Diabetes, Metabolic Syndrome and Obesity (Aug 2023)

Prognostic Nutritional Index (PNI) as a Predictor in Patients with Metabolic Syndrome and Heart Failure

  • Zhang X,
  • Zhang J,
  • Liu F,
  • Li W,
  • Zhang T,
  • Fang B,
  • Zhang Z,
  • Xie Q,
  • Yang Y,
  • Li X

Journal volume & issue
Vol. Volume 16
pp. 2503 – 2514

Abstract

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Xuehe Zhang,1,* Jixin Zhang,1,* Fen Liu,2 Wenling Li,1 Tong Zhang,1 Binbin Fang,2 Zhiyang Zhang,1 Qian Xie,1 Yining Yang,3 Xiaomei Li1 1Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic of China; 2State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Clinical Medical Research Institute, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, People’s Republic of China; 3Department of Cardiology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yining Yang, Department of Cardiology, People’s Hospital of Xinjiang Uygur Autonomous Region, 91 Tianchi Road, Urumqi, 830054, People’s Republic of China, Tel +86-991-4361690, Email [email protected] Xiaomei Li, Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, 137 Liyushan South Road, Urumqi, 830054, People’s Republic of China, Tel +86-991-4362611, Email [email protected]: There is a lack of research on nutritional status and poor prognosis in patients with metabolic syndrome and heart failure. This study evaluated the relationship between nutritional status as defined by the PNI and adverse outcomes in patients with metabolic syndrome and heart failure.Methods: A total of 1048 heart failure patients with metabolic syndrome admitted to the Heart Center of the First Affiliated Hospital of Xinjiang Medical University from January 2015 to December 2019 were consecutively. PNI was used to assess their nutritional status.Results: A total of 51.0% of the patients were in the nonmalnutrition group (PNI≥ 45), 27.9% were in the mild malnutrition group (40≤PNI< 45), and 21.1% of patients were in the malnutrition group (PNI< 40). At 36 months of follow-up, after adjusting for other confounding factors, malnutrition (PNI< 40) was independently associated with all-cause death (HR: 1.787, 95% CI: 1.451– 2.201, P< 0.001) and cardiovascular death (HR: 1.837, 95% CI: 1.467– 2.301, P< 0.001). PNI showed additional prognostic predictive value when included in the established risk factor model, both for all-cause death (AUC: 0.620, 95% CI: 0.579– 0.661, P< 0.001) and cardiovascular death (AUC: 0.596, 95% CI: 0.555– 0.636, P< 0.001).Conclusion: In patients with metabolic syndrome and heart failure, malnutrition assessed by PNI is an independent predictor for all-cause death and cardiovascular death, and PNI is negatively correlated with the occurrence of adverse outcomes.Keywords: prognostic nutritional index, metabolic syndrome, heart failure, malnutrition, prognosis

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