Department of Pulmonary and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, 410011, China; The Clinical Medical Research Center for Pulmonary and Critical Care Medicine in Hunan Province, 410011, China; Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, 410011, China.
Department of Pulmonary and Critical Care Medicine, the Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, 410011, China; The Clinical Medical Research Center for Pulmonary and Critical Care Medicine in Hunan Province, 410011, China; Diagnosis and Treatment Center of Respiratory Disease, Central South University, Changsha, Hunan, 410011, China.
Respir Med. 2024 Nov;233:107774. doi: 10.1016/j.rmed.2024.107774. Epub 2024 Aug 19.
To describe the nutritional status of IPF patients, report clinical associations and evaluate the prognostic value of them in IPF.
264 IPF patients diagnosed with IPF at the Second Xiangya Hospital of Central South University between January 2011 and January 2021 were recruited. Three different scoring systems, including nutritional risk index (NRI), controlling nutritional status (CONUT) score, and prognostic nutritional index (PNI) were used to describe the nutritional status of IPF patients.
This study investigated the prevalence of malnutrition in 264 IPF patients, of which the percentage with malnutrition varied from 37.5 % with the NRI, to 47.4 % with the CONUT score, and to 6.4 % with the PNI. The moderate to severe malnutrition ranged from 10.2 % to 31.1 % across these indices, with PNI identifying only 4.9 % in this category. Worsening malnutrition status was associated with significantly higher incidence of all-cause mortality and IPF death regard of the malnutrition index as NRI (p < 0.05). When the normal nutrition of NRI was used as a reference, patients in the moderate to severe risk remained at a higher risk of all-cause death (HR = 2.06(1.25-3.41)) and IPF death(HR = 2.36(1.35-4.15)). The adjusted multivariate analysis, identified age(HR = 1.13(1.08-1.20)), DLCO <60, % predicted (HR = 3.31(1,24-9.42)) and the use of anti-fibrotic drugs (HR = 0.25(0.10-0.60)) as independent predictors of mortality.
Malnutrition is common among patients with IPF and the baseline as diagnosis of IPF is strongly related to increased mortality.
描述 IPF 患者的营养状况，报告临床相关性，并评估其在 IPF 中的预后价值。
纳入 2011 年 1 月至 2021 年 1 月在中南大学湘雅二医院确诊为 IPF 的 264 例 IPF 患者。使用三种不同的评分系统，包括营养风险指数（NRI）、控制营养状态（CONUT）评分和预后营养指数（PNI），描述 IPF 患者的营养状况。
本研究调查了 264 例 IPF 患者营养不良的患病率，其中 NRI 营养不良的百分比为 37.5%，CONUT 评分营养不良的百分比为 47.4%，PNI 营养不良的百分比为 6.4%。这些指数中中重度营养不良的范围为 10.2%至 31.1%，PNI 仅在这一类别中识别出 4.9%。无论使用哪种营养不良指数，营养不良状况恶化均与全因死亡率和 IPF 死亡发生率显著升高相关（p<0.05）。当 NRI 的正常营养状况作为参考时，中重度风险的患者仍有更高的全因死亡风险（HR=2.06（1.25-3.41））和 IPF 死亡风险（HR=2.36（1.35-4.15））。多变量调整分析表明，年龄（HR=1.13（1.08-1.20））、DLCO<60%，预测值（HR=3.31（1,24-9.42））和抗纤维化药物的使用（HR=0.25（0.10-0.60））是死亡率的独立预测因素。
营养不良在 IPF 患者中很常见，作为 IPF 诊断的基线与死亡率增加密切相关。
