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老年营养风险指数(GNRI)与慢性血液透析患者其他营养指标的相关性

Correlation of the Geriatric Nutritional Risk Index (GNRI) With Other Indicators of Nutrition in Chronic Hemodialysis Patients.

作者信息

Kosmadakis Georges, Necoara Aura, Fuentes Fanny, Ramade Nathalie, Baudenon Julien, Deville Clemence, Enache Ioana, Gueret Claudine, Haskour Abraham

机构信息

Aura Sante, Clermont Ferrand, France.

出版信息

Hemodial Int. 2025 Apr;29(2):185-189. doi: 10.1111/hdi.13199. Epub 2025 Jan 31.

Abstract

BACKGROUND

The GNRI (Geriatric Nutritional Risk Index1) is an index used in geriatrics to predict the risk of complications and mortality associated with malnutrition. It considers serum albumin levels and the ratio of current weight or BMI to the ideal theoretical weight/BMI.

AIM

The aim of this study was to evaluate this index in a population of metabolically stable chronic hemodialysis patients aged > 60 years and associate it with other nutritional markers.

METHODS

The studied patient cohort was divided into two groups based on their Geriatric Nutritional Risk Index (GNRI) scores: Gr 1 with GNRI score < 97 and Gr 2 with GNRI ≥ 97. We registered the anthropometric, clinical, and biological data of the study population.

RESULTS

One hundred seventy-seven patients (102 M-75F) undergoing chronic hemodialysis were included. There were no differences in age, muscle mass estimated by bioimpedance analysis, potassium levels, phosphorus levels, and nPCR between the groups. However, there were significant differences between the two groups concerning the primary disease. Gr 1 presented with a higher prevalence of diabetes and cardiovascular comorbidities. Additionally, Gr 1 presented with lower handgrip strength (Mean ± standard deviation in kg, 19.79 ± 9.37 vs. 26.83 ± 11.63, p = 0.05), lower fat mass index estimated by bioimpedance analysis (Mean ± standard deviation in kg/m2, 7.31 ± 4.55 vs. 15.24 ± 6.47, p < 0.001), and higher CRP levels (Mean ± standard deviation in mg/l, 22.27 ± 23.49 vs. 8.13 ± 10.14, p < 0.001).

CONCLUSION

In conclusion, the GNRI, an easy calculation tool for nutrition assessment, is associated with important nutritional status parameters in chronic hemodialysis patients.

摘要

背景

老年营养风险指数(GNRI)是老年医学中用于预测与营养不良相关的并发症和死亡风险的一项指标。它综合考虑血清白蛋白水平以及当前体重或体重指数(BMI)与理想理论体重/BMI的比值。

目的

本研究旨在对60岁以上代谢稳定的慢性血液透析患者群体评估该指数,并将其与其他营养指标相关联。

方法

根据老年营养风险指数(GNRI)评分,将研究的患者队列分为两组:第1组GNRI评分<97,第2组GNRI≥97。我们记录了研究人群的人体测量学、临床和生物学数据。

结果

纳入了177例接受慢性血液透析的患者(102例男性 - 75例女性)。两组在年龄、通过生物电阻抗分析估算的肌肉量、钾水平、磷水平和标准化蛋白分解代谢率方面无差异。然而,两组在原发性疾病方面存在显著差异。第1组糖尿病和心血管合并症的患病率较高。此外,第1组的握力较低(以千克为单位的平均值±标准差,19.79±9.37 vs. 26.83±11.63,p = 0.05),通过生物电阻抗分析估算的脂肪量指数较低(以kg/m²为单位的平均值±标准差,7.31±4.55 vs. 15.24±6.47,p < 0.001),且C反应蛋白水平较高(以mg/l为单位的平均值±标准差,22.27±23.49 vs. 8.13±10.14,p < 0.001)。

结论

总之,GNRI作为一种易于计算的营养评估工具,与慢性血液透析患者的重要营养状况参数相关。

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