[1]彭玉姣,黄晶晶,吴颖升,等.基于NHANES2011～2014数据分析握力相关恶病质指数与肝功能异常人群全因死亡相关性研究[J].现代检验医学杂志,2025,40(06):137-141，170.[doi:10.3969/j.issn.1671-7414.2025.06.025]
　PENG Yujiao,HUANG Jingjing,WU Yingsheng,et al.Study on the Correlation between Hand Grip Strength-baseed Cachexia Index and All-Cause Mortality in A Population with Abnormal Liver Function Based on NHANES 2011~2014 Data[J].Journal of Modern Laboratory Medicine,2025,40(06):137-141，170.[doi:10.3969/j.issn.1671-7414.2025.06.025]
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基于NHANES2011～2014数据分析握力相关恶病质指数与肝功能异常人群全因死亡相关性研究()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第40卷
期数:
2025年06期
页码:
137-141，170
栏目:
论著
出版日期:
2025-11-15

文章信息/Info

Title:
Study on the Correlation between Hand Grip Strength-baseed Cachexia Index and All-Cause Mortality in A Population with Abnormal Liver Function Based on NHANES 2011~2014 Data
文章编号:
1671-7414（2025）06-137-06
作者:
彭玉姣，黄晶晶，吴颖升，卢 露，陈焕灵，杜沅沁
广西中医药大学第一附属医院脾胃肝病科，南宁 530000
Author(s):
PENG Yujiao，HUANG Jingjing，WU Yingsheng，LU Lu，CHENG Huanlin，DU Yuanqin
Department of Spleen, Gastroenterology and Hepatology, the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine, Nanning 530000, China
关键词:
基于握力的恶病质指数; 全因死亡率; 国家健康和营养检查调查; 肝功能异常
分类号:
R195.4；R446.112
DOI:
10.3969/j.issn.1671-7414.2025.06.025
文献标志码:
A
摘要:
目的探究基于握力（HGS）的癌症恶病质指数(H-CXI）水平与肝功能异常人群全因死亡率的关系。方法研究基于2011～2014年美国国家健康和营养检查调查（NHANES）数据，纳入2752例肝功能异常的人群，并随访至2019年12月31日，采用Kaplan-Meier生存分析和COX回归模型评估H-CXI水平与全因死亡率之间的关系，进行限制性立方样条分析探索两者的非线性关系。结果在平均82.70±3.86个月的随访时间中，有244例全因死亡人数。将H-CXI作为分类变量（四分位数）进行分析，COX回归分析显示在模型2中，与Q1组相比，Q2，Q3和Q4组全因死亡风险降低（HR=0.41,95%CI：0.21～0.82,P=0.0121；HR=0.34,95%CI：0.16～0.69,P=0.0031；HR=0.24,95%CI：0.09～0.67,P=0.0063）。亚组分析显示中风与全因死亡率存在交互作用，限制性立方样条揭示H-CXI水平与全因死亡率呈非线性关系。结论H-CXI水平与肝功能异常人群的全因死亡风险呈负相关，临床实践中需关注H-CXI水平，以预防不良健康结局。
Abstract:
Objective To investigate the relationship between the level of hand grip strength(HGS)-based cachexia index (H-CXI) and all-cause mortality in a population with abnormal liver function. Methods The study was based on the America National Health and Nutrition Examination Survey (NHANES) data from 2011~2014, which included 2 752 cases of people with abnormal liver function and followed up until December 31, 2019, using Kaplan-Meier survival analysis and COX regression modeling to assess the relationship between H-CXI levels and all-cause mortality, and restricted cubic spline analysis to explore the nonlinear relationship. Results There were 244 all-cause deaths during a mean follow-up time of 82.70 ± 3.86 months. H-CXI was ana-lyzed as a categorical variable (quartiles), and Cox regression analyses showed that in model 2, the risk of all-cause mortality was reduced in groups Q2, Q3 and Q4 compared with group Q1 (HR=0.41, 95%CI: 0.21 ~ 0.82, P=0.012 1; HR=0.34, 95%CI: 0.16 ~0.69, P=0.003 1; HR = 0.24, 95%CI: 0.09 ~ 0.67, P=0.006 3). Subgroup analyses revealed an interaction between stroke and all-cause mortality, and restricted cubic spline revealed a nonlinear relationship between H-CXI levels and all-cause mortality. Con-clusion H-CXI levels are negatively associated with the risk of all-cause mortality in people with abnormal liver function, and attention to H-CXI levels is needed in clinical practice to prevent adverse health outcomes.

