Interaction of nutritional and inflammatory levels on all-cause mortality among individuals with rheumatoid arthritis: a prospective cohort study.

IF 2.9 3区 医学 Q2 RHEUMATOLOGY
Zhuang Ma, Shixin Wu, Lin-En Xiong, Juncheng Zhong, Baiwen Lin, Liangkai Chen, Ting Xiong, Yuanjue Wu
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引用次数: 0

Abstract

Background: Malnutrition and systemic inflammation are frequently prevalent in individuals with rheumatoid arthritis (RA). However, limited studies have explored the combined impacts of nutritional and inflammatory levels on all-cause mortality among RA. This study is aimed at investigating these potential associations.

Methods: We involved 2213 RA patients from the National Health and Nutrition Examination Survey (2001-2018). Nutritional risk index (NRI) and systemic inflammatory response index (SIRI) were used to evaluate the nutritional and inflammatory status of participants, respectively. Weight-based Kaplan-Meier survival curves and COX proportional hazard models were employed to ascertain the independent and joint association.

Results: Over a median follow-up of 7.98 years, 544 deaths occurred. Following the adjustment for confounding factors, we found that individuals with moderate/severe malnutrition (HR, 2.13; 95%CI, 1.50-3.03) or high SIRI (HR, 1.49; 95%CI, 1.07-2.07) were independently associated with an increased risk of all-cause mortality. Furthermore, the simultaneous moderate/severe malnutrition and high SIRI further elevated the mortality risk (HR, 2.34; 95%CI, 1.53-3.56). An additive interaction was observed between malnutrition and high SIRI, yielding an excess risk of 0.34 (95%CI 0.06-0.62, P = 0.014), and the attributable proportion for the interaction was 20.9% (95%CI 7.6-34.2%).

Conclusions: This research indicated that malnutrition and high systemic inflammation levels were independent risk factors for the prognosis of RA patients, and co-occurrence can further deteriorate the prognosis. Our findings highlight the importance of maintaining nutrition and anti-inflammation in patients with RA, providing new insights into the prognosis of RA patients.

营养和炎症水平对类风湿关节炎患者全因死亡率的影响:一项前瞻性队列研究
背景:营养不良和全身性炎症在类风湿关节炎(RA)患者中常见。然而,有限的研究探讨了营养和炎症水平对类风湿关节炎全因死亡率的综合影响。本研究旨在调查这些潜在的关联。方法:我们纳入了2001-2018年全国健康与营养检查调查的2213例RA患者。采用营养风险指数(NRI)和全身炎症反应指数(SIRI)分别评价参与者的营养和炎症状况。采用基于权重的Kaplan-Meier生存曲线和COX比例风险模型来确定独立关联和联合关联。结果:在中位随访7.98年期间,发生544例死亡。在调整混杂因素后,我们发现中度/重度营养不良的个体(HR, 2.13;95%CI, 1.50-3.03)或高SIRI (HR, 1.49;95%CI, 1.07-2.07)与全因死亡风险增加独立相关。此外,同时出现的中度/重度营养不良和高SIRI进一步提高了死亡风险(HR, 2.34;95%可信区间,1.53 - -3.56)。观察到营养不良和高SIRI之间存在加性相互作用,产生0.34的额外风险(95%CI 0.06-0.62, P = 0.014),该相互作用的归因比例为20.9% (95%CI 7.6-34.2%)。结论:本研究提示,营养不良和全身性炎症水平高是影响RA患者预后的独立危险因素,两者同时存在可进一步恶化RA患者预后。我们的研究结果强调了在RA患者中维持营养和抗炎症的重要性,为RA患者的预后提供了新的见解。
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来源期刊
Clinical Rheumatology
Clinical Rheumatology 医学-风湿病学
CiteScore
6.90
自引率
2.90%
发文量
441
审稿时长
3 months
期刊介绍: Clinical Rheumatology is an international English-language journal devoted to publishing original clinical investigation and research in the general field of rheumatology with accent on clinical aspects at postgraduate level. The journal succeeds Acta Rheumatologica Belgica, originally founded in 1945 as the official journal of the Belgian Rheumatology Society. Clinical Rheumatology aims to cover all modern trends in clinical and experimental research as well as the management and evaluation of diagnostic and treatment procedures connected with the inflammatory, immunologic, metabolic, genetic and degenerative soft and hard connective tissue diseases.
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