The accuracy of the Geriatric Nutritional Risk Index in detecting frailty and sarcopenia in hospitalized older adults

Rasheedy, Doha; El-Kawaly, Wessam H.

doi:10.1007/s40520-020-01492-5

Cited by 26 publications

(32 citation statements)

References 24 publications

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“…21 Although body composition needs to be evaluated for clinical diagnosis of sarcopenia/frailty, Rasheedy et al reported usefulness of GNRI for detecting sarcopenia/frailty in hospitalized elderly. 29 Therefore, considering the results in this study, GNRI might be worth applying for estimation of sarcopenia/frailty in EOUC.…”

Section: Discussionmentioning

confidence: 78%

Relation of geriatric nutritional risk index with clinical risks in elderly‐onset ulcerative colitis

Higashiyama

Komoto

Suzuki

et al. 2020

J of Gastro and Hepatol

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Background and AimWorldwide increasing aging societies have many elderlies with intractable diseases including ulcerative colitis (UC). Reportedly, each patients' frailty as well as chronological age is a clinical risk factor of elderly‐onset UC (EOUC). Because malnutrition is one of the major manifestations of frailty, we aimed to investigate the effect of malnutrition on the prognosis of EOUC with geriatric nutritional risk index (GNRI), a prognostic tool for several diseases in the elderly to estimate malnutrition, and to evaluate clinical risks among EOUC patients in Japan, the world‐leading aging society.MethodsThe EOUC patients (≥ 65 years at diagnosis, n = 2778) in the previous nationwide survey were classified by age and GNRI, and odds ratios (ORs) of hospitalization and UC‐related surgery were determined to evaluate the effects of malnutrition on the EOUC patients as well as aging.ResultsThe risks of hospitalization and surgery were elevated as age advanced. The value of GNRI, negatively correlated with disease activity (r = −0.53), could distinguish severe activity (cutoff ≤ 86.82, sensitivity = 0.79, and specificity = 0.77) and discriminate the EOUC patients suffering from surgery and hospitalization. In a multivariate analysis, GNRI ≤ 86.82 was a higher risk of hospitalization (OR: 4.0, 95% CI, 2.5–6.5) and surgery (OR: 2.7, 95% CI, 0.98–7.4) than cutoff age ≥ 75 years old (OR of hospitalization and surgery were 1.4 [95% CI, 0.99–2.0] and 2.3 [95% CI, 0.8–6.3], respectively).ConclusionMalnutrition estimated by GNRI was significantly related with poor clinical courses of the EOUC patients, suggesting that evaluation of nutritional status at the onset might be useful for predicting risks of clinical courses.

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Section: Discussionmentioning

confidence: 78%

Relation of geriatric nutritional risk index with clinical risks in elderly‐onset ulcerative colitis

Higashiyama

Komoto

Suzuki

et al. 2020

J of Gastro and Hepatol

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“… 20 , 21 Recent studies have demonstrated that poor nutritional status, screened by the MNA-SF or the full MNA, and frailty are closely related in hospitalized older patients, 22–25 but data on the relationship of GNRI with frailty were lacking. Before designing the present study, only a small study by Rasheedy et al, 26 including 150 hospitalized older patients, used the GNRI to assess its potential in identifying frailty and found a significant association between the GNRI and frailty status. Our results were consistent with the previous finding, but there was a large sample size in our study.…”

Section: Discussionmentioning

confidence: 99%

Association Between Geriatric Nutritional Risk Index and Frailty in Older Hospitalized Patients

