Clinical Interventions in Aging (Oct 2022)
Association Between Poor Nutritional Status and Increased Risk for Subsequent Vertebral Fracture in Elderly People with Percutaneous Vertebroplasty
Abstract
Xin-Yue Fang,1 Hao-Wei Xu,1 Hao Chen,1 Shu-Bao Zhang,1 Yu-Yang Yi,1 Xiao-Yong Ge,1 Shan-Jin Wang1– 3 1Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, People’s Republic of China; 2Institute of Spinal Diseases, Jinggangshan University, Jiangxi, People’s Republic of China; 3Department of Orthopedic, Shanghai East Hospital, Ji’An Hospital, Jiangxi, People’s Republic of ChinaCorrespondence: Shan-Jin Wang, Tel +86-21-38804518 ext 12025, Fax +86-21-63595958, Email [email protected]: The relationship between a poor nutritional state and the risk of fractures has not been investigated. This study aimed to investigate the ability of the Controlling Nutritional Status (CONUT) and Geriatric Nutritional Risk Index (GNRI) to predict the incidence of subsequent vertebral fracture (SVF) after percutaneous vertebroplasty (PVP).Methods: A total of 307 women and 138 men over 50 years old who underwent PVP for osteoporotic vertebral compression fracture (OVCF) were included. Blood biochemical indexes, body mass index (BMI), bone mineral density (BMD), physical function, and muscle strength were measured at baseline. Cox regression analysis was used to determine whether nutritional state was an independent predictor for SVF.Results: During follow-up, 35 (25.4%) men and 85 (27.7%) women suffered SVF. Patients with SVF had lower BMI, serum albumin levels, GNRI scores, grip strength, lumbar BMD, and Short-Physical Performance Battery (SPPB) scores and higher fall rates and CONUT scores (P < 0.05). Compared with normal nutrition, mild malnutrition was associated with higher risk for SVF (women: HR 2.37, p=0.001, men: HR 2.97, p=0.021 by GNRI; women: HR 2.36, p=0.005, men: HR 3.62, p=0.002 by CONUT) after adjusting for confounding factors. Those with moderate–severe malnutrition also had a higher risk of SVF. Kaplan–Meier analysis showed that poor nutrition state was significantly associated with lower SVF-free survival (P< 0.05). The area under curve (AUC) for predicting SVF was 0.65 and 0.73 for the GNRI and 0.67 and 0.66 for the CONUT in men and women, respectively.Conclusion: GNRI and CONUT are simple and effective tools for predicting SVF in patients undergoing PVP. Health management and nutrition supplement after PVP is a potentially effective prevention strategy against SVF.Keywords: nutrition status, osteoporotic vertebral fracture, percutaneous vertebroplasty, subsequent vertebral fracture
