{"title":"营养状况在NAION中的重要性：用PNI和CONUT评分进行风险评估。","authors":"Ahmet Özdemir, Muhiddin Fatih Bodur, İnci Güngör","doi":"10.1080/08164622.2025.2527820","DOIUrl":null,"url":null,"abstract":"<p><strong>Clinical relevance: </strong>Nutritional and immune status are emerging as systemic factors that may influence the onset and course of optic nerve disorders. Recognising their potential role in neuro-ophthalmology can enhance preventive strategies and support holistic patient management in clinical practice.</p><p><strong>Background: </strong>Non-arteritic anterior ischaemic optic neuropathy (NAION) is a common cause of sudden, painless vision loss in older adults. Although vascular and systemic risk factors such as diabetes mellitus and hypertension are well-documented, emerging evidence suggests that nutritional and immune status may also play a role in its development.</p><p><strong>Methods: </strong>A retrospective case-control study was conducted involving 50 NAION patients and 50 age-matched ophthalmologically healthy controls. The Prognostic Nutritional Index (PNI) was calculated as 10 × serum albumin (g/dL) + 0.005 × lymphocyte count (per mm<sup>3</sup>). Controlling Nutritional Status (CONUT) scores were derived from serum albumin, total cholesterol, and lymphocyte counts. Group differences were assessed using the Mann-Whitney U and Chi-square tests. Logistic regression identified independent predictors of NAION, with significance set at <i>p</i> < 0.05.</p><p><strong>Results: </strong>PNI values were significantly lower in NAION patients than in controls (42.32 ± 5.05 vs. 46.87 ± 1.95, <i>p</i> < 0.001), while CONUT scores were significantly higher (1.24 ± 1.62 vs. 0.22 ± 0.50, <i>p</i> < 0.001). Both PNI (OR = 0.657, 95% CI: 0.531-0.812, <i>p</i> < 0.001) and CONUT (OR = 3.102, 95% CI: 1.236-7.789, <i>p</i> = 0.009) independently predicted NAION. Diabetes mellitus and hypertension were also more prevalent in the NAION group (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>PNI and CONUT scores may serve as non-invasive, independent biomarkers for assessing NAION risk. These findings underscore the contribution of systemic nutritional and immune factors to NAION pathogenesis and support their integration into comprehensive patient evaluations. Prospective studies are needed to confirm these results and explore clinical applications.</p>","PeriodicalId":10214,"journal":{"name":"Clinical and Experimental Optometry","volume":" ","pages":"1-7"},"PeriodicalIF":1.5000,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The importance of nutritional status in NAION: risk assessment with PNI and CONUT scores.\",\"authors\":\"Ahmet Özdemir, Muhiddin Fatih Bodur, İnci Güngör\",\"doi\":\"10.1080/08164622.2025.2527820\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Clinical relevance: </strong>Nutritional and immune status are emerging as systemic factors that may influence the onset and course of optic nerve disorders. Recognising their potential role in neuro-ophthalmology can enhance preventive strategies and support holistic patient management in clinical practice.</p><p><strong>Background: </strong>Non-arteritic anterior ischaemic optic neuropathy (NAION) is a common cause of sudden, painless vision loss in older adults. Although vascular and systemic risk factors such as diabetes mellitus and hypertension are well-documented, emerging evidence suggests that nutritional and immune status may also play a role in its development.</p><p><strong>Methods: </strong>A retrospective case-control study was conducted involving 50 NAION patients and 50 age-matched ophthalmologically healthy controls. The Prognostic Nutritional Index (PNI) was calculated as 10 × serum albumin (g/dL) + 0.005 × lymphocyte count (per mm<sup>3</sup>). Controlling Nutritional Status (CONUT) scores were derived from serum albumin, total cholesterol, and lymphocyte counts. Group differences were assessed using the Mann-Whitney U and Chi-square tests. Logistic regression identified independent predictors of NAION, with significance set at <i>p</i> < 0.05.