Correlation analysis of nutritional status and prognosis for heart failure in elderly women

doi:10.3969/j.issn.1004-583X.2021.12.004

Abstract

Abstract:

Objective To explore the application value of mini nutritional assessment short-form version(MNA-SF) for assessing nutritional status of heart failure(HF) in elderly women and its relationship with poor prognosis. Methods The data of 279 elderly HR women, who treated in our hospital from January 1, 2018 to January 1, 2020 were enrolled to analyze the clinical characteristics. MNA-SF score was used to assess the nutritional status, and the correlation between MNA-SF score and prognosis was explored. Results Malnutrition rate of cardiac function level Ⅳ in those patients was significantly higher than that of cardiac function level Ⅱ, Ⅲ (93.3% vs 69.4%,76.3%,P=0.035). MNA-SF was negatively related to N-terminal pro-B-type natriuretic peptide (NT-proBNP)(r=-0.382, P<0.01), NT-proBNP level of malnutrition patients was significantly higher than that of normal patients (P<0.01)and with significantly higher the adverse incidence for HR(28.6% vs 12.1%, P=0.007). Conclusion For elderly HR women the incidence of malnutrition is common. MNA-SF score can be used to evaluate for their nutritional status, with great significance for prognosis.

Key words: heart failure, nutritional status, prognosis

CLC Number:

R541

Li Heng, Li Yonghui, Wang Lin, He Feng. Correlation analysis of nutritional status and prognosis for heart failure in elderly women[J]. Clinical Focus, 2021, 36(12): 1079-1082.

Add to citation manager EndNote|Ris|BibTeX

URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2021.12.004

https://huicui.hebmu.edu.cn/EN/Y2021/V36/I12/1079

Figures/Tables 4

项目	心功能Ⅱ级组(n=72)	心功能Ⅲ级组(n=177)	心功能Ⅳ级组(n=30)	统计值	P值
年龄(岁)	79.0±6.9	81.9±6.4	82.1±4.2^*△	F=5.634	0.004
糖尿病[例(%)]	24(33.3)	82(46.3)	10(33.3)	χ²=4.498	0.105
高血压[例(%)]	52(72.2)	163(92.1)	22(73.3)	χ²=19.344	0.000
心率(次/min)	82.0±18.0	79.0±21.8	100.8±14.4^*△	F=7.358	0.001
BMI(kg/m²)	25.0±3.6	24.5±4.3	21.8±1.2^*△	F=7.548	0.026
cTnT(μg/L)	0.0±0.0	0.1±0.2	0.3±0.3^*△	F=16.635	0.000
NT-proBNP(ng/L)	735.0(342.9, 2094.0)	1027.0(432.9, 5062.0)	7419.2(2757.0, 12818.1)^*△	F=8.041	0.001
CRP(mg/L)	19.0±18.0	24.9±30.4	70.9±28.4	F=19.441	0.000
BUN(μmol/L)	8.5±4.0	8.6±4.2	9.0±4.2	F=0.099	0.906
UA(μmol/L)	383.3±137.6	377.6±133.7	383.0±91.3	F=0.024	0.976
Cr(μmol/L)	98.6±60.5	89.0±37.9	118.9±20.8	F=6.275	0.002
GLU(mmol/L)	8.9±4.0	7.5±2.9	7.8±4.0	F=4.867	0.008
TP(g/L)	64.3±8.1	64.1±6.3	64.1±6.2	F=0.021	0.979
GLB(g/L)	28.8±6.4	27.5±4.7	22.9±3.1	F=14.087	0.000
ALB(g/L)	36.3±3.8	36.7±3.8	29.9±2.7	F=40.767	0.000
ALT(U/L)	22.8±54.8	25.0±54.6	73.7±21.2	F=11.330	0.004
AST(U/L)	41.6±93.2	32.3±35.6	57.3±25.1	F=2.823	0.061
TC(mmol/L)	4.3±1.2	4.3±2.0	3.9±1.0	F=0.847	0.430
TG(mmol/L)	1.3±0.6	1.5±0.9	0.9±0.2	F=7.529	0.001
LDL(mmol/L)	2.9±0.9	2.9±1.4	2.5±0.8	$F$ =1.227	0.295
HDL(mmol/L)	1.1±0.3	1.1±0.3	1.3±0.3	$F$ =2.704	0.069
HBG(g/L)	116.5±9.6	119.5±14.0	96.5±6.8	$F$ =14.884	0.000
TSH(μU/mL)	5.7±16.5	4.0±5.7	2.2±1.4	$F$ =0.715	0.491
FIB(g/L)	4.2±1.5	3.7±1.3	4.1±1.3	$F$ =1.514	0.224
D-dimer(μg/mL)	1.2±1.1	1.3±2.4	3.5±4.0	$F$ =5.346	0.006
LV(mm)	43.7±4.0	45.7±5.4	49.6±5.5	$F$ =11.867	0.000
EF(%)	58.6±6.2	54.5±8.3	44.1±9.1^*△	$F$ =33.970	0.000
营养不良[例(%)]	50(69.4)	135(76.3)	28(93.3)	χ²=6.693	0.035
MNA-SF评分(分)	10.3±2.2	9.4±2.6	7.1±3.0^*△	$F$ =16.258	0.000