参考文献/References:

[1] RAJAK S, RAZA S, SINHA R A. ULK1 signaling in the liver: autophagy dependent and independent actions[J]. Fron-tiers in Cell and Developmental Biology, 2022, 10: 836021.
[2] ASRANI S K, DEVARBHAVI H, EATON J, et al. Bur-den of liver diseases in the world[J]. Journal of Hepa-tology, 2019, 70(1): 151-171.
[3] XIE H L, RUAN G T, WEI L S, et al. Hand grip strength-based cachexia index as a predictor of cancer cachexia and prognosis in patients with cancer[J]. Journal of Cachexia, Sarcopenia and Muscle, 2023, 14(1): 382-390.
[4] 闫美田,郑雨桐,孙艳美,等.新型冠状病毒肺炎患者血液CRP,CREA,ALB,IL-6水平检测对疾病预后的应用价值分析[J].现代检验医学杂志,2020.35(5): 106-109. YAN M T, ZHENG Y T, SUN Y M, et al. Analysis of the value of detection of blood CRP,CREA,ALB and IL-6 level in patients with new coronavirus pneumonia to the prognosis of the disease[J]. Journal of Modern Laboratory Medicine, 2020, 35(5): 106-109.
[5] HANBERG J S, FREIBERG M S, GOETZ M B, et al. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as prognostic inflammatory biomarkers in hu-man immunodeficiency virus (HIV), hepatitis C virus (HCV), and HIV/HCV coinfection[J]. Open Forum Infectious Diseases, 2019, 6(10): ofz347.
[6] HADZIBEGOVIC S, PORTHUN J, LENA A, et al. Hand grip strength in patients with advanced cancer: a prospective study[J]. Journal of Cachexia, Sarcopenia and Muscle, 2023, 14(4): 1682-1694.
[7] AKINBAMI L J, TE-CHING C, ORLANDO D, et al. National health and nutrition examination survey, 2017–March 2020 prepandemic file:sample design,estimation,and analytic guidelines[J]. Vital and Health Statistics. Ser. 1, Programs and Collection Procedures, 2022 (190): 1-36.
[8] YAN L S, HU X Y, WU S S, et al, Association between grip strength and albuminuria in the general United States population: NHANES 2011-2014[J]. Frontiers in Public Health, 2024, 12: 1353881.
[9] SHI T, WANG Y, PENG Y Z, et al. Advanced lung cancer inflammation index combined with geriatric nutritional risk index predict all-cause mortality in heart failure patients[J]. BMC Cardiovascular Disorders, 2023, 23(1): 565.
[10] XU J, XU Z X, YANG Q F, et al. Association between the sarcopenia index and abnormal liver function in the adult population in the United States: a cross-sectional study[J]. Frontiers in Medicine (Lausanne), 2023, 10: 1266253.
[11] XU W, FENG Y T, ABDULLAH G, et al. Association between the AHA life’s essential 8 and prediabetes/dia-betes: a cross-sectional NHANES study[J]. Frontiers in Endocrinology, 2024, 15: 1376463.
[12] CHEN J H, LIU Z H, YANG L C, et al. Relationship between nocturia and hypertension: findings from the NHANES 2005-2016[J]. Frontiers in Cardiovascular Medicine, 2023, 10: 1165092.
[13] SHi R F, YANG F, WU H L, et al. The diagnostic value of liver biopsy for unexplained liver dysfunction: a ret-rospective study[J]. Journal of Multidisciplinary Health-care, 2024, 17: 2399-2407.
[14] YAN X, ZHANG S Y, JIA J M, et al. Total parenteral nutrition treatment improves the nutrition status of gynecological cancer patients by improving serum albumin level[J]. Frontiers in Medicine(Lausanne), 2022, 8: 759387.
