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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.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 all-cause mortality risk.The GNRI's area under the ROC curve for predicting death was 0.70(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(P-interaction=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.