项目	心功能Ⅱ级组(n=72)	心功能Ⅲ级组(n=177)	心功能Ⅳ级组(n=30)	统计值	P值
年龄(岁)	79.0±6.9	81.9±6.4	82.1±4.2^*△	F=5.634	0.004
糖尿病[例(%)]	24(33.3)	82(46.3)	10(33.3)	χ²=4.498	0.105
高血压[例(%)]	52(72.2)	163(92.1)	22(73.3)	χ²=19.344	0.000
心率(次/min)	82.0±18.0	79.0±21.8	100.8±14.4^*△	F=7.358	0.001
BMI(kg/m²)	25.0±3.6	24.5±4.3	21.8±1.2^*△	F=7.548	0.026
cTnT(μg/L)	0.0±0.0	0.1±0.2	0.3±0.3^*△	F=16.635	0.000
NT-proBNP(ng/L)	735.0(342.9, 2094.0)	1027.0(432.9, 5062.0)	7419.2(2757.0, 12818.1)^*△	F=8.041	0.001
CRP(mg/L)	19.0±18.0	24.9±30.4	70.9±28.4	F=19.441	0.000
BUN(μmol/L)	8.5±4.0	8.6±4.2	9.0±4.2	F=0.099	0.906
UA(μmol/L)	383.3±137.6	377.6±133.7	383.0±91.3	F=0.024	0.976
Cr(μmol/L)	98.6±60.5	89.0±37.9	118.9±20.8	F=6.275	0.002
GLU(mmol/L)	8.9±4.0	7.5±2.9	7.8±4.0	F=4.867	0.008
TP(g/L)	64.3±8.1	64.1±6.3	64.1±6.2	F=0.021	0.979
GLB(g/L)	28.8±6.4	27.5±4.7	22.9±3.1	F=14.087	0.000
ALB(g/L)	36.3±3.8	36.7±3.8	29.9±2.7	F=40.767	0.000
ALT(U/L)	22.8±54.8	25.0±54.6	73.7±21.2	F=11.330	0.004
AST(U/L)	41.6±93.2	32.3±35.6	57.3±25.1	F=2.823	0.061
TC(mmol/L)	4.3±1.2	4.3±2.0	3.9±1.0	F=0.847	0.430
TG(mmol/L)	1.3±0.6	1.5±0.9	0.9±0.2	F=7.529	0.001
LDL(mmol/L)	2.9±0.9	2.9±1.4	2.5±0.8	$F$ =1.227	0.295
HDL(mmol/L)	1.1±0.3	1.1±0.3	1.3±0.3	$F$ =2.704	0.069
HBG(g/L)	116.5±9.6	119.5±14.0	96.5±6.8	$F$ =14.884	0.000
TSH(μU/mL)	5.7±16.5	4.0±5.7	2.2±1.4	$F$ =0.715	0.491
FIB(g/L)	4.2±1.5	3.7±1.3	4.1±1.3	$F$ =1.514	0.224
D-dimer(μg/mL)	1.2±1.1	1.3±2.4	3.5±4.0	$F$ =5.346	0.006
LV(mm)	43.7±4.0	45.7±5.4	49.6±5.5	$F$ =11.867	0.000
EF(%)	58.6±6.2	54.5±8.3	44.1±9.1^*△	$F$ =33.970	0.000
营养不良[例(%)]	50(69.4)	135(76.3)	28(93.3)	χ²=6.693	0.035
MNA-SF评分(分)	10.3±2.2	9.4±2.6	7.1±3.0^*△	$F$ =16.258	0.000

