Han Kun, Wang Tianhong, Zou Congcong, Li Tao, Zhou Leng
Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu, 610041, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, 610041, China.
Nutr Metab (Lond). 2024 Jul 12;21(1):48. doi: 10.1186/s12986-024-00827-7.
Previous studies have reported a close association between the Geriatric Nutritional Risk Index (GNRI) and various conditions. However, the association between the GNRI and mortality remains unclear. To examine the correlation between the GNRI and all-cause, cancer-specific, and cardiovascular mortality, this study was performed.
We analyzed elderly participants in the National Health and Nutrition Examination Survey from 2005 to 2016. The GNRI was calculated using body mass index and serum albumin. Kaplan-Meier survival curves were drawn to compare the survival probability between the normal and decreased GNRI groups. Weighted multivariate Cox regression and restricted cubic spline (RCS) models were employed to determine the linear and non-linear associations of the GNRI with all-cause, cancer-specific, and cardiovascular mortality.
A total of 3,276 participants were included in the analysis. The Kaplan-Meier survival curve showed that the decreased GNRI group had a lower survival probability for all-cause mortality and cancer-specific mortality (P < 0.001) but not for cardiovascular mortality (P > 0.05). In the full regression models, the decreased group had a higher risk of all-cause mortality (HR = 1.67, 95% CI = 1.21-2.30, P = 0.002), and cancer-specific mortality (HR = 2.20, 95% CI = 1.32-3.67, P = 0.003) than the normal group. For cardiovascular mortality, no significant association with GNRI (HR = 1.39, 95% CI = 0.60-3.22, P = 0.436) was detected. Notably, the RCS analysis identified a linear downward trend between the GNRI and all-cause, alongside cancer-specific mortalities (all P for overall < 0.05). The time-dependent Receiver Operating Characteristic (ROC) analysis unveiled the predictive power of the GNRI for 5-year all-cause mortality, cancer mortality, and cardiovascular mortality was 0.754, 0.757, and 0.836, respectively, after adjusting for covariates.
Individuals with a decreased GNRI had increased risks of all-cause, and cancer-specific mortality. There were linear associations of the GNRI with all-cause, and cancer-specific mortality. Nutritional status should be carefully monitored, which may improve the overall prognosis for the general population.
既往研究报道了老年营养风险指数（GNRI）与多种疾病之间存在密切关联。然而，GNRI与死亡率之间的关联仍不明确。为了研究GNRI与全因死亡率、癌症特异性死亡率和心血管死亡率之间的相关性，开展了本研究。
我们分析了2005年至2016年美国国家健康与营养检查调查中的老年参与者。使用体重指数和血清白蛋白计算GNRI。绘制Kaplan-Meier生存曲线，以比较GNRI正常组和降低组之间的生存概率。采用加权多因素Cox回归和受限立方样条（RCS）模型来确定GNRI与全因死亡率、癌症特异性死亡率和心血管死亡率之间的线性和非线性关联。
总共3276名参与者纳入分析。Kaplan-Meier生存曲线显示，GNRI降低组在全因死亡率和癌症特异性死亡率方面的生存概率较低（P<0.001），但在心血管死亡率方面无差异（P>0.05）。在全回归模型中，GNRI降低组的全因死亡率（HR=1.67，95%CI=1.21-2.30，P=0.002）和癌症特异性死亡率（HR=2.20，95%CI=1.32-3.67，P=0.003）风险高于正常组。对于心血管死亡率，未检测到与GNRI有显著关联（HR=1.39，95%CI=0.60-3.22，P=0.436）。值得注意的是，RCS分析确定GNRI与全因死亡率以及癌症特异性死亡率之间呈线性下降趋势（总体所有P<0.05）。时间依赖性受试者工作特征（ROC）分析显示，在调整协变量后，GNRI对5年全因死亡率、癌症死亡率和心血管死亡率的预测能力分别为0.754、0.757和0.836。
GNRI降低的个体全因死亡率和癌症特异性死亡率风险增加。GNRI与全因死亡率和癌症特异性死亡率之间存在线性关联。应仔细监测营养状况，这可能改善普通人群的总体预后。
