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营养风险指数及其他指标对中国无癌症中老年人群肌肉减少症的诊断价值:ROC曲线分析

Diagnostic Value of Nutritional Risk Index and Other Indices for Predicting Sarcopenia in the Middle-Aged and Elderly Population of China Without Cancer: A ROC Curve Analysis.

作者信息

Zou Jing-Feng, Li Shao-Tian, Wang Li-Ping, Zhou Nian-Li, Ran Jia-Jia, Yang Xin, Tian Chun-Hui, Liu Yi-Ting, Liu Yun, Peng Wen

机构信息

Department of General Practice, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, WuHan, Hubei, People's Republic of China.

出版信息

Int J Gen Med. 2024 Jun 1;17:2527-2538. doi: 10.2147/IJGM.S457252. eCollection 2024.

Abstract

BACKGROUND

Emerging evidence suggests that systemic inflammatory and nutritional biomarkers, along with derived indices, could serve as predictors for sarcopenia in cancer population. This study aimed to compare these predictors, focusing on the nutritional risk index (NRI) and evaluate its diagnostic value, for sarcopenic patients without cancer.

METHODS

This cross-sectional retrospective study included 1674 participants. Sarcopenia is defined by skeletal muscle mass index (SMI). Laboratory data reflected the values of systemic inflammatory and nutritional biomarkers, from which the derived indices were calculated. Multiple logistic regression analysis, ROC curve analysis, and the Youden index were utilized to assess the association between these markers and sarcopenia and determine the cutoff value for predicting sarcopenia.

RESULTS

Among all participants (1110 men and 564 women, mean age 61.97 ± 9.83 years), 398 individuals were diagnosed with sarcopenia, indicating a prevalence of 23.78% in China's middle-aged and elderly population without cancer. Logistic regression analysis revealed significant associations between all biomarkers and derived indices with sarcopenia. Following adjustment for potential confounders, lower NRI values were significantly associated with a higher incidence of sarcopenia. For sarcopenia diagnosis, the area under the curve (AUC) for NRI was 0.769 ([95% CI, 0.742, 0.796], < 0.001), with a cutoff value of 106.016, sensitivity of 75.6% and specificity of 66.1%. NRI demonstrated greater predictive advantage for sarcopenia incidence in men compared to women.

CONCLUSION

A lower NRI value was associated with a higher prevalence of sarcopenia. NRI shows promise for early, rapid, and effective sarcopenia screening, particularly in China's middle-aged and elderly male population without cancer.

摘要

背景

新出现的证据表明,全身炎症和营养生物标志物以及衍生指标可作为癌症患者肌肉减少症的预测指标。本研究旨在比较这些预测指标,重点关注营养风险指数(NRI),并评估其对无癌症的肌肉减少症患者的诊断价值。

方法

这项横断面回顾性研究纳入了1674名参与者。肌肉减少症由骨骼肌质量指数(SMI)定义。实验室数据反映了全身炎症和营养生物标志物的值,并据此计算衍生指标。采用多元逻辑回归分析、ROC曲线分析和尤登指数来评估这些标志物与肌肉减少症之间的关联,并确定预测肌肉减少症的临界值。

结果

在所有参与者(1110名男性和564名女性,平均年龄61.97±9.83岁)中,398人被诊断为肌肉减少症,表明在中国无癌症的中老年人群中患病率为23.78%。逻辑回归分析显示,所有生物标志物和衍生指标与肌肉减少症之间均存在显著关联。在对潜在混杂因素进行调整后,较低的NRI值与较高的肌肉减少症发病率显著相关。对于肌肉减少症的诊断,NRI的曲线下面积(AUC)为0.769([95%CI,0.742,0.796],P<0.001),临界值为106.016,敏感性为75.6%,特异性为66.1%。与女性相比,NRI对男性肌肉减少症发病率的预测优势更大。

结论

较低的NRI值与较高的肌肉减少症患病率相关。NRI有望用于早期、快速且有效的肌肉减少症筛查,尤其是在中国无癌症的中老年男性人群中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e0d/11152168/cc2b29b24517/IJGM-17-2527-g0001.jpg

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