{"title":"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","authors":"Zhuang Ma, Shixin Wu, Lin-En Xiong, Juncheng Zhong, Baiwen Lin, Liangkai Chen, Ting Xiong, Yuanjue Wu","doi":"10.1007/s10067-025-07458-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Interaction of nutritional and inflammatory levels on all-cause mortality among individuals with rheumatoid arthritis: a prospective cohort study.\",\"authors\":\"Zhuang Ma, Shixin Wu, Lin-En Xiong, Juncheng Zhong, Baiwen Lin, Liangkai Chen, Ting Xiong, Yuanjue Wu\",\"doi\":\"10.1007/s10067-025-07458-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%).</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":10482,\"journal\":{\"name\":\"Clinical Rheumatology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-04-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Rheumatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10067-025-07458-0\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Rheumatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10067-025-07458-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
Interaction of nutritional and inflammatory levels on all-cause mortality among individuals with rheumatoid arthritis: a prospective cohort study.
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.
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.