营养风险指数与老年胃癌根治术后肌少症的相关性分析

Correlation analysis between geriatric nutritional risk index and sarcopenia inelderly patients after radical gastrectomy for gastric cancer

目的探讨营养风险指数(GNRI)与老年胃癌根治术后患者肌肉减少症(肌少症)之间的相关性。方法回顾性选取2021年2月~2024年2月于南京市江宁医院接受胃癌根治术的260例老年患者,根据欧洲老年肌少症工作组的标准分为肌少症组(n=145)和非肌少症组(n=115)。对两组的临床资料进行分析;利用多因素logistic回归模型筛选老年胃癌根治术后肌少症发生的危险因素;采用受试者工作特征(ROC)曲线分析GNRI联合指标在老年胃癌根治术后肌少症诊断中的应用价值;通过Pearson相关性分析探讨GNRI与肌少症相关指标之间的相关性。结果260例老年患者中,肌少症的检出率为55.77%(145/260)。多因素logistic回归分析结果显示,年龄、体质量指数(BMI)、白蛋白(ALB)、中性粒细胞与淋巴细胞比值(NLR)及GNRI均是老年胃癌根治术后肌少症发生的独立危险因素(P<0.05)。ROC曲线分析结果显示,年龄、BMI、ALB、NLR和GNRI各指标联合预测老年胃癌根治术后肌少症的发生显示出较高的诊断效能,AUC为0.874,灵敏度为80.5%,特异度为76.5%。Pearson相关性分析结果显示,GNRI与肌少症相关指标(握力、骨骼肌指数、步速)均呈正相关(r=0.268、0.364、0.273,P<0.05)。结论老年胃癌根治术后肌少症的发生与GNRI之间存在明显的相关性,对于早期筛查和干预老年胃癌根治术后肌少症具有重要的临床意义。

Objective To explore the correlation between the Geriatric Nutritional Risk Index(GNRI)and sarcopenia in elderly patients following radical gastrectomy for gastric cancer.Methods A retrospective analysis was conducted on 260 elderly patients who underwent radical gastrectomy for gastric cancer at Jiangning Hospital from February 2021 to February 2024.Patients were categorized into sarcopenia(n=145)and non-sarcopenia groups(n=115)based on the European Working Group on Sarcopenia in Older People(EWGSOP2)criteria.Clinical data of both groups were analyzed.A multivariate logistic regression model was utilized to identify risk factors for sarcopenia post-radical gastrectomy.The Receiver Operating Characteristic(ROC)curve analysis was employed to assess the diagnostic value of GNRI in combination with other indices for sarcopenia after radical gastrectomy in elderly patients.Pearson's correlation analysis was also used to investigate the relationship between GNRI and sarcopenia-related indicators.Results The prevalence of sarcopenia among the 260 elderly patients was 55.77%(145∕260).Multivariate logistic regression analysis indicated that age,Body Mass Index(BMI),albumin(ALB),neutrophil-to-lymphocyte ratio(NLR),and GNRI were independent risk factors for sarcopenia following radical gastrectomy(P<0.05).The ROC curve analysis revealed that a combination of age,BMI,ALB,NLR,and GNRI as predictors demonstrated high diagnostic efficacy for sarcopenia after radical gastrectomy in elderly patients,with an AUC of 0.874,sensitivity of 80.5%,and specificity of 76.5%.Pearson's correlation analysis showed that GNRI was positively correlated with sarcopenia-related indicators(handgrip strength,skeletal muscle index,and gait speed)with coefficients(r)of 0.268,0.364,and 0.273,respectively(P<0.05).Conclusion There is a significant correlation between GNRI and the occurrence of sarcopenia in elderly patients after radical gastrectomy for gastric cancer,which is of considerable clinical importance for the early detection and intervention of sarcopenia in this patient population.