项目	心功能 Ⅱ级组 ( $n$ =72)	心功能 Ⅲ级组 ( $n$ =177)	心功能 Ⅳ级组 ( $n$ =30)	统计值	$P$ 值
住院天数	7.1±2.5	7.6±2.8	10.1±2.9^*△	$F$ =13.280	0.000
住院全因死亡	0	0	6(20.0)	χ²=50.895	0.000
随访6月全因死亡	2(2.8)	2(1.1)	0	χ²=1.354	0.508
随访6月再入院	10(13.9)	45(25.4)	8(33.3)^*△	χ²=5.395	0.067

项目	心功能 Ⅱ级组 ( $n$ =72)	心功能 Ⅲ级组 ( $n$ =177)	心功能 Ⅳ级组 ( $n$ =30)	统计值	$P$ 值
住院天数	7.1±2.5	7.6±2.8	10.1±2.9^*△	$F$ =13.280	0.000
住院全因死亡	0	0	6(20.0)	χ²=50.895	0.000
随访6月全因死亡	2(2.8)	2(1.1)	0	χ²=1.354	0.508
随访6月再入院	10(13.9)	45(25.4)	8(33.3)^*△	χ²=5.395	0.067

指标	$r$ 值	$P$ 值
NT-proBNP	-0.382	<0.01
EF	0.223	<0.01
LV	-0.304	<0.01
BMI	0.236	<0.01
Cr	0.047	<0.01
HGB	0.277	<0.01
ALB	0.217	<0.01
住院天数	-0.186	<0.01

指标	$r$ 值	$P$ 值
NT-proBNP	-0.382	<0.01
EF	0.223	<0.01
LV	-0.304	<0.01
BMI	0.236	<0.01
Cr	0.047	<0.01
HGB	0.277	<0.01
ALB	0.217	<0.01
住院天数	-0.186	<0.01

指标	营养不良组( $n$ =213)	营养正常组( $n$ =66)	统计值	$P$ 值
MNA-SF(分)	8.3±2.1	12.9±0.7	$t$ =60.700	0.000
BMI(kg/m²)	24.1±4.0	25.1±3.9	$t$ =0.294	0.088
NT-proBNP(ng/L)	1853.0(735.0, 6849.0)	442.3(218.5, 603.0)	$t$ =41.842	0.000
LV(mm)	46.1±5.6	44.8±4.6	$t$ =1.580	0.210
EF(%)	53.9±9.2	55.6±7.7	$t$ =6.717	0.164
HGB(g/L)	114.5±17.2	120.6±12.9	$t$ =9.979	0.015
住院天数(d)	8.0±2.8	6.6±2.6	$t$ =1.378	0.000
住院全因死亡[例(%)]	6(2.8)	0	χ²=1.900	0.168
6月全因死亡[例(%)]	4(1.9)	0	χ²=1.294	0.255
6个月内再入院[例(%)]	55(26.6)	8(12.1)	χ²=5.885	0.015
心脏不良事件[例(%)]	61(28.6)	8(12.1)	χ²=7.385	0.007
心功能Ⅳ级[例(%)]	28(13.1)	2(3.0)	χ²=3.693	0.030

指标	营养不良组( $n$ =213)	营养正常组( $n$ =66)	统计值	$P$ 值
MNA-SF(分)	8.3±2.1	12.9±0.7	$t$ =60.700	0.000
BMI(kg/m²)	24.1±4.0	25.1±3.9	$t$ =0.294	0.088
NT-proBNP(ng/L)	1853.0(735.0, 6849.0)	442.3(218.5, 603.0)	$t$ =41.842	0.000
LV(mm)	46.1±5.6	44.8±4.6	$t$ =1.580	0.210
EF(%)	53.9±9.2	55.6±7.7	$t$ =6.717	0.164
HGB(g/L)	114.5±17.2	120.6±12.9	$t$ =9.979	0.015
住院天数(d)	8.0±2.8	6.6±2.6	$t$ =1.378	0.000
住院全因死亡[例(%)]	6(2.8)	0	χ²=1.900	0.168
6月全因死亡[例(%)]	4(1.9)	0	χ²=1.294	0.255
6个月内再入院[例(%)]	55(26.6)	8(12.1)	χ²=5.885	0.015
心脏不良事件[例(%)]	61(28.6)	8(12.1)	χ²=7.385	0.007
心功能Ⅳ级[例(%)]	28(13.1)	2(3.0)	χ²=3.693	0.030

