The Affiliated Chaohu Hospital of Anhui Medical University, Hefei, China.
The Zigong Affiliated Hospital of Southwest Medical University, Zigong Mental Health Center, Zigong, China.
J Health Popul Nutr. 2024 Aug 24;43(1):131. doi: 10.1186/s41043-024-00623-2.
Malnutrition is a well-known risk factor for mortality among older adults. Arthritis and rheumatism are characterized by chronic inflammation and are also related to malnutrition as diagnosed using the Global Leadership Initiative on Malnutrition (GLIM) criteria. This study was thus developed to examine the associations linking malnutrition and all-cause death among older adults in China, employing the GLIM criteria to assess malnutrition.
Two waves of the China Health and Retirement Longitudinal Study from 2013 and 2018 were used to conduct this study. Moderate malnutrition was defined as low BMI (< 18.5 and < 20 for individuals < 70 and 70 + years of age, respectively), an unintended 10-20% decrease in weight, or low muscle mass based on the sex-specific lowest 20% of the height-adjusted muscle mass as < 5.039 kg/m in women and < 6.866 kg/m in men. Severe malnutrition was defined as a > 20% unintended decrease in weight only or the combination of both low muscle mass and an unintended reduction of over 10% in weight. Associations between malnutrition and the risk of all-cause death were assessed through Cox regression analyses.
Overall, this study enrolled 1766 subjects 60 + years of age, of whom 57.36% (1033/1766) were female. Malnutrition was estimated to affect 418 (23.67%) of these individuals at baseline, with 21.06% and 2.60% affected by moderate and severe malnutrition, respectively. Over the 5-year follow-up, 189 of these individuals died. Covariate-adjusted Cox regression analyses confirmed a significant association between severe malnutrition and the risk of death in this cohort (HR = 2.196, 95%CI 1.125-4.286, P = 0.021).
Severe malnutrition, identified through screening based on the GLIM criteria, was associated with an increased risk of all-cause death among older Chinese adults with arthritis or rheumatism.
营养不良是老年人死亡的一个众所周知的危险因素。关节炎和风湿病的特点是慢性炎症，也与营养不良有关，根据全球营养不良倡议 (GLIM) 标准进行诊断。因此，本研究旨在使用 GLIM 标准评估营养不良，以检查中国老年人中营养不良与全因死亡之间的关联。
本研究使用了 2013 年和 2018 年中国健康与退休纵向研究的两个波次。中度营养不良定义为低 BMI（<18.5 和 <20，分别适用于年龄<70 岁和 70 岁及以上的个体）、体重意外下降 10-20%、或根据性别特异性身高调整后的肌肉质量最低的 20%，<5.039 kg/m2 女性和 <6.866 kg/m2 男性。严重营养不良定义为体重意外下降>20%，或低肌肉量与体重意外下降超过 10%的组合。通过 Cox 回归分析评估营养不良与全因死亡风险之间的关联。
总体而言，这项研究纳入了 1766 名 60 岁及以上的受试者，其中 57.36%（1033/1766）为女性。营养不良估计在基线时影响了 1766 名患者中的 418 名（23.67%），其中中度和重度营养不良分别影响了 21.06%和 2.60%。在 5 年的随访中，这些患者中有 189 人死亡。调整协变量的 Cox 回归分析证实，在该队列中，严重营养不良与死亡风险之间存在显著关联（HR=2.196，95%CI 1.125-4.286，P=0.021）。
通过 GLIM 标准筛查确定的严重营养不良与中国关节炎或风湿病老年患者全因死亡风险增加相关。
