老年营养风险指数与社区老年人群全因死亡风险的相关性研究  

Associations of the Geriatric Nutritional Risk Index(GNRI)and all-cause mortality risk in community-dwelling older adults

作　　者：杨苏瑞 张驰[2] 李哲林 韩怡文[2] 李瑞奇 曾平[2] Yang Surui;Zhang Chi;Li Zhelin;Han Yiwen;Li Ruiqi;Zeng Ping(Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;The Key Laboratory of Geriatrics,Beijing Institute of Geriatrics,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing Hospital,National Center of Gerontology of National Health Commission,Beijing 100730,China;School of Design,South China University of Technology,Guangzhou510006,China)

机构地区：[1]北京医院国家老年医学中心北京协和医学院中国医学科学院,北京100730 [2]北京医院国家老年医学中心、国家卫生健康委北京老年医学研究所、国家卫生健康委老年医学重点实验室、中国医学科学院老年医学研究院,北京100730 [3]华南理工大学设计学院,广州510006

出　　处：《中华老年医学杂志》2024年第8期1059-1064,共6页Chinese Journal of Geriatrics

基　　金：国家重点研发计划(2022YFC2010100,2022YFF0607000);中央高水平医院临床科研业务费项目(BJ-2022-133,BJ-2023-072);全民营养科学基金(CNS-NNSRG2019)。

摘　　要：目的探讨老年营养风险指数(GNRI)与老年人群全因死亡风险的关联。方法基于中国老年健康影响因素追踪调查社区人群的队列研究, 在2012-2014年的基线调查中, 利用身高、体重和血清白蛋白水平构建老年营养风险指数(GNRI), 划分为正常组(GNRI>98)、轻度营养不良组(92≤GNRI≤98)、中度/重度营养不良组(GNRI<92)。调查对象被随访至2018年, 在追踪调查中收集死亡结局和生存时间。使用Kaplan-Meier曲线和Cox比例风险回归模型分析GNRI对全因死亡风险的影响。结果共有3 016名老年人被纳入分析, 其中1 296人(42.97%)存在不同程度的营养不良。经过10 594.5人年的随访后, 发生了1 280人死亡事件。在校正社会人口学特征、活动能力、认知功能和多种慢性疾病后, 相对于正常组, 轻度营养不良组的HR(95%CI)为1.35(1.18~1.56), 中度/重度营养不良组为1.85(1.61~2.12)。通过GNRI预测死亡结局的受试者操作特征曲线下面积为0.70(95%CI:0.61~0.77), 灵敏度为71.3%, 特异度为65.4%。在亚组分析中, 营养不良与死亡风险的关联强度在男性中高于女性(交互项P=0.037)。结论老年人的全因死亡风险与营养不良的程度呈正相关。GNRI对老年人的生存结局具有一定的预测价值。Objective The study aims to investigate the relationship between the Geriatric Nutritional Risk Index(GNRI)and the risk of all-cause mortality in older adults living in the community.Methods Using data from the Chinese Longitudinal Healthy Longevity Survey.a community-based population cohort study utilized the Geriatric Nutritional Risk Index(GNRI),which was calculated based on height,weight,and serum albumin levels during baseline surveys conducted in 2012 and 2014.Participants were categorized into normal(GNRI>98),mild malnutrition(92≤GNRI<98),and moderate/severe malnutrition(GNRI<92)groups.Follow-up of all participants continued until 2018,during which data on death outcomes and survival time were gathered.The study employed Kaplan-Meier curves and Cox proportional hazards regression models to assess the relationship between GNRI levels and the risk of all-cause mortality.I Results A total of 3,016 older adults were analyzed,with 1,296(42.97%)identified as having malnutrition.Over a follow-up period of 10,594.5 person-years,there were 1,280 deaths recorded.Adjusting for various factors such as sociodemographic characteristics,functional abilities,cognitive function,and chronic diseases,the mild malnutrition group showed a hazard ratio(CI)of 1.35(95%CI:1.18-1.56)compared to the normal group,while the moderate/severe malnutrition group had a HR of 1.85(95%CI:1.61-2.12)for allcause mortality risk.The GNRI's area under the ROC curve for predicting death was O.70(95%CI:0.61-0.77),with a sensitivity of 71.3%and specificity of 65.4%.Subgroup analysis revealed a more significant association between malnutrition and mortality risk in men compared to women(Pinteraction=0.037).Conclusions The findings suggest a notable link between malnutrition levels and the risk of all-cause mortality,indicating that GNRI could be a valuable tool for predicting survival outcomes in this population.

关 键 词：老年营养风险指数 全因死亡 老年人 

分 类 号：R153.3[医药卫生—营养与食品卫生学]