Chung Eunki, Woo Ala, Yong Seung Hyun, Park Youngmok, Lee Sang Hoon, Kim Song Yee, Kim Eun Young, Jung Ji Ye, Kang Young Ae, Kim Young Sam, Park Moo Suk
Division of Pulmonology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
Yonsei University Graduate School of Medicine, Seoul, Republic of Korea.
Sci Rep. 2024 Aug 1;14(1):17842. doi: 10.1038/s41598-024-68754-4.
The role of nutritional status as a prognostic factor in patients with Sjögren's syndrome-associated interstitial lung disease (SjS-ILD) is currently unclear. This study aimed to predict the prognosis of patients with SjS-ILD through their nutritional status assessment. In this retrospective observational study, nutritional status was evaluated at the time of diagnosis using body mass index (BMI) and nutritional markers such as controlling nutritional status (CONUT), the Glasgow prognostic score (GPS), and prognostic nutrition index (PNI) for all participants. Receiver operating characteristic (ROC) analyses were performed using BMI and each nutritional marker data to compare the area under the ROC curve (AUC) and find the cutoff value using the maximum Youden index. Kaplan-Meier analysis and Cox proportional hazards regression analysis were performed to predict the prognosis of SjS-ILD patients. A total of 112 SjS-ILD patients were enrolled in the study, and 8.9% died during the follow-up period. The median time from diagnosis to follow-up period was 4.2 years. The AUC for PNI was the highest among nutritional markers and BMI, and PNI cutoff value was used to distinguish between the PNI < 47.7 and PNI ≥ 47.7 groups. A statistical difference was observed in the Kaplan-Meier analysis and log-rank test (p = 0.005). In multivariable analyses, PNI < 47.7 (hazard ratio 9.40, 95% confidence interval 1.54-57.21) is associated with increased mortality, suggesting the importance of early nutritional intervention for malnutrition in SjS-ILD patients.
营养状况作为干燥综合征相关间质性肺疾病（SjS-ILD）患者预后因素的作用目前尚不清楚。本研究旨在通过评估患者的营养状况来预测SjS-ILD患者的预后。在这项回顾性观察研究中，在诊断时使用体重指数（BMI）以及控制营养状况（CONUT）、格拉斯哥预后评分（GPS）和预后营养指数（PNI）等营养标志物对所有参与者的营养状况进行评估。使用BMI和每个营养标志物数据进行受试者工作特征（ROC）分析，以比较ROC曲线下面积（AUC），并使用最大约登指数确定临界值。进行Kaplan-Meier分析和Cox比例风险回归分析以预测SjS-ILD患者的预后。共有112例SjS-ILD患者纳入本研究，随访期间8.9%的患者死亡。从诊断到随访期的中位时间为4.2年。在营养标志物和BMI中，PNI的AUC最高，PNI临界值用于区分PNI＜47.7组和PNI≥47.7组。在Kaplan-Meier分析和对数秩检验中观察到统计学差异（p = 0.005）。在多变量分析中，PNI＜47.7（风险比9.40，95%置信区间1.54 - 57.21）与死亡率增加相关，这表明对SjS-ILD患者的营养不良进行早期营养干预很重要。