[15] SHEINENZON A, SHEHADEH M, MICHELIS R, et al. Se-rum albumin levels and inflammation[J]. International Journal of Biological Macromolecules, 2021, 184: 857-862.
[16] VAISHYA R, MISRA A, VAISH A, et al. Hand grip strength as a proposed new vital sign of health: a narra-tive review of evidences[J]. Journal of Health, Popula-tion, and Nutrition, 2024, 43(1): 7.
[17] CHAKRAVARTHY M V, SIDDIQUI M S, FORSGREN M F, et al. Harnessing muscle-liver crosstalk to treat nonalcoholic steatohepatitis[J]. Frontiers in Endocrinolo-gy, 2020, 11: 592373.
[18] KUMAR R, PRAKASH S S, PRIYADARSHI R N, et al. Sarcopenia in chronic liver disease: a metabolic perspec-tive[J]. Journal of Clinical and Translational Hepatology, 2022, 10(6): 1213-1222.
[19] 严夏继,纪雯涓,朱晓骏,等.慢性肝病合并肌少症的中医证候调查及影响因素分析[J].上海中医药杂志, 2024, 58 (5): 19-23. YAN X J,JI W J,ZHU X J. et al.Investigation of tradi-tional Chinese medicine syndromes and analysis of in-fluencing factors in chronic liver disease complicated by sarcopenia[J].Shanghai Journal of Traditional Chinese Medicine,2024,58(5):19-23.
[20] HANAI T, SHIRAKI M, IMAI K, et al. Reduced hand-grip strength is predictive of poor survival among pa-tients with liver cirrhosis: a sex-stratified analysis[J]. Hepatology Research, 2019, 49(12): 1414-1426.
[21] ZHAI L P, PEI H Y, YANG Y, et al. NOX4 promotes Kupffer cell inflammatory response via ROS-NLRP3 to aggravate liver inflammatory injury in acute liver inju-ry[J]. Aging (Albany NY), 2022, 14(17): 6905-6916.
[22] LIU J, LI H, XIA J, et al. Baseline neutrophil-to-lym-phocyte ratio is independently associated with 90-day transplant-free mortality in patients with cirrhosis[J]. Frontiers in Medicine, 2021, 8: 726950.
[23] ZHANG D Y, ZENG H L, PAN Y X, et al. Liver tumor markers, HALP score, and NLR: simple, cost-effective, easily accessible indexes for predicting prognosis in ICC patients after surgery[J]. Journal of Personalized Medi-cine, 2022, 12(12): 2041.
[24] LO C H, LEE H L, HSIANG C W, et al. Pretreatment neutro-phil-to-lymphocyte ratio predicts survival and liver toxicity in patients with hepatocellular carcinoma treated with stereotactic ablative radiation therapy[J]. International Journal of Radiation Oncology, Biology, Physics, 2021, 109(2): 474-484.
[25] CAI X H, TANG Y M, CHEN S R, et al. Prognostic val-ue of neutrophil-to-lymphocyte ratio in end-stage liver disease: a meta-analysis[J]. World Journal of Hepatolo-gy, 2024, 16(3): 477-489.
[26] YAN X L, WU L M, TANG X B, et al. Comparison of the cachexia index based on hand-grip strength (H-CXI) with the original CXI for the prediction of cancer cachexia and progno-sis in patients who underwent radical colectomy for colorectal cancer[J]. Frontiers in Nutrition, 2024, 11: 1290299.

备注/Memo

备注/Memo:
基金项目：广西自然科学基金项目（2022GXNSFAA035460,2024GXNSFDA010005）；广西研究生教育创新计划(YCSW2023395)。
作者简介：彭玉姣（1998-），女，本科，初级医师，研究方向：肝胆防治，E-mail：2502224348@qq.com。
通讯作者：黄晶晶（1982-），女，教授，主任医师，研究方向：肝胆系病证防治研究，E-mail：55869563@qq.com。
更新日期/Last Update: 2025-11-15