ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutritional Epidemiology
This article is part of the Research TopicNutritional Factors, Mental Health, and Growth Outcomes: An Epidemiological Investigation Among Vulnerable PopulationsView all articles
Association between geriatric nutritional risk index and fecal incontinence in individuals with stroke: mediating roles of systemic immune inflammation index and oxidative balance scores
Provisionally accepted
- 1Lishui Central Hospital, Lishui, China
- 2The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
- 3Shanghai 6th Peoples Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
- 4Qingdao University, Qingdao, Shandong, China
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Background: This study aims to investigate the association of geriatric nutritional risk index (GNRI) with fecal incontinence (FI) and fecal incontinence severity index (FISI) in individuals with stroke and to explore potential mechanisms underlying this link. Methods: Data were from the health examination centers of Lishui Municipal Center Hospital and Shanghai Deji Hospital, with 1906 participants. Multivariate logistic regression models, multivariate linear regression models, and restricted cubic spline (RCS) models were applied to assess the association of GNRI with FI and FISI in individuals with stroke. Subgroup analyses and interaction tests were performed to evaluate heterogeneity. Sensitivity analyses were used to test the robustness of the findings. Mediation analysis was employed to investigate the mediating roles of the systemic immune-inflammation index (SII) and oxidative balance score (OBS). Results: After full adjustment for covariates, GNRI demonstrated a significant linear negative association with both FI (OR = 0.69, 95% CI: 0.53-0.81) and FISI (β = -1.08, 95% CI: -1.81 to -0.83)in individuals with stroke. Subgroup analyses confirmed the consistency of these negative associations across all predefined strata, with significant interaction effects observed for BMI categories, smoking status, household income, and diabetes. The SII and OBS were identified as significant mediators of the association of GNRI with FI and FISI in individuals with stroke. Sensitivity analyses revealed that the association of GNRI with both FI and FISI in individuals with stroke remained robust. Conclusions: GNRI has a significant negative linear association with FI and FISI in individuals with stroke, mediated by the SII index and OBS. These results highlight the critical role of anti-inflammatory interventions and antioxidant strategies in mitigating FI risk in individuals with stroke.
Keywords: Geriatric Nutritional Risk Index, Fecal Incontinence, Fecal incontinenceseverity index, systemic immune inflammation index, oxidative balance scores, Stroke
Received: 25 Aug 2025; Accepted: 05 Nov 2025.
Copyright: © 2025 Xiang, Zhu, Shi and Yi. 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: Kefan Yi, ykf224618@163.com
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