References 13

[1]	Murphy SP, Ibrahim NE, Januzzi JL Jr. Heart failure with reduced ejection fraction: A review[J]. JAMA, 2020, 324(5):488-504. doi: 10.1001/jama.2020.10262 pmid: 32749493
[2]	Bozkurt B, Khalaf S. Heart failure in women[J]. Methodist Debakey Cardiovasc J, 2017, 13(4):216-223. doi: 10.14797/mdcj-13-4-216 pmid: 29744014
[3]	Kuehneman T, Gregory M, de Waal D, et al. Academy of nutrition and dietetics evidence-based practice guideline for the management of heart failure in adults[J]. J Acad Nutr Diet, 2018, 118(12):2331-2345. doi: S2212-2672(18)30293-4 pmid: 29759644
[4]	Rubenstein LZ, Harker JO, Salvà A, et al. Screening for undernutrition in geriatric practice: Developing the short-form mini-nutritional assessment (MNA-SF)[J]. J Gerontol A Biol Sci Med Sci, 2001, 56(6):M366-372. doi: 10.1093/gerona/56.6.M366 URL
[5]	Kaiser MJ, Bauer JM, Ramsch C, et al. Validation of the mini nutritional assessment short-form (MNA-SF): A practical tool for identification of nutritional status[J]. J Nutr Health Aging, 2009, 13(9):782-788. doi: 10.1007/s12603-009-0214-7 pmid: 19812868
[6]	Isautier JMJ, Bosni'c M, Yeung SSY, et al. Validity of nutritional screening tools for community-dwelling older adults: A systematic review and meta-analysis[J]. J Am Med Dir Assoc, 2019, 20(10): 1351.e13-1351.e25.
[7]	Lin H, Zhang H, Lin Z, et al. Review of nutritional screening and assessment tools and clinical outcomes in heart failure[J]. Heart Fail Rev, 2016, 21(5):549-565. doi: 10.1007/s10741-016-9540-0 URL
[8]	Lorenzo-López L, Maseda A, de Labra C, et al. Nutritional determinants of frailty in older adults: A systematic review[J]. BMC Geriatr, 2017, 17(1):108. doi: 10.1186/s12877-017-0496-2 pmid: 28506216
[9]	Tadic M, Cuspidi C, Plein S, et al. Sex and heart failure with preserved ejection fraction: From pathophysiology to clinical studies[J]. J Clin Med, 2019, 8(6):792. doi: 10.3390/jcm8060792 URL
[10]	Gök G, Zoghi M, Sinan ÜY, et al. Demographics of patients with heart failure who were over 80 years old and were admitted to the cardiology clinics in Turkey[J]. Anatol J Cardiol, 2019, 21(4):196-205.
[11]	Yaku H, Ozasa N, Morimoto T, et al. Demographics, management, and in-hospital outcome of hospitalized acute heart failure syndrome patients in contemporary real clinical practice in Japan-observations from the prospective, multicenter Kyoto Congestive Heart Failure (KCHF) registry[J]. Circ J, 2018, 82(11):2811-2819. doi: 10.1253/circj.CJ-17-1386 URL
[12]	Hirose S, Miyazaki S, Yatsu S, et al. Impact of the Geriatric Nutritional Risk Index on in-hospital mortality and length of hospitalization in patients with acute decompensated heart failure with preserved or reduced ejection fraction[J]. J Clin Med, 2020, 9(4):1169. doi: 10.3390/jcm9041169 URL
[13]	Wleklik M, Uchmanowicz I, Jankowska-Polańska B, et al. The role of nutritional status in elderly patients with heart failure[J]. J Nutr Health Aging, 2018, 22(5):581-588. doi: 10.1007/s12603-017-0985-1 pmid: 29717757

