Low Geriatric Nutritional Risk Index (<98) was associated with a higher risk of all-cause mortality (HR 1.67; 95% CI 1.43-1.96) compared to high GNRI (≥98) in adults with obesity.
Cohort (n=8,834)
Yes
Does a low Geriatric Nutritional Risk Index increase the risk of all-cause, cardiovascular, and diabetes-related mortality in adults with obesity?
Lower Geriatric Nutritional Risk Index scores are independently associated with significantly higher risks of all-cause, cardiovascular, and diabetes-related mortality in adults with obesity, supporting the use of nutritional risk screening in this population.
Effect estimate: HR 1.67 (95% CI 1.43, 1.96)
This study aimed to examine the association between the Geriatric Nutritional Risk Index (GNRI) and mortality outcomes, encompassing all-cause, cardiovascular, and diabetes-associated deaths, among adults living with obesity. This prospective cohort analysis employed nationally representative survey information from 8834 adults with obesity (BMI ≥30 kg/m 2 ) enrolled in ten consecutive cycles of the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2018. Vital status was determined via linkage to the National Death Index, with follow-up extending through December 31, 2019. Multivariate Cox proportional hazards models, restricted cubic spline analyses, and stratified subgroup evaluations were performed. Throughout the observation period, 2110 deaths from all causes, 715 cardiovascular-related deaths, and 111 diabetes-attributed deaths were recorded. Following comprehensive covariate adjustment, low GNRI (<98) exhibited markedly higher risks of all-cause death (hazard ratio HR: 1.67; 95% confidence interval CI: 1.43, 1.96), cardiovascular death (HR: 1.61; 95% CI: 1.20, 2.13), and diabetes-associated death (HR: 2.44; 95% CI: 1.41, 4.17) relative to those with high GNRI (≥98). Non-linear relationships were detected for all-cause and cardiovascular mortality, with threshold values identified at GNRI levels of 100.5 and 98.7, respectively. The observed associations persisted consistently across the majority of demographic and clinical strata. Lower GNRI scores demonstrated independent associations with heightened mortality among adults with obesity. These results offer supportive evidence for incorporating nutritional risk screening into routine clinical management approaches for this patient population. • Lower GNRI is independently associated with mortality in adults with obesity. • Diabetes-related mortality shows strongest association with low GNRI. • Nonlinear dose-response relationships with clinically actionable thresholds
Yang et al. (Fri,) conducted a cohort in Obesity (n=8,834). Low Geriatric Nutritional Risk Index (GNRI <98) vs. High GNRI (≥98) was evaluated on All-cause death (HR 1.67, 95% CI 1.43, 1.96). Low Geriatric Nutritional Risk Index (<98) was associated with a higher risk of all-cause mortality (HR 1.67; 95% CI 1.43-1.96) compared to high GNRI (≥98) in adults with obesity.