Correlation Of Nutritional Risk And Peripheral T Lymphocytes In The Elderly

ObjectiveThe study aimed to explore the correlation of nutritional risk and peripheral T lymphocyte subsets in the elderly.MethodsA total of 109 elderly patients(57 males and 52 females)admitted to The Affiliated Hospital of Qingdao University from August 2020 to September 2021 were selected.All patients were evaluated for nutritional risk.According to the NRS 2002 score,the patients were divided into nutritional risk group and normal nutrition group,including 43 patients with nutritional risk and 66 patients with normal nutrition.The peripheral blood CD4~+T lymphocytes,CD8~+T lymphocytes and the ratio of CD4~+/CD8~+T lymphocytes were measured.Multiple clinical test results of the patients were also collected,including blood lipid,hemoglobin(Hb),albumin(Alb),white blood cell count,neutrophil count,skeletal muscle mass index(SMI)etc.General data,white blood cell count,neutrophil count,blood lipid,Alb,Hb,CD4~+T cells,CD8~+T cells,CD4~+/CD8~+T cells ratio were compared to explore the differences between the two groups of patients.Excel 2019 was used to sort the data and SPSS 26.0 software was used for statistical analysis.The measurement data were expressed as x±s.The comparison of the measurement data of the two groups was using the independent sample t-test.And the count data was expressed by the number of cases and percentages.The comparison of the count data of the two groups was using the X~2 test.Spearman correlation and logistic regression were used to analyze the relationship between nutritional risk and factors in the elderly,and the receiver operating characteristic(ROC)curve was used to analyze the predictive value of nutritional risk in the elderly.P<0.05 was considered statistically significant.Results1.Among the elderly patients,the nutritional risk prevalence rate was 39.45%,including 38.60%in males and 40.38%in females.2.Comparison of general data:Compared with normal nutrition group,there were statistically significant differences in age,height,weight,body mass index(BMI)and SMI in nutritional risk group(P<0.05).There was no significant difference in gender,chronic disease(hypertension,cerebral infarction,diabetes).3.Comparison of laboratory indicators:There were significant differences in Hb and Alb between the two groups(P<0.05).There was no significant difference in WBC,NEUT,low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC)and triglyceride(TG).4.Comparison of cytokines;There was significant difference in IL6 between nutritional risk group and normal nutrition group(P<0.05),but no significant difference in IL10,TNFαand IFN-γ.5.Comparison of T lymphocytes:The ratio of CD4~+/CD8~+T cells in the nutritional risk group was higher than that in the other group[2.31(1.59,3.06)vs 1.87(1.38,2.40),P<0.05].There was no significant difference in CD4~+T cells and CD8~+T cells.6.CD4+/CD8+T cell ratio,age and IL6 were significantly positively correlated with NRS 2002(r=0.200.P=0.037<0.05;r=0.330,P<0.001;r=0.200,P=0.037<0.05).SMI,weight,BMI,Hb and Alb were significantly negatively correlated with NRS 2002(r=-0.445,P<0.001;r=-0.318,P=0.001<0.05;r=-0.263,P=0.006<0.05;r=-0.357,P<0.001;r=-0.411,P<0.001)7.Taking nutritional risk as the dependent variable and the above statistically significant indicators as the independent variables.After adjusting for age,BMI,Hb,Alb,SMI and IL6 confounders,logistic regression analysis showed that CD4~+/CD8~+was an independent risk factor for nutritional risk in elderly patients(OR 2.290,P=0.006<0.05).Hb,Alb and BMI were not independent risk factors,while age and IL6 were independent risk factors for nutritional risk in old age(OR 1.084,P=0.043<0.05;OR 1.170,P=0.009<0.05),SMI was a protective factor(OR 0.428,P=0.005<0.05).8.The optimal CD4~+/CD8~+cutoff point was 2.135,sensitivity was 62.8%and specificity was 66.7%,[95%confidence interval(CI):0.506-0.731,area under curve(AUC):0.618,P=0.038<0.05].The optimal age cutoff point was 2.135,sensitivity was74.4%and specificity was 62.1%,[95%CI:0.590-0.799,AUC:0.694,P=0.001<0.05].The optimal SMI cutoff point was 7.75,sensitivity was 76.7%and specificity was 63.6%,[95%CI:0.670-0.850,AUC:0.760,P<0.001].The optimal IL-6 cutoff point was 11.9,sensitivity was 27.8%and specificity was 100%,[95%CI:0.502-0.734,AUC:0.618,P=0.038<0.05].The area under the curve of CD4~+/CD8~+combined with IL6 was0.774(95%CI:0.684-0.865,P<0.001).Conclusion1.The elderly have a high incidence of nutritional risk,whose risk factors include age,IL6,CD4~+/CD8~+T cell ratio.SMI was protective factor for nutritional risk in geriatric patients2.The ratio of CD4~+/CD8~+T cells in elderly patients with nutritional risk was significantly higher,and there was a positive correlation between the ratio of CD4~+/CD8~+T cells and nutritional risk.3.The ratio of CD4~+/CD8~+T cells,IL6,SMI and age can predict nutritional risk in elderly patients.CD4~+/CD8~+may be an adjunctive nutritional indicator in the elderly.