Jian Zhijie, Meng Zixuan, Qiao Xiangrui, Liu Hui, Li Bolin, Wu Yue, Liu Wenjun, Cheng Lele
Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Front Nutr. 2025 Aug 22;12:1583220. doi: 10.3389/fnut.2025.1583220. eCollection 2025.
Cancer survivors have a heightened risk of cardiovascular disease (CVD), partly associated with high rates of malnutrition, which is linked to poor cardiovascular outcomes. Changes in aortic morphology affect vascular hemodynamics and cardiovascular health. However, the relationship between malnutrition and aortic morphology in cancer patients remains unreported. This study aims to investigate the relationship between malnutrition and thoracic aorta morphological changes in cancer adults.
We performed a cross-sectional study of 189 adults without known cardiovascular disease who underwent computed tomography (CT) enhanced scan between 2020 and 2021. All patients were divided into three groups according to three categories of the geriatric nutritional risk index (GNRI): moderate to severe, GNRI of < 92 ( = 54); low, GNRI of 92-98 ( = 36); and absence of risk, GNRI of ≥98 ( = 99). The morphology of the aorta was measured by segmental diameters and tortuosity using CT.
A total of 189 patients were included in the study. The average age in this study was 60.8 ± 16.5 years, with 115 men (60.8%). About half of the patients were at risk of malnutrition. Compared with the absent-risk group, participants with low or moderate to severe risk exhibited significantly larger diameters and more tortuosity of the ascending and arcus aorta, thoracic aorta, and descending thoracic aorta (all < 0.05). We observed linear and negative associations of the GNRI value with the diameter in L1-L3 ( = -0.47, = -0.48, = -0.47, respectively; all < 0.001) and tortuosity of the ascending and arcus aorta, thoracic aorta and descending thoracic aorta ( = -0.54, = -0.53, = -0.59, all < 0.001). Besides, there were significant associations between malnourishment risk and morphological characteristics of the thoracic aorta in both the adjusted and unadjusted linear regression models, especially in older patients.
Our findings indicate that malnutrition measured by GNRI is linked to aortic diameter and tortuosity in cancer patients, reflecting the exploratory role in identifying malnutrition as a novel risk marker in cardio-oncology. Future studies could explore whether improving GNRI through targeted nutritional support mitigates aortic remodeling.
癌症幸存者患心血管疾病(CVD)的风险更高,部分原因与高营养不良率有关,而营养不良又与不良的心血管结局相关。主动脉形态的改变会影响血管血流动力学和心血管健康。然而,癌症患者中营养不良与主动脉形态之间的关系尚未见报道。本研究旨在探讨癌症成年患者中营养不良与胸主动脉形态变化之间的关系。
我们对189例无已知心血管疾病的成年人进行了一项横断面研究,这些患者在2020年至2021年间接受了计算机断层扫描(CT)增强扫描。根据老年营养风险指数(GNRI)的三类情况将所有患者分为三组:中度至重度,GNRI<92(n=54);低风险,GNRI为92-98(n=36);无风险,GNRI≥98(n=99)。使用CT通过节段直径和迂曲度测量主动脉的形态。
本研究共纳入189例患者。本研究的平均年龄为60.8±16.5岁,男性115例(60.8%)。约一半的患者存在营养不良风险。与无风险组相比,低风险或中度至重度风险的参与者升主动脉、主动脉弓、胸主动脉和胸降主动脉的直径明显更大,迂曲度更高(均P<0.05)。我们观察到GNRI值与L1-L3节段的直径(分别为r=-0.47、r=-0.48、r=-0.47;均P<0.001)以及升主动脉、主动脉弓、胸主动脉和胸降主动脉的迂曲度(r=-0.54、r=-0.53、r=-0.59,均P<0.001)呈线性负相关。此外,在调整和未调整的线性回归模型中,营养不良风险与胸主动脉的形态特征之间均存在显著关联,尤其是在老年患者中。
我们的研究结果表明,通过GNRI测量的营养不良与癌症患者的主动脉直径和迂曲度有关,这反映了在将营养不良确定为心脏肿瘤学中的一种新风险标志物方面的探索作用。未来的研究可以探讨通过有针对性的营养支持改善GNRI是否能减轻主动脉重塑。