Abstract：
BACKGROUND: Despite many significant advances in treatment and management, cardiovascular disease remains the main cause of the global disease burden. Nutrition-related disease is a modifiable cardiovascular risk factor. However, few studies have examined the relationship between nutrition-related diseases and cardiovascular mortality.
OBJECTIVE: We aimed to investigate the association of nutrition-related diseases with cardiovascular mortality based on a large nationally representative community population.
METHODS: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 1999-2006 with mortality follow-up through December 31, 2015. Finally, 12,469 participants were analyzed. Each participant was assigned to one of four groups: normal nutrition without sarcopenia, sarcopenia with normal nutrition, malnutrition without sarcopenia, and malnutrition-sarcopenia syndrome. Survival curves and Cox regressions based on the NHANES recommended weights were used to assess the association between nutrition-related diseases and cardiovascular mortality.
RESULTS: Of the 12,469 patients included in the study and divided into four groups, malnutrition-sarcopenia syndrome had the highest 5- and 10-year cardiovascular mortality rates. After adjustment for related factors, sarcopenia with normal nutrition (hazard ratio [HR]: 1.62, 95% confidence interval [CI]: 1.28-2.06; P < 0.001), malnutrition without sarcopenia (HR: 1.28, 95% CI:1.03-1.58; P = 0.024), and malnutrition-sarcopenia syndrome (HR: 2.66, 95% CI:1.89 - 3.74; P < 0.001) were significantly associated with increased risk of all-cause mortality. Malnutrition-sarcopenia syndrome remained associated with an increased risk of cardiovascular mortality (HR: 3.56, 95% CI: 1.17 - 10.84; P < 0.001).
CONCLUSIONS: Malnutrition-sarcopenia syndrome was highly prevalent among community-dwelling adults in the United States and was a strong prognostic factor for cardiovascular mortality in the community setting. Randomized clinical trials are needed to demonstrate whether prevention or treatment of malnutrition-sarcopenia syndrome in community populations can reduce global cardiovascular mortality.
OBJECTIVE: We aimed to investigate the association of nutrition-related diseases with cardiovascular mortality based on a large nationally representative community population.
METHODS: We analyzed data from the National Health and Nutrition Examination Survey (NHANES) 1999-2006 with mortality follow-up through December 31, 2015. Finally, 12,469 participants were analyzed. Each participant was assigned to one of four groups: normal nutrition without sarcopenia, sarcopenia with normal nutrition, malnutrition without sarcopenia, and malnutrition-sarcopenia syndrome. Survival curves and Cox regressions based on the NHANES recommended weights were used to assess the association between nutrition-related diseases and cardiovascular mortality.
RESULTS: Of the 12,469 patients included in the study and divided into four groups, malnutrition-sarcopenia syndrome had the highest 5- and 10-year cardiovascular mortality rates. After adjustment for related factors, sarcopenia with normal nutrition (hazard ratio [HR]: 1.62, 95% confidence interval [CI]: 1.28-2.06; P < 0.001), malnutrition without sarcopenia (HR: 1.28, 95% CI:1.03-1.58; P = 0.024), and malnutrition-sarcopenia syndrome (HR: 2.66, 95% CI:1.89 - 3.74; P < 0.001) were significantly associated with increased risk of all-cause mortality. Malnutrition-sarcopenia syndrome remained associated with an increased risk of cardiovascular mortality (HR: 3.56, 95% CI: 1.17 - 10.84; P < 0.001).
CONCLUSIONS: Malnutrition-sarcopenia syndrome was highly prevalent among community-dwelling adults in the United States and was a strong prognostic factor for cardiovascular mortality in the community setting. Randomized clinical trials are needed to demonstrate whether prevention or treatment of malnutrition-sarcopenia syndrome in community populations can reduce global cardiovascular mortality.
摘要：
背景：尽管在治疗和管理方面取得了许多重大进展，心血管疾病仍然是全球疾病负担的主要原因。营养相关疾病是可改变的心血管危险因素。然而,很少有研究探讨营养相关疾病与心血管死亡率之间的关系.
目的：我们的目的是调查营养相关疾病与心血管疾病死亡率之间的关系，以具有全国代表性的社区人群为基础。
方法：我们分析了1999-2006年国家健康和营养调查（NHANES）的数据，并对死亡率进行了随访，直至2015年12月31日。最后,对12469名参与者进行了分析。每个参与者被分配到四组中的一组：没有肌肉减少症的正常营养，营养正常的肌肉减少症，没有肌肉减少症的营养不良，营养不良-肌肉减少综合征。使用基于NHANES推荐权重的生存曲线和Cox回归来评估营养相关疾病和心血管死亡率之间的关联。
结果：在纳入研究的12,469名患者中，分为四组，营养不良-肌肉减少综合征的5年和10年心血管死亡率最高.经相关因素调整后，营养正常的肌肉减少症（风险比[HR]：1.62，95％置信区间[CI]：1.28-2.06；P<0.001），无肌肉减少症的营养不良(HR:1.28,95%CI:1.03-1.58;P=0.024),营养不良-肌肉减少综合征(HR:2.66,95%CI:1.89-3.74;P<0.001)与全因死亡风险增加显著相关。营养不良-肌肉减少综合征仍然与心血管死亡风险增加相关(HR:3.56,95%CI:1.17-10.84;P<0.001)。
结论：营养不良-肌肉减少综合征在美国社区居住的成年人中非常普遍，并且是社区环境中心血管死亡率的重要预后因素。需要随机临床试验来证明在社区人群中预防或治疗营养不良-肌肉减少综合征是否可以降低全球心血管死亡率。
目的：我们的目的是调查营养相关疾病与心血管疾病死亡率之间的关系，以具有全国代表性的社区人群为基础。
方法：我们分析了1999-2006年国家健康和营养调查（NHANES）的数据，并对死亡率进行了随访，直至2015年12月31日。最后,对12469名参与者进行了分析。每个参与者被分配到四组中的一组：没有肌肉减少症的正常营养，营养正常的肌肉减少症，没有肌肉减少症的营养不良，营养不良-肌肉减少综合征。使用基于NHANES推荐权重的生存曲线和Cox回归来评估营养相关疾病和心血管死亡率之间的关联。
结果：在纳入研究的12,469名患者中，分为四组，营养不良-肌肉减少综合征的5年和10年心血管死亡率最高.经相关因素调整后，营养正常的肌肉减少症（风险比[HR]：1.62，95％置信区间[CI]：1.28-2.06；P<0.001），无肌肉减少症的营养不良(HR:1.28,95%CI:1.03-1.58;P=0.024),营养不良-肌肉减少综合征(HR:2.66,95%CI:1.89-3.74;P<0.001)与全因死亡风险增加显著相关。营养不良-肌肉减少综合征仍然与心血管死亡风险增加相关(HR:3.56,95%CI:1.17-10.84;P<0.001)。
结论：营养不良-肌肉减少综合征在美国社区居住的成年人中非常普遍，并且是社区环境中心血管死亡率的重要预后因素。需要随机临床试验来证明在社区人群中预防或治疗营养不良-肌肉减少综合征是否可以降低全球心血管死亡率。
