老年营养风险指数与老年人慢性肾脏病风险和死亡率的关系。
Associations between the geriatric nutritional risk index and the risk of and mortality associated with chronic kidney disease in older individuals.
机构信息
Department of Geriatrics, Institute of Gerontology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Key Laboratory of Vascular Aging, Tongji Hospital, Tongji Medical College, Ministry of Education, Huazhong University of Science and Technology, Wuhan, 430030, PR China.
出版信息
BMC Public Health. 2024 Oct 21;24(1):2893. doi: 10.1186/s12889-024-20283-5.
BACKGROUND
Malnutrition is a complication of chronic kidney disease (CKD). Whether malnutrition, assessed via the geriatric nutritional risk index (GNRI), is associated with the incidence and risk of CKD in older individuals remains unclear.
METHODS
Data from the National Health and Nutrition Examination Survey and the UK Biobank database were used. Older participants over 60 years old with available data for GNRI assessment and CKD diagnosis were enrolled. Logistic regression models and Cox regression models were used to assess associations between the geriatric nutritional risk index and the risk of and mortality associated with CKD.
RESULTS
This study enrolled 13,162 participants from the NHANES and 66,326 participants from the UK Biobank. We identified 6,135 and 16,662 CKD patients in the NHANES and UK Biobank, respectively, with the majority being male (74% in the NHANES and 52% in the UK Biobank). The average age of CKD patients was 72.3 (SD 7.2) years in the NHANES and 64.9 (SD 2.9) years in the UK Biobank. The median follow-up times of older CKD patients were 81 months and 162 months in the NHANES and UK Biobank, respectively. According to the cross-sectional analysis, individuals with a lower GNRI had an increased likelihood of having CKD, with odds ratios of 1.38 (95% CI: 1.05-1.80, P = 0.020) in the NHANES and 2.35 (95% CI: 1.89-2.92, P < 0.001) in the UK Biobank. According to our analysis of the risk of incident CKD in the UK Biobank, a lower GNRI was associated with a greater incidence of CKD (HR: 1.11, 95% CI: 1.04-1.18; P = 0.002). According to the analysis of the risk of mortality, a lower GNRI was associated with an increased risk of death among older CKD patients (NHANES: HR: 1.69, 95% CI: 1.13-2.53, P = 0.011; UK Biobank: HR: 2.28, 95% CI: 1.94-2.69, P < 0.001).
CONCLUSION
Malnutrition assessed by the GNRI was significantly and independently associated with the incidence of CKD. Moreover, CKD patients with malnutrition also have a high risk of mortality.
背景
营养不良是慢性肾脏病（CKD）的并发症。在老年人中，通过老年营养风险指数（GNRI）评估的营养不良与 CKD 的发病率和风险之间的关系尚不清楚。
方法
本研究使用了来自全国健康和营养检查调查（NHANES）和英国生物银行（UK Biobank）数据库的数据。纳入了年龄在 60 岁以上、有 GNRI 评估和 CKD 诊断数据的老年人。使用逻辑回归模型和 Cox 回归模型评估了老年营养风险指数与 CKD 风险和死亡率之间的关系。
结果
本研究纳入了来自 NHANES 的 13162 名参与者和来自 UK Biobank 的 66326 名参与者。我们在 NHANES 和 UK Biobank 中分别确定了 6135 名和 16662 名 CKD 患者，其中大多数为男性（NHANES 为 74%，UK Biobank 为 52%）。CKD 患者的平均年龄在 NHANES 中为 72.3（SD 7.2）岁，在 UK Biobank 中为 64.9（SD 2.9）岁。在 NHANES 和 UK Biobank 中，老年 CKD 患者的中位随访时间分别为 81 个月和 162 个月。根据横断面分析，GNRI 较低的个体发生 CKD 的可能性增加，NHANES 的比值比为 1.38（95%CI：1.05-1.80，P=0.020），UK Biobank 的比值比为 2.35（95%CI：1.89-2.92，P<0.001）。根据 UK Biobank 中 CKD 发病风险的分析，GNRI 较低与 CKD 的发病率增加相关（HR：1.11，95%CI：1.04-1.18；P=0.002）。根据死亡率风险分析，GNRI 较低与老年 CKD 患者死亡风险增加相关（NHANES：HR：1.69，95%CI：1.13-2.53，P=0.011；UK Biobank：HR：2.28，95%CI：1.94-2.69，P<0.001）。
结论
GNRI 评估的营养不良与 CKD 的发病率显著且独立相关。此外，营养不良的 CKD 患者也有较高的死亡风险。
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