ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition, Psychology and Brain Health
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1588896
Associations of a prognostic immune and nutritional index with all-cause and causespecific mortality in individuals with depression: Evidence from NHANES 2005-2018
Provisionally accepted
- Anhui Medical University, Hefei, China
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Background: The prognostic immune and nutritional index (PINI) has been used to predict survival outcomes in colon cancer patients. However, the relationship between the PINI and survival outcomes in patients with depression remains unclear. This study aimed to explore the association of the PINI with all-cause and cause-specific mortality in patients with depression.Methods: This study enrolled 6,610 patients with depression from the National Health and Nutrition Examination Survey (2005–2018). Mortality outcomes were determined by National Death Index records through December 31, 2019. Weighted Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for all-cause and cause-specific mortality. Kaplan–Meier curves were used to visualize survival probabilities by PINI levels, and subgroup analyses were performed to assess interactions with key variables. Smoothed curve fitting was also used to examine the non-linear relationship between the PINI and various mortality outcomes in the association. Results: During a median follow-up of 6.5 years, a total of 702 all-cause deaths and 178 Cardiovascular Disease(CVD) deaths were recorded. Higher PINI quartiles were associated with lower all-cause, CVD, and cancer mortality (all P < 0.001). Cox regression showed that the highest PINI quartile had significantly lower hazard ratios for all-cause mortality (HR=0.458, 95% CI: 0.349–0.603), CVD mortality (HR=0.258, 95% CI: 0.134–0.498) and cancer mortality (HR=0.554, 95% CI: 0.284–1.081). A smooth curve fitting analysis revealed an L-shaped inverse relationship between the PINI and all-cause, CVD, and cancer mortality.Conclusion: Higher PINI levels are associated with significantly lower all-cause and CVD mortality in individuals with depression. More large-scale and diverse population studies are needed to clarify the effects of higher PINI levels on all-cause and specific mortality.
Keywords: NHANES, prognostic immune and nutritional index, PINI, Depression, Mortality
Received: 12 Mar 2025; Accepted: 24 Jun 2025.
Copyright: © 2025 Fang, Zhang, Gong, XU and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Yuanhong XU, Anhui Medical University, Hefei, China
Lei Sun, Anhui Medical University, Hefei, China
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