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Geriatric nutrition risk index: a more powerful index identifying muscle mass loss in patients with rheumatoid arthritis

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Abstract

Objective

To explore the association of geriatric nutrition risk index (GNRI), a traditional albumin-body weight calculation, with myopenia in patients with rheumatoid arthritis (RA) and compare its ability to identify myopenia with protein indicators.

Methods

This cross-sectional study was carried out based on a Chinese RA cohort. Clinical data and protein indicators (including albumin, globulin, albumin to globulin ratio, prealbumin, hemoglobin) were collected. GNRI was estimated by serum albumin and body weight. Myopenia was indicated as muscle mass loss measured by bioelectric impedance analysis.

Results

There were 789 RA patients included with mean age 52.6 ± 12.6 years and 77.6% female. There were 41.3%, 18.0%, 27.5%, 13.2% patients with no (GNRI > 98), low (GNRI 92 to ≤ 98), moderate (GNRI 82 to < 92), and major nutrition-related risk (GNRI < 82). There were 406 (51.5%) RA patients with myopenia, RA patients with major nutrition-related risk had the highest prevalence of myopenia (87.5% vs. 73.3% vs. 50.0% vs. 26.1%). Multivariate logistic analysis showed that compared with no risk, RA patients with low (OR = 3.23, 95% CI: 1.86–5.61), moderate (OR = 9.56, 95% CI: 5.70–16.01), and major nutrition-related risk (OR = 28.91, 95% CI: 13.54–61.71) were associated with higher prevalence of myopenia. Receiver operating characteristic curves showed that GNRI (AUC = 0.79) performed a better identifiable ability toward myopenia than serum albumin (AUC = 0.66) or others indicators (AUC range 0.59 to 0.65), respectively.

Conclusion

GNRI, an objective and convenient albumin-weight index, may be preferable for identifying myopenia in RA patients.

Key Points

• We firstly elucidated the association of GNRI with muscle mass loss among RA patients, and compared its ability to identify muscle mass loss with serum albumin or other protein indicators.

• Major nutrition-related risk identified by GNRI showed the highest risk of muscle mass loss, GNRI demonstrated a greater ability to identify myopenia in RA patients. which indicated GNRI was an objective and convenient albumin-weight index to identify myopenia in RA patients.

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Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This research was funded by the Chinese National Key Technology R&D Program, Ministry of Science and Technology (2022YFC2504600 and 2022YFC2504601), National Natural Science Foundation of China (82171780, 81971527, and 82101892), Guangdong Basic and Applied Basic Research Foundation (2022A1515010524, 2023A1515030253 and 2020A1515110061), Guangdong Medical Scientific Research Foundation (A2021065), Guangzhou Municipal Science and Technology Project and Yat-sen Excellent Yong Scientists Fund (2023A03J0709).

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Authors and Affiliations

  1. Department of Rheumatology and Immunology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, People’s Republic of China

    Jie Pan, Tao Wu, Jian-Da Ma, Pei-Wen Jia, Yao-Wei Zou, Zhi-Ming Ouyang, Hu-Wei Zheng, Qian Zhang, Ye Lu, Le-Feng Chen & Lie Dai

  2. Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, People’s Republic of China

    Ze-Hong Yang

  3. Division of Clinical Research Design, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, People’s Republic of China

    Ying-Ying Zhu

  4. Zhongshan School of Medicine, Sun Yat-Sen University, 74 Zhongshan Road II, Guangzhou, Guangdong, People’s Republic of China

    Qing-Yang Song, Yun Su & Lin-Wang Su

  5. Department of Biostatistics, School of Public Health, Yale University, College Street, P.O. Box 20803460, New Haven, CT, 06520-0834, USA

    Wei Dai

  6. Department of Public Health, College of Health Sciences, Des Moines University, 8025 Grand Avenue, West Des Moines, IA, 50266, USA

    Jun Dai

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  1. Jie Pan
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  2. Tao Wu
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Correspondence to Jun Dai or Lie Dai.

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Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of Sun Yat-Sen Memorial Hospital (SYSEC-KY-KS-012 and SYSEC-KY-KS-2022–078).

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Informed consent was obtained from all subjects involved in the study.

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Jie Pan, Tao Wu and Jian-Da Ma are the co-first authors.

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Pan, J., Wu, T., Ma, JD. et al. Geriatric nutrition risk index: a more powerful index identifying muscle mass loss in patients with rheumatoid arthritis. Clin Rheumatol 43, 1299–1310 (2024). https://doi.org/10.1007/s10067-024-06918-3

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