Impact of the Malnutrition on Mortality in Patients With Osteoporosis: A Cohort Study From NHANES 2005-2010

Abstract

BackgroundOsteoporosis is the most common metabolic bone disease. Recent studies have shown that malnutrition can promote the development of osteoporosis. However, the incidence of malnutrition in patients with osteoporosis and the relationship between malnutrition and all-cause mortality has not been adequately studied. Therefore, our study investigated the relationship between malnutrition and all-cause mortality in patients with osteoporosis.MethodsWe analyzed data on 7,700 adults ≥20 years of age during National Health and Nutrition Examination Survey (NHANES) 2005-2010. Each patient was assigned to one of three groups: normal nutritional status, mild malnutrition, and moderate to severe malnutrition. Survival curves and univariate and multivariable cox regressions based on the NHANES recommended weights were used to assess the association between malnutrition status and mortality. Moreover, cox proportional hazards regression analyses were performed on the matched pairs.ResultsOverall, 7,700 eligible individuals with osteoporosis were included in the final analysis, and the mean age was 52.0 ± 0.4 years. From the Kaplan–Meier curves for long-term all-cause mortality of malnutrition, worsening malnutrition status was associated with higher incidence of all-cause mortality. In the fully adjusted models, the adjusted hazard ratio (aHR) was 1.54 [95% confidence interval (CI), 1.02–2.31, p = 0.039] at mild malnutrition status and 2.70 (95%CI, 1.95–3.74, p < 0.001) at moderate to severe malnutrition status. The cox model after matching indicated that malnutrition was still a high mortality risk than no malnutrition (aHR = 2.23, 95% CI, 1.66–3.01, p < 0.001).ConclusionsPoor malnutrition status, common in osteoporotic patients, is strongly associated with a risk for all-cause mortality comparable to that seen with normal nutritional status. These findings highlight the importance of risk stratification for nutritional status in osteoporotic patients and the implementation of strategies that is now available to help prevent malnutrition in these patients.

Osteoporosis de los huesos maxilares

“…Una investigación que debatió sobre cómo los diferentes estados nutricionales afectan el pronóstico de los pacientes con osteoporosis, descubrió que el estado de desnutrición, común en los pacientes osteoporóticos, está estrechamente relacionado con un riesgo de mortalidad por todas las causas en comparación al observado en aquellos con estado nutricional normal. Estos hallazgos subrayan la importancia de evaluar el riesgo del estado nutricional en pacientes con osteoporosis y de implementar estrategias disponibles para prevenir la desnutrición en este grupo de pacientes (18).…”

“… Fosfatasa alcalina total sérica: Otro marcador del recambio óseo, aunque no ofrece valores específicos para zonas óseas particulares (1). Los adultos con hipofosfatasia (HPP) pueden presentar osteoporosis, fracturas de fragilidad y problemas dentales (18).…”

Protein Intake and Bone Health in the Elderly

“…Osteoporosis is linked to a person's lifestyle and eating behaviour. Especially in people over 65, bone mineral density can be affected by their diet [6]. Also, intestinal absorption and appetite decreases with age and the elderly become malnourished more quickly.…”

Analysis of the predictive value of the Geriatric Nutritional Risk Index for osteoporosis in elderly patients with T2DM: a single-center retrospective study

“…Poor nutritional status is an important risk factor for the development of T2DM and osteoporosis. A study by SHANGGUAN et al illustrated that patients with osteoporosis in the presence of nutritional deficiencies have a higher risk of all-cause mortality [ 9 ], and diabetic patients in the presence of nutritional deficiencies have a poorer quality of life than nondiabetic patients [ 10 ].…”