Jiang Zong, Cai Xin, Lan Weiya, Jin Zexu, Liu Jiajun, Tang Fang, Fan Haixia
Second Clinical Medical College, Guizhou University of Traditional Chinese Medicine, Guiyang, 550001, China.
Department of Rheumatology and Immunology, The First People's Hospital Of Guiyang, Guiyang, 550001, China.
BMC Geriatr. 2025 Aug 5;25(1):592. doi: 10.1186/s12877-025-06225-9.
We intended to investigate the correlation of the geriatric nutritional risk index (GNRI) and the risks of all-cause and cardiovascular mortality in elderly patients with osteoarthritis (OA).
This study included 2,922 OA patients aged ≥ 60 years from National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. GNRI was obtained using serum albumin and body weight, with participants stratified into high (≥ 98) and low (< 98) GNRI groups. Cox regressions, survival analysis, and restricted cubic spline (RCS) regression have been utilized to assess mortality risks. Nonlinear threshold effects were evaluated using piecewise regression. Moreover, subgroup analyses have also been completed based on demographic, lifestyle, and clinical features.
Participants with low GNRI had significantly higher risks of all-cause mortality (adjusted HR = 1.494, 95% CI: 1.192-1.872, P < 0.001) and cardiovascular mortality (adjusted HR = 1.592, 95% CI: 1.142-2.219, P = 0.006). RCS analysis presented with a nonlinear J-shaped relationship, with optimal GNRI around 120. Subgroup analyses confirmed consistent associations across age, sex, race, and comorbidity strata.
Lower GNRI could independently lead to increased all-cause and cardiovascular mortality in OA patients, highlighting the importance of nutritional assessment in OA management. As a result, GNRI could serve as a valuable prognostic indicator for identifying high-risk individuals who could benefit from targeted nutritional interventions.
我们旨在研究老年骨关节炎（OA）患者的老年营养风险指数（GNRI）与全因死亡和心血管死亡风险之间的相关性。
本研究纳入了1999年至2018年美国国家健康与营养检查调查（NHANES）中2922名年龄≥60岁的OA患者。使用血清白蛋白和体重计算GNRI，并将参与者分为高GNRI组（≥98）和低GNRI组（<98）。采用Cox回归、生存分析和限制立方样条（RCS）回归来评估死亡风险。使用分段回归评估非线性阈值效应。此外，还根据人口统计学、生活方式和临床特征进行了亚组分析。
低GNRI参与者的全因死亡风险（调整后HR = 1.494，95%CI：1.192 - 1.872，P < 0.001）和心血管死亡风险（调整后HR = 1.592，95%CI：1.142 - 2.219，P = 0.006）显著更高。RCS分析呈现非线性J形关系，最佳GNRI约为120。亚组分析证实了在年龄、性别、种族和合并症分层中的一致关联。
较低的GNRI可独立导致OA患者全因死亡和心血管死亡增加，凸显了营养评估在OA管理中的重要性。因此，GNRI可作为一个有价值的预后指标，用于识别可能从针对性营养干预中获益的高危个体。