[1]	Liu Lili, Yuan Yuting, Lai Gengliang, Tian Chuan, Lan Xiang, Ye Zhonglv. The relationship between minimal residual disease on day 15 and prognosis in children with acute lymphoblastic leukemia [J]. Clinical Focus, 2024, 39(1): 47-52.
[2]	Duan Fang, Cui Wei. Application principles of vasodilators in the treatment of acute heart failure [J]. Clinical Focus, 2023, 38(9): 773-778.
[3]	Wang Tao, Gao Yuwei, Wang Xinghua, Hu Xiuhong, Cui Hongrui, Xu Baozhen, Yang Hongjuan. Correlation of anti-phospholipase A2 receptor antibody with idiopathic membranous nephropathy [J]. Clinical Focus, 2023, 38(7): 606-612.
[4]	Gao Qinyu, Bao Beiyan, Jin Yan, Zhao Yu. Analysis of clinical features and prognostic factors of IgA nephropathy complicated with depression [J]. Clinical Focus, 2023, 38(6): 510-515.
[5]	Sun Xingxing, Lin Hai. Changes in immune function and prognostic risk factors for severe pneumonia in children [J]. Clinical Focus, 2023, 38(6): 521-525.
[6]	Wang Zhen, Yang Xiaoyue, Li Shaojie, Wang Xian, Chen Shuxia, Gu Jian. Analysis of clinical characteristics and readmission risk factors in patients with ejection fraction preserved heart failure combined with atrial fibrillation [J]. Clinical Focus, 2023, 38(4): 308-314.
[7]	He Xiangyu, Pan Yan, Zhang Xiaolin. Correlation between serum lipoprotein-associated phospholipase A2 level and the severity and prognosis of acute ischemic stroke [J]. Clinical Focus, 2023, 38(4): 315-318.
[8]	Yang Jinqiang, Zhang Renmin. Prognostic value of procalcitonin to platelet ratio in patients with fever with thrombocytopenia syndrome [J]. Clinical Focus, 2023, 38(4): 346-351.
[9]	Zhang Fang, Zhang Yichao, Jia Xinwei, Li Jianlong, Chen Chunhong. Analysis of one-year follow-up results of ≥75-year-old atrial fibrillation inpatients with high CHA2DS2-VASc score [J]. Clinical Focus, 2023, 38(2): 117-120.
[10]	Li Nana, Jiang Shan. Predictive values of serum homocysteine, cystatin C and high sensitive C-reactive protein levels on heart failure after percutaneous coronary intervention in patients with acute ST-elevation myocardial infarction [J]. Clinical Focus, 2023, 38(2): 121-125.
[11]	Zhang Na, Sun Yue, Dong Han, Zhao Peng, Yang Xin, Qi Yuan, Wang Lingling. Correlation between the expression level of SPARC and prognosis in patients with non-small cell lung cancer: A meta-analysis [J]. Clinical Focus, 2023, 38(11): 972-978.
[12]	Wang Huixin, Zhao Fangqing, Zhang Xinyan, Hou Xiaowen. Relationship between uric acid and prognosis of Chinese patients with acute ischemic stroke: A meta analysis [J]. Clinical Focus, 2022, 37(9): 785-790.
[13]	Ye Qian, Ling Zhai, Liu Shenxiang, Lu Guotao, Yin Xudong. Meta analysis on effects of glucocorticoid on the immunotherapy of advanced cancer [J]. Clinical Focus, 2022, 37(7): 591-598.
[14]	Zhou Bin, Zeng Cizheng, Huang Yuge, Zhong Mianling, Wu Jiayuan. Effect of pSOFA score combined with C-reactive protein and procalcitonin in prognosis assessment of sepsis children [J]. Clinical Focus, 2022, 37(7): 616-622.
[15]	Zhang Jingshui, Xu Yanan, Wang Jun, Yang Yi, Jiang Haibing, Tang Long, Wang Xianping, Shao Mingliang. Clinical characteristics and long-term prognosis of initial patients with new onset different type of heart failure combined atrial fibrillation [J]. Clinical Focus, 2022, 37(6): 504-509.