Abstract：
BACKGROUND: Recent studies show that malnutrition increases all-cause mortality by 1.11 times and cardiovascular mortality by 2.60 times. Similarly, metabolic syndrome raises overall mortality by 40% and cardiovascular mortality by 37%. This research assesses the Nutritional Metabolic Risk Index (NMRI) for predicting these mortality risks.
METHODS: We analyzed data from 14,209 participants in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018, where the NMRI was calculated based on the ratio of GNRI to TyG-WHtR. The relationship between NMRI and mortality was investigated using Kaplan-Meier methods and Cox regression models, with restricted cubic splines (RCS) employed to examine non-linear associations. The predictive capabilities of NMRI, GNRI, and TyG-WHtR for mortality were assessed using receiver operating characteristic curve (ROC) curve analysis.
RESULTS: Over a median follow-up period of 89 months, there were 1358 all-cause deaths and 345 cardiovascular deaths recorded. Cox regression analysis indicated that each unit increase in NMRI was associated with an 8% reduction in all-cause mortality risk and a 15% reduction in cardiovascular mortality risk. RCS analysis found a nonlinear negative correlation between NMRI and both all-cause and cardiovascular mortality. NMRI demonstrated superior predictive accuracy for all-cause mortality (AUC: 0.696, 95% CI: 0.682-0.710) and cardiovascular mortality (AUC: 0.713, 95% CI: 0.689-0.737) compared to GNRI and TyG-WHtR (P < 0.05).
CONCLUSIONS: The NMRI is inversely associated with the risk of all-cause and cardiovascular mortality in American adults.
METHODS: We analyzed data from 14,209 participants in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018, where the NMRI was calculated based on the ratio of GNRI to TyG-WHtR. The relationship between NMRI and mortality was investigated using Kaplan-Meier methods and Cox regression models, with restricted cubic splines (RCS) employed to examine non-linear associations. The predictive capabilities of NMRI, GNRI, and TyG-WHtR for mortality were assessed using receiver operating characteristic curve (ROC) curve analysis.
RESULTS: Over a median follow-up period of 89 months, there were 1358 all-cause deaths and 345 cardiovascular deaths recorded. Cox regression analysis indicated that each unit increase in NMRI was associated with an 8% reduction in all-cause mortality risk and a 15% reduction in cardiovascular mortality risk. RCS analysis found a nonlinear negative correlation between NMRI and both all-cause and cardiovascular mortality. NMRI demonstrated superior predictive accuracy for all-cause mortality (AUC: 0.696, 95% CI: 0.682-0.710) and cardiovascular mortality (AUC: 0.713, 95% CI: 0.689-0.737) compared to GNRI and TyG-WHtR (P < 0.05).
CONCLUSIONS: The NMRI is inversely associated with the risk of all-cause and cardiovascular mortality in American adults.
摘要：
背景：最近的研究表明，营养不良使全因死亡率增加1.11倍，心血管死亡率增加2.60倍。同样，代谢综合征使总死亡率增加40%,心血管死亡率增加37%.这项研究评估了营养代谢风险指数（NMRI）来预测这些死亡风险。
方法：我们分析了2005年至2018年国家健康和营养检查调查（NHANES）的14,209名参与者的数据，其中NMRI是根据GNRI与TyG-WHtR的比率计算的。使用Kaplan-Meier方法和Cox回归模型研究NMRI与死亡率之间的关系,使用受限三次样条(RCS)检查非线性关联。NMRI的预测能力，GNRI,使用受试者工作特征曲线(ROC)曲线分析评估死亡率和TyG-WHtR.
结果：在89个月的中位随访期内，记录了1,358例全因死亡和345例心血管死亡.Cox回归分析表明，NMRI每增加一个单位与全因死亡风险降低8%和心血管死亡风险降低15%相关。RCS分析发现NMRI与全因死亡率和心血管死亡率之间存在非线性负相关。NMRI对全因死亡率（AUC：0.696，95%CI：0.682-0.710）和心血管死亡率（AUC：0.713，95%CI：0.689-0.737）的预测准确性优于GNRI和TyG-WHtR（P<0.05）。
结论：NMRI与美国成年人全因死亡和心血管死亡的风险呈负相关。
方法：我们分析了2005年至2018年国家健康和营养检查调查（NHANES）的14,209名参与者的数据，其中NMRI是根据GNRI与TyG-WHtR的比率计算的。使用Kaplan-Meier方法和Cox回归模型研究NMRI与死亡率之间的关系,使用受限三次样条(RCS)检查非线性关联。NMRI的预测能力，GNRI,使用受试者工作特征曲线(ROC)曲线分析评估死亡率和TyG-WHtR.
结果：在89个月的中位随访期内，记录了1,358例全因死亡和345例心血管死亡.Cox回归分析表明，NMRI每增加一个单位与全因死亡风险降低8%和心血管死亡风险降低15%相关。RCS分析发现NMRI与全因死亡率和心血管死亡率之间存在非线性负相关。NMRI对全因死亡率（AUC：0.696，95%CI：0.682-0.710）和心血管死亡率（AUC：0.713，95%CI：0.689-0.737）的预测准确性优于GNRI和TyG-WHtR（P<0.05）。
结论：NMRI与美国成年人全因死亡和心血管死亡的风险呈负相关。
