摘要
目的:探讨预后营养指数(PNI)与成年人群冠心病患病率的相关性。方法:基于2017~2020年美国国家健康和营养调查(NHANES)数据库作横断面分析,初步纳入成年样本12141例,根据疾病状态问卷资料分为冠心病组和对照组。基于血清白蛋白水平和淋巴细胞计数计算PNI,应用多因素logistic回归探讨PNI与成年人群冠心病患病率的关联,采用亚组分析评价两者间的关联在不同群体中是否稳定。构建限制性立方样条模型以明确PNI和成年人群冠心病患病率的剂量-反应关系。结果:最终纳入成年参与者3894例,成年人群冠心病患病率为5.14%(200/3894)。冠心病患者PNI水平显著低于对照组[(49.20±8.59)比(51.57±4.80),P<0.001]。多因素Logistic回归结果表明,在校正了性别、年龄、种族、婚姻、人体质量指数(BMI)、高血压、糖尿病、心血管病家族史等协变量后,PNI评分升高仍与冠心病患病率降低独立相关(OR=0.92,95%CI 0.89~0.94,P<0.001)。剂量-反应关系结果表明,PNI与冠心病患病率两者之呈负向线性关系(P<0.001)。亚组分析结果表明,PNI与冠心病的关联在BMI、高血压、糖尿病亚组间的差异具有统计学意义(P交互<0.05或<0.01)。结论:PNI升高与成年人群冠心病患病率降低显著相关,且在肥胖、高血压、糖尿病等特定高风险人群中的保护作用更为显著,维持良好的营养状态对于降低冠心病风险具有重要意义。
Objective:To explore the relationship between the prognostic nutritional index(PNI)and the prevalence of coronary heart disease(CHD)in adults.Methods:A cross-sectional analysis was conducted based on the 2017-2020 National Health and Nutrition Examination Survey(NHANES)database.A total of 12,141 adult participants were initially included and divided into CHD group and control group according to the disease status questionnaire.PNI was calculated using serum albumin level and lymphocyte count.Multivariable logistic regression was applied to explore the association between PNI and the prevalence of CHD in adults.Subgroup analysis was conducted to assess whether this association remained consistent across different populations.A restricted cubic spline model was constructed to clarify the dose-response relationship between PNI and CHD prevalence in adults.Results:Among the 3,894 adult participants,200(5.14%)had CHD.The PNI level in CHD patients was significantly lower than that of the control group[(49.20±8.59)vs.(51.57±4.80),P<0.001].Multivariable logistic regression analysis showed that,after adjustment for sex,age,race,marital status,body mass index(BMI),hypertension,diabetes and family history of cardiovascular disease,an increase in PNI was still independently associated with a lower prevalence of CHD(odds ratio[OR]=0.92,95%CI 0.89~0.94,P<0.001).The dose-response relationship indicated a negative linear correlation between PNI and CHD prevalence(P<0.001).Subgroup analysis showed that the association between PNI and CHD differed significantly across BMI,hypertension and diabetes subgroups(P for interaction<0.05 or<0.01).Conclusion:Increasing PNI was significantly associated with a lower prevalence of CHD in adults,and this association was more pronounced in specific high-risk populations,such as those with obesity,hypertension,and diabetes.Our findings suggest that maintaining good nutritional status is of great significance in reducing the risk of CHD.
作者
赵忠帅
薛玉峰
赵传斌
黄孟冬
尚圣云
ZHAO Zhong-shuai;XUE Yu-feng;ZHAO Chuan-bin;HUANG Meng-dong;SHANG Sheng-yun(Rehabilitation Medical Center,Qilu Hospital of Shandong University Dezhou Hospital(Dezhou People's Hospital),Dezhou,Shandong,253000,China)
出处
《心血管康复医学杂志》
2025年第4期497-503,共7页
Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词
冠心病
营养评价
预后
Coronary disease
Nutrition assessment
Prognosis
