肌肉减少症成人的营养与炎症状态与全因死亡率和心血管死亡率的关联：来自美国国家健康与营养检查调查（NHANES）的见解

Association of nutritional and inflammatory status with all-cause and cardiovascular mortality in adults with sarcopenia: Insights from NHANES.

作者信息

Yang Yang, Shen Si, Luo Xiang, Liu Yan, Wang Zhi-Xia, Li Yun-Xia, Zhang Xin-Yang, Zhang Zhi-Qiang

机构信息

Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Xinxiang Medical University, Henan 453100, China.

Laboratory of Laser Sports Medicine, School of Physical Education and Sports Science, South China Normal University, Guangzhou 510006, China.

出版信息

Maturitas. 2025 May;196:108233. doi: 10.1016/j.maturitas.2025.108233. Epub 2025 Mar 4.

DOI:10.1016/j.maturitas.2025.108233

PMID:40048843

Abstract

OBJECTIVE

Associations between scores on the advanced lung cancer inflammation index (ALI) and mortality among sarcopenic adults remains unknown. This study investigates the relationship between ALI and both all-cause and cardiovascular mortality among adults with sarcopenia.

METHODS

The study involved sarcopenic adults from the National Health and Nutrition Examination Survey (NHANES), conducted between 1999 and 2006 and 2011-2018. Mortality information was acquired from the National Death Index, which tracks deaths through to December 31, 2019. Weighted multivariable Cox proportional hazards regression was employed to calculate hazard ratios (HRs) for mortality in different models. Additionally, the restricted cubic spline (RCS) method was used to investigate non-linear associations. Subgroup analyses and sensitivity analyses were conducted to detect differences and examine the reliability of the findings.

RESULTS

This study included 2074 American adults with sarcopenia categorized into quartiles. 701 deaths occurred from all causes, with 236 linked to cardiovascular issues. Multivariate Cox regression models showed that those in the highest ALI quartile had a lower all-cause mortality rate than those in the lowest quartile (model 1: HR = 0.69, 95 % CI 0.55-0.87, P = 0.002; model 2: HR = 0.73, 95 % CI 0.56-0.94, P = 0.017). Likewise, those in the highest ALI quartile had a lower risk of death from cardiovascular causes (model 1: HR = 0.55, 95 % CI 0.36-0.85, P = 0.007; model 2: HR = 0.59, 95 % CI 0.37-0.95, P = 0.031). RCS results revealed an L-shaped correlation between ALI score and all-cause mortality.

CONCLUSIONS

A higher ALI score was strongly associated with lower rates of both all-cause and cardiovascular mortality among sarcopenic adults, particularly in the older population, males, smokers, and those with hypertension. This suggests that ALI may serve as a risk stratification tool.

摘要

目的

晚期肺癌炎症指数（ALI）得分与肌肉减少症成年人死亡率之间的关联尚不清楚。本研究调查了肌肉减少症成年人中ALI与全因死亡率和心血管死亡率之间的关系。

方法

该研究纳入了1999年至2006年以及2011年至2018年期间进行的美国国家健康与营养检查调查（NHANES）中的肌肉减少症成年人。死亡信息来自国家死亡指数，该指数追踪直至2019年12月31日的死亡情况。采用加权多变量Cox比例风险回归来计算不同模型中死亡率的风险比（HRs）。此外，使用受限立方样条（RCS）方法来研究非线性关联。进行亚组分析和敏感性分析以检测差异并检验研究结果的可靠性。

结果

本研究纳入了2074名美国肌肉减少症成年人，并将其分为四分位数。共发生701例全因死亡，其中236例与心血管问题有关。多变量Cox回归模型显示，ALI四分位数最高的人群全因死亡率低于四分位数最低的人群（模型1：HR = 0.69，95%CI 0.55 - 0.87，P = 0.002；模型2：HR = 0.73，95%CI 0.56 - 0.94，P = 0.017）。同样，ALI四分位数最高的人群心血管原因死亡风险较低（模型1：HR = 0.55，95%CI 0.36 - 0.85，P = 0.007；模型2：HR = 0.59，95%CI 0.37 - 0.95，P = 0.031）。RCS结果显示ALI得分与全因死亡率之间呈L形相关性。