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20岁及以上成年人的预后营养指数与蛋白尿:美国的一项横断面分析

Prognostic nutritional index and albuminuria in adults aged 20 years and above: a cross-sectional analysis in the United States.

作者信息

Jiang Zhimeng, Zhu Xingyu, Jiang Huixin, Zhao Donglin, Su Feifei

机构信息

Graduate School of Hebei North University, Zhangjiakou, China.

Department of Gastroenterology, Air Force Medical Center, Chinese People's Liberation Army, Beijing, China.

出版信息

Front Nutr. 2024 Nov 12;11:1462789. doi: 10.3389/fnut.2024.1462789. eCollection 2024.

Abstract

BACKGROUND AND OBJECTIVE

Albuminuria is an important early marker of kidney damage and progression of chronic kidney disease and is also linked to several chronic systemic diseases. The Prognostic Nutritional Index (PNI) is widely used in the assessment of multiple diseases. However, research dealing with the relationship between PNI and albuminuria remains scarce. This research project aims to examine this association.

METHODS AND MATERIALS

The present study employed data from the National Health and Nutrition Examination Survey (NHANES) between 2017 and 2020, including 7,737 adult participants who met the study criteria. PNI was analyzed as a quartile-categorized variable. Multivariable regression models and smoothing curve fitting were adopted to examine the relationship between PNI and albuminuria. In order to ascertain the stability of the association across different populations, subgroup analyses were performed.

RESULTS

The study found a statistically significant inverse relationship between higher PNI levels and the prevalence of albuminuria. The fully adjusted model indicates that a one-unit increase in PNI is associated with a 4% reduced odds of albuminuria prevalence [0.96 (0.93, 0.98)]. Quartile analysis showed a stable inverse relationship, with the highest PNI quartile having the significantly lower odds of albuminuria prevalence [0.76 (0.62, 0.94), p for trend = 0.0004]. Smooth curve fitting and two-piecewise linear regression models indicated a nonlinear relationship between PNI and albuminuria, with a turning point at 42. Subgroup analysis confirmed the reliability of the inverse relationship between PNI and albuminuria across all groups.

CONCLUSION

The findings of this study indicated that higher PNI levels are significantly inversely related to the odds prevalence of albuminuria. PNI could serve as an important predictor for the occurrence of albuminuria. Further prospective studies are needed to validate this association.

摘要

背景与目的

蛋白尿是肾脏损伤和慢性肾脏病进展的重要早期标志物,还与多种慢性全身性疾病相关。预后营养指数(PNI)广泛用于多种疾病的评估。然而,关于PNI与蛋白尿之间关系的研究仍然匮乏。本研究项目旨在探讨这种关联。

方法与材料

本研究采用了2017年至2020年美国国家健康与营养检查调查(NHANES)的数据,包括7737名符合研究标准的成年参与者。PNI被分析为四分位数分类变量。采用多变量回归模型和平滑曲线拟合来研究PNI与蛋白尿之间的关系。为了确定不同人群中这种关联的稳定性,进行了亚组分析。

结果

研究发现较高的PNI水平与蛋白尿患病率之间存在统计学上显著的负相关。完全调整模型表明,PNI每增加一个单位,蛋白尿患病率的比值降低4%[0.96(0.93,0.98)]。四分位数分析显示出稳定的负相关,最高PNI四分位数组的蛋白尿患病率比值显著较低[0.76(0.62,0.94),趋势p值 = 0.0004]。平滑曲线拟合和两段式线性回归模型表明PNI与蛋白尿之间存在非线性关系,转折点为42。亚组分析证实了所有组中PNI与蛋白尿之间负相关的可靠性。

结论

本研究结果表明,较高的PNI水平与蛋白尿的比值患病率显著负相关。PNI可作为蛋白尿发生的重要预测指标。需要进一步的前瞻性研究来验证这种关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a00/11588494/821d9588ee64/fnut-11-1462789-g001.jpg

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