PMID- 36324018
OWN - NLM
STAT- MEDLINE
DCOM- 20230123
LR  - 20230124
IS  - 1432-5233 (Electronic)
IS  - 0940-5429 (Print)
IS  - 0940-5429 (Linking)
VI  - 60
IP  - 2
DP  - 2023 Feb
TI  - Prognostic nutritional index as a risk factor for diabetic kidney disease and 
      mortality in patients with type 2 diabetes mellitus.
PG  - 235-245
LID - 10.1007/s00592-022-01985-x [doi]
AB  - AIMS: Microinflammation and malnutrition are common in individuals with type 2 
      diabetes mellitus (T2DM). We aimed to validate whether prognostic nutritional 
      index (PNI) may increase the risk of diabetic kidney disease (DKD) and all-cause 
      mortality in T2DM patients. METHODS: This retrospective cohort study was based on 
      the National Health and Nutrition Examination Survey (NHANES) and National Death 
      Index (NDI) 2013-2018 database. A total of 14,349 eligible subjects were 
      included, and 2720 of them were with T2DM. PNI was assessed by the 5 x lymphocyte 
      count (10(9)/L) + serum albumin (g/L). The Logistic and Cox regression analyses 
      were conducted to investigate the risk factors of DKD and mortality in T2DM 
      patients. RESULTS: For 14,349 participants represented 224.7 million 
      noninstitutionalized residents of the United State, the average PNI was 
      53.72 +/- 0.12, and the prevalence of T2DM was 14.89%. T2DM patients had a lower 
      level of PNI and dietary protein intake, a higher risk of mortality, kidney 
      injury, anemia, arterial hypertension and hyperuricemia, compared with non-T2DM 
      subjects. DKD occurred in 35.06% of diabetic participants and a higher PNI was 
      independently related with a lower risk of DKD (OR 0.64, 95% CI 0.459-0.892, 
      p = 0.01) in T2DM after multivariate adjustment. During a median follow-up of 46 
      person-months (29-66 months), a total of 233 T2DM individuals died from all 
      causes (mortality rate = 8.17%). Subjects with T2DM who had a higher PNI showed a 
      lower risk of all-cause mortality (HR 0.60, 95% CI 0.37-0.97, p = 0.036). 
      CONCLUSIONS: PNI, as a marker of immunonutrition, correlated with the incidence 
      of DKD, and was an independent predictor for all-cause mortality in participants 
      with T2DM. Thus, PNI may conduce to the risk stratification and timely 
      intervention of T2DM patients.
CI  - (c) 2022. Springer-Verlag Italia S.r.l., part of Springer Nature.
FAU - Zhang, Junlin
AU  - Zhang J
AD  - Department of Nephrology, The Third People's Hospital of Chengdu, Southwest 
      Jiaotong University, No. 37, Qinglong Street, Chengdu, 610014, Sichuan Province, 
      China.
FAU - Chen, Yao
AU  - Chen Y
AD  - Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, 
      610041, China.
FAU - Zou, Liang
AU  - Zou L
AD  - Department of Nephrology, The Third People's Hospital of Chengdu, Southwest 
      Jiaotong University, No. 37, Qinglong Street, Chengdu, 610014, Sichuan Province, 
      China.
FAU - Gong, Rong
AU  - Gong R
AUID- ORCID: 0000-0002-9268-2429
AD  - Department of Nephrology, The Third People's Hospital of Chengdu, Southwest 
      Jiaotong University, No. 37, Qinglong Street, Chengdu, 610014, Sichuan Province, 
      China. gongr2006@sina.com.
LA  - eng
PT  - Journal Article
DEP - 20221102
PL  - Germany
TA  - Acta Diabetol
JT  - Acta diabetologica
JID - 9200299
RN  - 0 (Dietary Proteins)
SB  - IM
MH  - Humans
MH  - Nutrition Assessment
MH  - *Diabetes Mellitus, Type 2/complications
MH  - Nutritional Status
MH  - Nutrition Surveys
MH  - Prognosis
MH  - *Diabetic Nephropathies/epidemiology/etiology
MH  - Retrospective Studies
MH  - Dietary Proteins
MH  - Risk Factors
PMC - PMC9629877
OTO - NOTNLM
OT  - All-cause mortality
OT  - Diabetic kidney disease
OT  - Immunonutrition
OT  - Prognostic nutritional index
OT  - Type 2 diabetes
COIS- The authors declare that they have no conflict of interest.
EDAT- 2022/11/04 06:00
MHDA- 2023/01/24 06:00
PMCR- 2022/11/02
CRDT- 2022/11/03 00:42
PHST- 2022/08/10 00:00 [received]
PHST- 2022/09/28 00:00 [accepted]
PHST- 2022/11/04 06:00 [pubmed]
PHST- 2023/01/24 06:00 [medline]
PHST- 2022/11/03 00:42 [entrez]
PHST- 2022/11/02 00:00 [pmc-release]
AID - 10.1007/s00592-022-01985-x [pii]
AID - 1985 [pii]
AID - 10.1007/s00592-022-01985-x [doi]
PST - ppublish
SO  - Acta Diabetol. 2023 Feb;60(2):235-245. doi: 10.1007/s00592-022-01985-x. Epub 2022 
      Nov 2.