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老年营养风险指数与低钾血症疾病的关联:2007 - 2018年美国国家健康与营养检查调查结果

The association between Geriatric Nutritional Risk Index and KSD disease: results from National Health and Nutrition Examination Survey 2007-2018.

作者信息

Tang Zhicheng, Zhong Hongzheng, Zhi Qingqing, Chen Yinqiu, Zhang JiaHao, Li Zhibiao, Lu Zechao, Liu Can, Tang Fucai, He Zhaohui, Sun Xuan

机构信息

Department of Urology, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.

School of Medicine, Sun Yat-sen University, Shenzhen, China.

出版信息

Front Nutr. 2024 Nov 6;11:1430668. doi: 10.3389/fnut.2024.1430668. eCollection 2024.

Abstract

BACKGROUND

Kidney stone disease (KSD) is a widespread problem in urology. But the associations between the Geriatric Nutritional Risk Index (GNRI), an important indicator for assessing the nutritional status of elderly hospitalized patients, and KSD are understudied.

OBJECTIVE

Utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning 2007-2018, our study analyzed the correlation between the GNRI and KSD prevalence at cross-sectional level. The aim of the study was to explore the association between GNRI and the prevalence of KSD to identify potential risk factors and inform prevention and management strategies for KSD.

METHODS

This cross-sectional study analyzed data focusing on 26,803 adults (20-80 years) after screening for complete data. It evaluated GNRI, a formula involving albumin, present, and ideal body weight, stratifying participants into quartiles. The primary outcome was the history of KSD, based on self-reports. Covariates included demographic, health, and lifestyle factors. Statistical analysis employed -tests, ANOVA, Wilcoxon, and Kruskal-Wallis tests, with logistic regression modeling GNRI's impact on KSD prevalence, assessing odds ratios and potential multicollinearity, and sensitivity analyses excluding individuals with low eGFR and adjusting cycle years.

RESULTS

Significant disparities are found in GNRI distributions between individuals with and without kidney stones. Higher GNRI levels are more common in kidney stone patients, with 39.249% in the highest quartile versus 33.334% in those without stones. Notably, those in the highest GNRI quartile (Q4) show a lower prevalence of kidney stone disease (KSD) than those in the lowest (Q1), with rates of 11.988% versus 8.631%, respectively ( < 0.0001). Adjusted model results reveal that higher GNRI quartiles (Q3-Q4) correlate with reduced KSD prevalence, with odds ratios of 0.85 (95% CI [0.72, 1.00]) and 0.76 (95% CI [0.65, 0.89]). A nonlinear inverse relationship exists between GNRI levels and KSD prevalence across the population ( < 0.001), confirming that higher GNRI lowers KSD prevalence. Subgroup and sensitivity analyses support these findings.

CONCLUSION

The study underscores a significant, albeit nonlinear, association between elevated GNRI levels and decreased KSD prevalence. This relationship highlights the importance of nutritional assessment and management in KSD prevention strategies.

摘要

背景

肾结石疾病(KSD)是泌尿外科中一个普遍存在的问题。但是,用于评估老年住院患者营养状况的重要指标——老年营养风险指数(GNRI)与KSD之间的关联尚未得到充分研究。

目的

利用2007 - 2018年美国国家健康与营养检查调查(NHANES)的数据,我们的研究在横断面水平上分析了GNRI与KSD患病率之间的相关性。该研究的目的是探索GNRI与KSD患病率之间的关联,以识别潜在风险因素,并为KSD的预防和管理策略提供信息。

方法

这项横断面研究分析了在筛选完整数据后聚焦于26803名成年人(20 - 80岁)的数据。它评估了GNRI,这是一个涉及白蛋白、现有体重和理想体重的公式,并将参与者分为四分位数。主要结果是基于自我报告的KSD病史。协变量包括人口统计学、健康和生活方式因素。统计分析采用t检验、方差分析、Wilcoxon检验和Kruskal - Wallis检验,通过逻辑回归模型分析GNRI对KSD患病率的影响,评估比值比和潜在的多重共线性,并进行敏感性分析,排除估算肾小球滤过率(eGFR)低的个体并调整周期年份。

结果

有肾结石和无肾结石个体的GNRI分布存在显著差异。较高的GNRI水平在肾结石患者中更为常见,最高四分位数中的比例为39.249%,而无结石者为33.334%。值得注意的是,GNRI最高四分位数(Q4)的个体患肾结石疾病(KSD)的患病率低于最低四分位数(Q1)的个体,分别为11.988%和8.631%(P < 0.0001)。调整后的模型结果显示,较高的GNRI四分位数(Q3 - Q4)与KSD患病率降低相关,比值比分别为0.85(95%置信区间[0.72, 1.00])和0.76(95%置信区间[0.65, 0.89])。在整个人口中,GNRI水平与KSD患病率之间存在非线性反比关系(P < 0.001),证实较高的GNRI会降低KSD患病率。亚组分析和敏感性分析支持了这些发现。

结论

该研究强调了升高的GNRI水平与降低的KSD患病率之间存在显著的、尽管是非线性的关联。这种关系凸显了营养评估和管理在KSD预防策略中的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ef2/11580257/ed97a7d266c0/fnut-11-1430668-g001.jpg

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