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Outline
To investigate the longitudinal association of dynamic trajectories and cumulative changes of the geriatric nutritional risk index (GNRI) with all-cause mortality risk in the elderly.
Based on the cohort data of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2012 and 2014, GNRI change indicators were constructed. With 2014 as the baseline, a 4-year prospective follow-up was conducted until 2018. K-means clustering was used to classify GNRI trajectory categories and calculate individual cumulative GNRI. Multivariable Cox proportional hazards models were used to examine the association with all-cause mortality. Restricted cubic spline (RCS) was used to explore the dose-response relationship, and time-dependent receiver operating characteristic curves were used to evaluate predictive performance.
A total of 1 102 participants were included, and 339 deaths occurred during follow-up (30.76%).Trajectory analysis showed that compared with the low-low group, the all-cause mortality risk was reduced by 47% (HR=0.53,95% CI: 0.37-0.77) in the high-high group and 39% (HR=0.61, 95% CI: 0.44-0.84) in the low-high group. In the cumulative GNRI quartile groups, the mortality risk of the Q3 and Q4 groups was reduced by 36% (HR=0.64, 95% CI: 0.45-0.91) and 54%(HR=0.46, 95% CI: 0.31-0.68) compared with the Q1 group. Cumulative GNRI was non-linearly and negatively associated with all-cause mortality risk, with AUC values of 0.692, 0.694, 0.720 and 0.712 at 12, 24, 36 and 48 months, respectively.
GNRI trajectories and cumulative GNRI were significantly associated with all-cause mortality risk among the elderly population. Cumulative GNRI has a good predictive value for all-cause mortality risk.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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