Zhao¹,

Hou²,

Zhang³

et al. 2021

CIA

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Objective Previous studies have explored the association between malnutrition and frailty, but no study has investigated whether the Geriatric Nutritional Risk Index (GNRI), a simple and objective nutritional risk screening tool, is associated with the frailty of older adults. The study aimed to examine the relationship between nutrition-related risk, as assessed by the GNRI, and frailty among older hospitalized patients. Methods A cross-sectional study was conducted in the West China Hospital of Sichuan University with 740 patients aged ≥70 years between March 2016 and Jan 2017. Nutritional and frailty status was evaluated with the GNRI and FRAIL scale, respectively. The adjusted and unadjusted ordinal logistic regression analyses were used to examine the relationship between nutritional risk and frailty. The ability of GNRI in detecting frailty was assessed by receiver operating characteristic (ROC) curve analysis. Results The prevalence of low, moderate, and severe nutritional risk among frail patients were 30.1%, 27.6%, and 12.5%, respectively. Ordinal logistic regression analysis showed that malnutrition assessed by the GNRI had a significant association with frailty after adjustment of age, sex, polypharmacy, comorbidity, vision impairment, hearing impairment, cognitive impairment, and depression. In the ROC analysis, the area under the curve for GNRI identifying frailty was 0.698 (95% CI: 0.66–0.74; P <0.001), and the optimal cut-point value was 97.16 (sensitivity: 64.3%; specificity: 66.9%). Conclusion Nutrition-related risk screened by the GNRI was independently associated with frailty. The GNRI could be used as a simple tool in detecting nutritional risk and frailty status of older patients.

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“…Our report shows that in the early post-transplant period, leptin concentration change is mainly dependent on fat mass gain and decreasing handgrip strength. As HGS is a marker of muscle mass and alongside bioimpedance-derived evidence for muscle mass loss after kidney transplantation in study subjects, we suppose that leptin association with GNRI, but not SGA or MIS, could be explained by better GNRI performance in detecting sarcopenia [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Early Post-Transplant Leptin Concentration Changes in Kidney Transplant Recipients

et al. 2021

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Background and Objectives: Kidney transplant recipients represent a unique population with metabolic abnormalities, altered nutritional and immune status, as well as an imbalanced regulation of adipocytokine metabolism. Leptin is a hormonally active protein mainly produced by fat tissue that modulates appetite, satiety, and influences growth, energy, and bone metabolism. There has been great interest in the role of this hormone in chronic kidney disease-related protein energy wasting; thus, a positive leptin correlation with body mass index and fat mass was confirmed. This study was designed to determine the association of pre and post-kidney transplant leptin concentration with nutritional status and body composition. Materials and Methods: We studied 65 kidney transplant recipients. Nutritional status was evaluated before kidney transplantation and 6 months later using three different malnutrition screening tools (Subjective Global Assessment Scale (SGA), Malnutrition Inflammation Score (MIS), and Geriatric Nutritional Risk Index (GNRI)), anthropometric measurements, and body composition (bioelectrical impedance analysis (BIA)). Demographic profile, serum leptin levels, and other biochemical nutritional markers were collected. Statistical analysis was performed with R software. Results: Median age of the studied patients was 45 years, 42% were females, and 12% had diabetes. Leptin change was associated with body weight (p < 0.001), waist circumference (p < 0.001), fat mass (p < 0.001) and body fat percentage (p < 0.001), decrease in parathyroid hormone (PTH) (p < 0.001) transferrin (p < 0.001), diabetes mellitus (p = 0.010), and residual renal function (p = 0.039), but not dependent on dialysis vintage, estimated glomerular filtration rate (eGFR), or delayed graft function at any time during the study. After adjustment for age and sex, body mass index (BMI) (p < 0.001), fat mass (p < 0.001), and body fat percentage (p < 0.001) were independent variables significantly associated with post-transplant leptin change. Lower leptin values were found both before and after kidney transplantation in the SGA B group. GNRI as a nutritional status tool was strongly positively related to changes in leptin within the 6-month follow-up period. Conclusions: Kidney transplant recipients experience change in leptin concentration mainly due to an increase in fat mass and loss of muscle mass. GNRI score as compared to SGA or MIS score identifies patients in whom leptin concentration is increasing alongside an accumulation of fat and decreasing muscle mass. Leptin concentration evaluation in combination with BIA, handgrip strength measurement, and GNRI assessment are tools of importance in defining nutrition status in the early post-kidney transplant period.

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The accuracy of the Geriatric Nutritional Risk Index in detecting frailty and sarcopenia in hospitalized older adults

Cited by 26 publications

References 24 publications

Relation of geriatric nutritional risk index with clinical risks in elderly‐onset ulcerative colitis

Relation of geriatric nutritional risk index with clinical risks in elderly‐onset ulcerative colitis

Association Between Geriatric Nutritional Risk Index and Frailty in Older Hospitalized Patients

Early Post-Transplant Leptin Concentration Changes in Kidney Transplant Recipients

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