Association between prognostic nutritional indexand stroke: a nationally representative cross-sectional study from NHANES

Linshan Pan; Yongjun Peng; Lihua Jiang

doi:10.1016/j.jstrokecerebrovasdis.2024.108165

Association between prognostic nutritional indexand stroke: a nationally representative cross-sectional study from NHANES

J Stroke Cerebrovasc Dis. 2024 Nov 29:108165. doi: 10.1016/j.jstrokecerebrovasdis.2024.108165. Online ahead of print.

Authors

Linshan Pan¹, Yongjun Peng², Lihua Jiang³

Affiliations

¹ Department of Acupuncture and Rehabilitation,Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China. Electronic address: oneorangekeanhuan@foxmail.com.
² Department of Acupuncture and Rehabilitation,Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China. Electronic address: pengyongjun2004@126.com.
³ Department of Acupuncture, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210029, China; Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing 210028,China. Electronic address: jiang_lh89@163.com.

PMID: 39617218
DOI: 10.1016/j.jstrokecerebrovasdis.2024.108165

Abstract

Background: The correlation between the prognostic nutritional index (PNI) and the risk of stroke has become a hot spot within the medical research community. The available evidence from a large sample regarding the correlation between PNI and stroke is inadequate. There is also a need for more research analysis from national surveys.

Objective: The principal goal of this research is to improve our understanding of the relationship between PNI and the risk of stroke. This study also intends to investigate the potential synergistic influence of PNI on stroke in combination with other interacting variables.

Methods: A cross-sectional study was conducted with35,549 participants selected from the National Health and Nutrition Examination Survey (NHANES) 2005-2018 cycle. Information was gathered from all participants regarding the following:lymphocyte count, albumin levels, stroke occurrence, age, sex, race/ethnicity, education level, poverty income ratio (PIR), marital status, body mass index (BMI), smoking habits, drinking status, physical activity measured in total metabolic equivalents (PA_total_MET), diabetesstatus,glycohemoglobin levels, total cholesterol, direct high-density lipoprotein cholesterol(directHDL-cholesterol), hypertension, and coronary heart disease. Curve fitting, subgroup analysis, and multifactor weighted logistic regression analysis were used to examine the relationship between PNI and stroke.

Results: The overall prevalence of stroke was found to be 3.9%, PNI quartile 4(Q4) had an increased prevalence of stroke than quartile 1, 2, and 3(Q1,2,3). Our research suggested a negative association between PNI and the risk of stroke, as indicated by the odds ratio (OR=0.98) with a 95% confidence interval (CI=0.97∼0.99) and a p-value <0.05. (P=0.005), even after adjusting for all confounders. Subsequent subgroup analysisindicated a significant difference in the impact of PNI on stroke between individuals with different Body Mass Index(BMI) levels (p for interaction = 0.02).

Conclusion: Our findings underscore that lower PNI in US adults is associated with an increased stroke risk, shedding light on a potentialinterrelationship between nutrition, inflammatoryparameters, and stroke.

Keywords: Cross-sectional study; NHANES; Prognostic nutritional index; Stroke.