老年营养风险指数降低与心力衰竭住院患者的糖尿病患病率和住院死亡率有关
Reduced Geriatric Nutritional Risk Index Is Associated with Prevalent Diabetes Mellitus and In-Hospital Mortality in Patients Hospitalized with Heart Failure.
摘要(中文译文)
营养不良日益被认为是心力衰竭（HF）患者预后的重要决定因素。老年营养风险指数（GNRI）是一种简单的营养评估工具，与不良心血管结局相关，但其与糖尿病及住院HF患者院内死亡率的关系尚未完全明确。本研究评估了GNRI定义的营养风险、糖尿病与住院HF患者院内死亡率之间的关联。本前瞻性观察研究纳入了2025年9月至2026年3月期间在一家三级心脏病中心连续住院的278例HF患者。采用GNRI评估营养状况，将患者分为无营养风险（GNRI≥98）和GNRI定义的营养风险（GNRI<98）。采用logistic回归评估GNRI与糖尿病的关联，采用Cox比例风险回归和Kaplan-Meier分析评估院内死亡率。42.1%的患者存在GNRI定义的营养风险。与无营养风险的患者相比，GNRI定义营养风险的患者糖尿病患病率更高（73.5% vs. 50.9%，<0.001）、住院时间更长、院内死亡率高出近三倍（29.1% vs. 10.6%，<0.001）。较高的GNRI值与较低的糖尿病患病率相关。在主Cox模型中，较低的GNRI值也与较高的院内死亡率相关；然而，在调整心力衰竭严重程度标志物后，该关联减弱且不再具有统计学显著性。较低的GNRI值可识别出住院HF期间营养和临床脆弱性更高的患者。需要进一步研究以确定GNRI是否能提供超越现有HF风险标志物的增量预后价值。
Abstract
Malnutrition is increasingly recognized as an important determinant of prognosis in patients with heart failure (HF). The Geriatric Nutritional Risk Index (GNRI) is a simple nutritional assessment tool associated with adverse cardiovascular outcomes, but its relationship with diabetes mellitus and in-hospital mortality in hospitalized HF patients remains incompletely characterized. This study evaluated the association between GNRI-defined nutritional risk, diabetes mellitus, and in-hospital mortality in patients hospitalized with HF. This prospective observational study included 278 consecutive patients hospitalized with HF at a tertiary cardiology center between September 2025 and March 2026. Nutritional status was assessed using GNRI, and patients were classified as having no nutritional risk (GNRI ≥ 98) or GNRI-defined nutritional risk (GNRI < 98). Logistic regression evaluated the association between GNRI and diabetes mellitus, while Cox proportional hazards regression and Kaplan-Meier analyses assessed in-hospital mortality. GNRI-defined nutritional risk was identified in 42.1% of patients. Compared with patients without nutritional risk, those with GNRI-defined nutritional risk had a higher prevalence of diabetes mellitus (73.5% vs. 50.9%, < 0.001), longer hospital stays, and a nearly threefold higher in-hospital mortality rate (29.1% vs. 10.6%, < 0.001). Higher GNRI values were associated with a lower prevalence of diabetes mellitus. Lower GNRI values were also associated with higher in-hospital mortality in the main Cox models; however, this association was attenuated and no longer statistically significant after adjustment for markers of heart failure severity. Lower GNRI values identified patients with greater nutritional and clinical vulnerability during hospitalization for HF. Further studies are needed to determine whether GNRI provides incremental prognostic value beyond established HF risk markers.
如何引用
AMA
Constanta Corina Nitu, Victoria Ancuta Nyulas, Florina Ruta, Tiberiu Nyulas, Sara Suciu, Ionel Nitu, et al. Reduced Geriatric Nutritional Risk Index Is Associated with Prevalent Diabetes Mellitus and In-Hospital Mortality in Patients Hospitalized with Heart Failure.. Nutrients. 2026; doi:10.3390/nu18132198.
APA
Constanta Corina Nitu, Victoria Ancuta Nyulas, Florina Ruta, Tiberiu Nyulas, Sara Suciu, Ionel Nitu, et al (2026). Reduced Geriatric Nutritional Risk Index Is Associated with Prevalent Diabetes Mellitus and In-Hospital Mortality in Patients Hospitalized with Heart Failure.. Nutrients. https://doi.org/10.3390/nu18132198
GB/T 7714
Constanta Corina Nitu, Victoria Ancuta Nyulas, Florina Ruta, Tiberiu Nyulas, Sara Suciu, Ionel Nitu, et al. Reduced Geriatric Nutritional Risk Index Is Associated with Prevalent Diabetes Mellitus and In-Hospital Mortality in Patients Hospitalized with Heart Failure.[J]. Nutrients, 2026 doi:10.3390/nu18132198.
在 PubMed增强版 阅读全文
翻译全文 · AI 文献问答 · PDF 原文下载 · 引用导出