Indian journal of thoracic and cardiovascular surgery · 2025
Exophytic left ventricular angiomyxoma.
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Singhmor Priya, Ghuman Navdeep Kaur, Kathuria Priyanka, Sharma Charu, Jain Mayank, Shet Suma, Mathew Priya Susan, Singh Pratibha
Аннотация
BACKGROUND: Low muscle reserve combined with excess adiposity is clinically relevant in diabetes, but whether laboratory-based nutritional risk scores differ in their associations with this phenotype remains unclear.
METHODS: This cross-sectional NHANES 2011-2018 analysis included U.S. adults aged 20-59 years with diabetes. The primary outcome was a DXA-defined low-lean-mass obesity phenotype, defined as low appendicular lean mass adjusted for body mass index combined with BMI-defined obesity. The Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) score were analyzed as standardized continuous variables and quartiles using survey-weighted logistic regression.
RESULTS: Among 1,130 participants, 97 met the phenotype definition. Because poverty-income ratio was missing in 81 participants, 1,049 participants with 87 events contributed to the fully adjusted model. Each 1-standard deviation increase in GNRI was associated with lower odds of the phenotype (OR 0.74, 95% CI 0.57-0.96; P = 0.026), whereas PNI and CONUT were not significantly associated and showed no consistent quartile dose-response patterns. The GNRI association remained inverse when obesity was defined by waist circumference or DXA body-fat percentage, but was attenuated to the null after adjustment for BMI or waist circumference.
CONCLUSIONS: GNRI was more consistently associated with the phenotype than PNI or CONUT. However, attenuation after body-size adjustment and component analyses suggest body-size-related construct overlap. GNRI should be interpreted as a composite albumin/body-size marker rather than an independent nutritional indicator.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-026-02028-w.
METHODS: This cross-sectional NHANES 2011-2018 analysis included U.S. adults aged 20-59 years with diabetes. The primary outcome was a DXA-defined low-lean-mass obesity phenotype, defined as low appendicular lean mass adjusted for body mass index combined with BMI-defined obesity. The Geriatric Nutritional Risk Index (GNRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) score were analyzed as standardized continuous variables and quartiles using survey-weighted logistic regression.
RESULTS: Among 1,130 participants, 97 met the phenotype definition. Because poverty-income ratio was missing in 81 participants, 1,049 participants with 87 events contributed to the fully adjusted model. Each 1-standard deviation increase in GNRI was associated with lower odds of the phenotype (OR 0.74, 95% CI 0.57-0.96; P = 0.026), whereas PNI and CONUT were not significantly associated and showed no consistent quartile dose-response patterns. The GNRI association remained inverse when obesity was defined by waist circumference or DXA body-fat percentage, but was attenuated to the null after adjustment for BMI or waist circumference.
CONCLUSIONS: GNRI was more consistently associated with the phenotype than PNI or CONUT. However, attenuation after body-size adjustment and component analyses suggest body-size-related construct overlap. GNRI should be interpreted as a composite albumin/body-size marker rather than an independent nutritional indicator.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-026-02028-w.