预后营养指数与高血压之间的关系：基于NHANES 2007~2018

The Association between the Prognostic Nutritional Index and Hypertension in the NHANES 2007~2018

摘要: 目的：预后营养指数(PNI)是一种新颖的营养免疫指标，与心血管事件相关。本研究旨在探讨PNI与高血压之间可能存在的联系。方法：本项横断面研究纳入了2007~2018年国家健康与营养调查(NHANES)中PNI和高血压数据完整的参与者。将PNI进行对数转换后作为连续的自变量进行评估，并按三分位数分组评估其稳健性。采用logistic回归分析和交互作用检验，并通过2个分段logistic回归模型进一步探究二者之间的关系。结果：研究共纳入30,017名参与者，结果显示高血压组的PNI略低于非高血压组(52.53 vs. 53.56, P < 0.001)。在全调整的模型中，发现LogPNI与高血压存在关联(OR: 10.62, 95% CI: 4.98~22.68, P < 0.0001)。交互作用检验表明，性别、糖尿病和年龄对LogPNI与高血压之间的关系没有显著影响(所有交互作用的P值 > 0.05)。在两段式Logistic回归模型分析中发现，当LogPNI值 ≥ 1.66时，其升高与较高的高血压患病风险显著相关(OR: 19.23, 95% CI: 8.18~45.16, P < 0.0001)。结论：较高的PNI与美国成年人高血压风险增加相关。这提示PNI可以作为高血压风险的有用生物标志物。

Abstract: Background: The prognostic nutritional index (PNI) is a novel indicator of nutritional immunity linked to cardiovascular events. Our goal was to investigate any potential connections between PNI and the frequency of hypertension. Methods: This cross-sectional study included participants with complete data on PNI and hypertension from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. PNI was logarithmically transformed and evaluated as a continuous independent variable, and its robustness was assessed by grouping according to quartiles. Logistic regression analysis and interaction tests were used, and the relationship between the two was further explored through two piecewise logistic regression models. Results: The study comprised 30,017 participants, and the PNI was lower in the hypertensive group compared with the non-hypertensive group (52.53 vs. 53.56, P < 0.001). In fully adjusted model, an association was found between logPNI and the prevalence of hypertension (OR: 10.62, 95% CI: 4.98~22.68, P < 0.0001). Interaction tests showed that gender, diabetes, and age had no significant effect on the relationship between LogPNI and the prevalence of hypertension (all P for interaction > 0.05). In the analysis of the two-segment logistic regression model, it was found that when the LogPNI value is ≥1.66, its increase is significantly correlated with a higher risk of hypertension (OR: 19.23, 95% CI: 8.18~45.16, P < 0.0001). Conclusions: A higher PNI is associated with an increased risk of hypertension in American adults. This suggests that PNI can serve as a useful biomarker for hypertension risk.