Association between Naples Prognostic score and all-cause and cardiovascular mortality in us adults with diabetes mellitus

• Lirong Chen ^[1] ; Change Ma ^[1] ; Hongxia Xiao ^[1] ; Fanling Kong ^[1]
  1. [1] Department of Endocrinology and Nephrology. Hexi University-Affiliated Zhangye People’s Hospital. Zhangye, Gansu. People’s Republic of China
• Localización: Nutrición hospitalaria: Órgano oficial de la Sociedad Española de Nutrición Clínica y Metabolismo (SENPE), ISSN-e 1699-5198, ISSN 0212-1611, Vol. 42, Nº. 4, 2025, págs. 710-719
• Idioma: inglés
• DOI: 10.20960/nh.05658
• Títulos paralelos:
  • Asociación entre la puntuación pronóstica napolitana y la mortalidad por todas las causas y de origen cardiovascular en adultos de EE. UU. con diabetes mellitus
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• Resumen
  • español

    Objetivo: este estudio tiene como objetivo evaluar la relación entre el Naples Prognostic Score (NPS) y la mortalidad por todas las causas y la mortalidad cardiovascular en pacientes adultos estadounidenses con diabetes de tipo 2.

    Método: este estudio utilizó el conjunto de datos de la encuesta nacional de salud y nutrición (NHANES) (2001-2018). Se utilizó el modelo Cox corregido por múltiples variables, el análisis de supervivencia Kaplan-Meier y el análisis de triple empalme restrictivo (RCS) para explorar la asociación entre el NPS en pacientes con diabetes de tipo 2 y la mortalidad por todas las causas y enfermedades cardiovasculares (CVD). Se realizaron análisis de subgrupos basados en la edad, el sexo, el nivel de educación, el IMC, el tabaquismo, el consumo de alcohol, los antecedentes de hipertensión y los antecedentes de hiperlipidemia para explorar más a fondo estas asociaciones.

    Resultados: este estudio incluyó 3.663 pacientes con diabetes de tipo 2. Después de ajustar muchos factores relacionados (todos los valores p son inferiores a 0,001), el NPS se asoció significativamente con la mortalidad por todas las causas y la mortalidad cardiovascular en pacientes con diabetes de tipo 2. En comparación con el grupo 0 (NPS = 0), la relación de riesgo de mortalidad por todas las causas en el Grupo 2 (NPS = 3-4) fue (HR: 2,22, IC 95 %: 1,46-3,38, p < 0,001) y la relación de riesgo de mortalidad cardiovascular también fue (HR = 2,23, IC 95 % = 1,01-4,93, p = 0,047). El RCS mostró que el NPS en pacientes con diabetes de tipo 2 estaba relacionado con la mortalidad por todas las causas y la muerte cardiovascular en forma de J no lineal (no lineal p < 0,0001, no lineal p = 0,0192).

    Conclusiones: los resultados de este estudio sugieren que el NPS puede ser un indicador pronóstico potencial de resultados adversos en pacientes con di

  • English

    Objective: this study aimed to assess the association between the Naples Prognostic Score (NPS) and all-cause as well as cardiovascular mortality in US adults with type 2 diabetes mellitus (T2DM).

    Methods: data were obtained from the National Health and Nutrition Examination Survey (NHANES) spanning 2001-2018. Multivariable-adjusted Cox proportional hazards models, Kaplan-Meier survival analysis, and restricted cubic spline (RCS) analyses were used to evaluate the relationship between NPS and mortality outcomes. Subgroup analyses were conducted based on age, sex, education, body mass index (BMI), smoking status, alcohol consumption, and histories of hypertension and hyperlipidemia.

    Results: a total of 3,663 adults with T2DM were included. Higher NPS was significantly associated with increased all-cause and cardiovascular mortality after adjustment for potential confounders (all p-values < 0.001). Compared to Group 0 (NPS = 0), Group 2 (NPS = 3-4) had a hazard ratio (HR) of 2.22 (95 % CI: 1.46-3.38; p < 0.001) for all-cause mortality and an HR of 2.23 (95 % CI: 1.01-4.93; p = 0.047) for cardiovascular mortality. RCS analysis demonstrated a J-shaped non-linear association between NPS and all-cause and cardiovascular mortality (p for nonlin- earity < 0.0001 and 0.0192, respectively).

    Conclusion: the results of this study suggest that NPS is independently associated with increased risks of all-cause and cardiovascular mor- tality in US adults with T2DM. These findings indicate that NPS may be a useful prognostic marker in this population and help inform clinical management strategies.

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