ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1625281
This article is part of the Research TopicDietary Pattern and Metabolic SyndromeView all articles
Geriatric Nutritional Risk Index and mortality in individuals with prediabetes and diabetes: a longitudinal cohort study
Provisionally accepted
- 1Second Affiliated Hospital of Nanchang University, Nanchang, China
- 2Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
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Background: This study examines the relationship between Geriatric Nutrition Risk Index (GNRI) and all-cause and cardiovascular mortality in individuals with prediabetes and diabetes, aiming to guide clinical nutrition management and extend life expectancy.Methods: We analyzed a weighted sample of 7640 individuals with prediabetes and diabetes from the NHANES 2005-2018 and the NCI database. Nutritional status was assessed using the GNRI. Survival outcomes, including all-cause and cardiovascular mortality, were analyzed using Cox proportional hazards regression models and Kaplan-Meier survival curves. Subgroup analyses and restricted cubic spline (RCS) regressions were further conducted to evaluate the robustness and potential nonlinear relationships between GNRI and mortality outcomes.Results: Over a median follow-up of 8.00 years, 1210 participants died, including 319 from cardiovascular diseases. Kaplan-Meier curves revealed significantly lower survival rates for both mortalities in participants with low GNRI. Fully adjusted COX regression models revealed a 2.50-fold (95% CI 2.14-2.92, P < 0.001) increased risk of all-cause mortality and a 2.78-fold (95% CI 2.04-3.77, P < 0.001) increased risk of cardiovascular mortality in the low GNRI group. These associations remained robust across subgroup analyses. RCS analyses presented nonlinear associations between GNRI and both mortalities (both P-non-linear < 0.05, P-overall < 0.05).Conclusions: GNRI demonstrated a significant, negative, and nonlinear association with all-cause and cardiovascular mortality in US individuals with prediabetes and diabetes, highlighting its utility in improving survival outcomes through nutritional assessment.
Keywords: Nutritional Status, Geriatric Nutritional Risk Index, diabetes, prediabetes, All-cause mortality, Cardiovascular mortality
Received: 08 May 2025; Accepted: 23 Jun 2025.
Copyright: © 2025 Qiao, Li, Peng, Xie, Wu, Li and Tang. 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: Zhenyu Tang, Second Affiliated Hospital of Nanchang University, Nanchang, China
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