</p><p><strong>Results: </strong>PNI values were significantly lower in NAION patients than in controls (42.32 ± 5.05 vs. 46.87 ± 1.95, <i>p</i> < 0.001), while CONUT scores were significantly higher (1.24 ± 1.62 vs. 0.22 ± 0.50, <i>p</i> < 0.001). Both PNI (OR = 0.657, 95% CI: 0.531-0.812, <i>p</i> < 0.001) and CONUT (OR = 3.102, 95% CI: 1.236-7.789, <i>p</i> = 0.009) independently predicted NAION. Diabetes mellitus and hypertension were also more prevalent in the NAION group (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>PNI and CONUT scores may serve as non-invasive, independent biomarkers for assessing NAION risk. These findings underscore the contribution of systemic nutritional and immune factors to NAION pathogenesis and support their integration into comprehensive patient evaluations. Prospective studies are needed to confirm these results and explore clinical applications.</p>\",\"PeriodicalId\":10214,\"journal\":{\"name\":\"Clinical and Experimental Optometry\",\"volume\":\" \",\"pages\":\"1-7\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-07-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical and Experimental Optometry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/08164622.2025.2527820\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Experimental Optometry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/08164622.2025.2527820","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
临床相关性：营养和免疫状态正逐渐成为影响视神经疾病发病和病程的系统性因素。认识到它们在神经眼科中的潜在作用可以增强预防策略，并支持临床实践中的整体患者管理。背景：非动脉性前缺血性视神经病变（NAION）是老年人突然无痛性视力丧失的常见原因。虽然血管和全身性危险因素如糖尿病和高血压有充分的文献记载，但新出现的证据表明，营养和免疫状况也可能在其发展中发挥作用。方法：采用回顾性病例对照研究，纳入50例NAION患者和50例年龄匹配的眼科健康对照者。预后营养指数（PNI）计算为10 ×血清白蛋白(g/dL) + 0.005 ×淋巴细胞计数（每mm3）。控制营养状态（CONUT）评分来源于血清白蛋白、总胆固醇和淋巴细胞计数。采用Mann-Whitney U检验和卡方检验评估组间差异。结果：独立预测NAION的患者PNI值显著低于对照组（42.32±5.05 vs 46.87±1.95,p p p = 0.009）。结论：PNI和CONUT评分可以作为评估NAION风险的非侵入性、独立的生物标志物。这些发现强调了全身性营养和免疫因素在NAION发病机制中的作用，并支持将其纳入全面的患者评估。需要前瞻性研究来证实这些结果并探索临床应用。
The importance of nutritional status in NAION: risk assessment with PNI and CONUT scores.
Clinical relevance: Nutritional and immune status are emerging as systemic factors that may influence the onset and course of optic nerve disorders. Recognising their potential role in neuro-ophthalmology can enhance preventive strategies and support holistic patient management in clinical practice.
Background: Non-arteritic anterior ischaemic optic neuropathy (NAION) is a common cause of sudden, painless vision loss in older adults. Although vascular and systemic risk factors such as diabetes mellitus and hypertension are well-documented, emerging evidence suggests that nutritional and immune status may also play a role in its development.
Methods: A retrospective case-control study was conducted involving 50 NAION patients and 50 age-matched ophthalmologically healthy controls. The Prognostic Nutritional Index (PNI) was calculated as 10 × serum albumin (g/dL) + 0.005 × lymphocyte count (per mm3). Controlling Nutritional Status (CONUT) scores were derived from serum albumin, total cholesterol, and lymphocyte counts. Group differences were assessed using the Mann-Whitney U and Chi-square tests. Logistic regression identified independent predictors of NAION, with significance set at p < 0.05.
Results: PNI values were significantly lower in NAION patients than in controls (42.32 ± 5.05 vs. 46.87 ± 1.95, p < 0.001), while CONUT scores were significantly higher (1.24 ± 1.62 vs. 0.22 ± 0.50, p < 0.001). Both PNI (OR = 0.657, 95% CI: 0.531-0.812, p < 0.001) and CONUT (OR = 3.102, 95% CI: 1.236-7.789, p = 0.009) independently predicted NAION. Diabetes mellitus and hypertension were also more prevalent in the NAION group (p < 0.05).
Conclusion: PNI and CONUT scores may serve as non-invasive, independent biomarkers for assessing NAION risk. These findings underscore the contribution of systemic nutritional and immune factors to NAION pathogenesis and support their integration into comprehensive patient evaluations. Prospective studies are needed to confirm these results and explore clinical applications.
期刊介绍：
Clinical and Experimental Optometry is a peer reviewed journal listed by ISI and abstracted by PubMed, Web of Science, Scopus, Science Citation Index and Current Contents. It publishes original research papers and reviews in clinical optometry and vision science. Debate and discussion of controversial scientific and clinical issues is encouraged and letters to the Editor and short communications expressing points of view on matters within the Journal''s areas of interest are welcome. The Journal is published six times annually.
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