the PNI scores were specifically associated with the scores of global cognition and attention domain. It can be a promising and straightforward screening indicator to identify the person with impaired immune-nutritional status at higher risk of PSCI.
预后营养指数（PNI）已被描述为几种疾病患者预后的有用筛查工具。作为一种潜在的诊断指标，它引起了许多医生的兴趣。然而，PNI 与卒中后认知障碍（PSCI）之间的相关性尚不清楚。
共纳入 285 例急性缺血性脑卒中患者。PNI 评估为血清白蛋白（g/L）+5×淋巴细胞计数（10/L），根据预设截断值 48.43 将其分为高和低两组。PSCI 定义为 6-10 个月随访时简易精神状态检查（MMSE）<27。采用多因素逻辑回归和线性回归分析评估 PNI 与认知结局之间的关系。
校正年龄、性别、教育程度、美国国立卫生研究院卒中量表（NIHSS）、深部白质高信号（DWMH）和卒中史后，低 PNI 与 PSCI 独立相关（比值比 [OR]：2.158；95%置信区间 [CI]：1.205-3.863）。PNI 评分与 MMSE 和注意力域显著相关（=0.113，=0.006；=0.109，=0.041）。PNI 可改善包含其他临床危险因素模型的判别能力。
低 PNI 与 PSCI 的发生独立相关，PNI 评分与总体认知和注意力域评分特异性相关。它可能是一种有前途的、直接的筛选指标，可以识别免疫营养状况受损、PSCI 风险较高的人群。
