Table 1_Association between cerebral small vessel disease and malnutrition risk: a retrospective cross-sectional study.docx

IntroductionMalnutrition is associated with increased morbidity and mortality from multiple diseases. However, the relationship between cerebral small vessel disease (CSVD) and malnutrition or malnutrition risk remains underexplored. This retrospective study investigated the association between malnutrition risk and CSVD, along with its common imaging markers.
MethodsA total of 806 participants from a neurology department underwent cranial MRI scans and nutritional assessments. The presence of imaging markers of CSVD, including white matter hyperintensities, lacune, perivascular spaces, and cerebral microbleeds, was evaluated by expert neurologists. Malnutrition risk was assessed using the Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status (CONUT) scores. Logistic regression, subgroup, and interaction analyses were performed to evaluate the associations between malnutrition risk, CSVD, and its common imaging markers.
Results and discussionAfter adjusting for potential confounders, patients at risk of malnutrition, as identified by both the GNRI and CONUT scores, exhibited more severe CSVD and its common imaging markers. Further analyses revealed interactions between GNRI score and smoking, highlighting potential modifying effects on the relationship between malnutrition risk and CSVD. Collectively, malnutrition risk, as assessed by objective nutritional indices, is independently associated with CSVD and its common imaging markers. These results emphasize the importance of addressing malnutrition in the prevention and management of CSVD.

引言
营养不良与多种疾病的发病率及死亡率升高密切相关。然而，目前关于脑小血管病（cerebral small vessel disease, CSVD）与营养不良或营养不良风险之间的关联仍有待深入探索。本项回顾性研究旨在探讨营养不良风险与脑小血管病及其常见影像学标志物之间的关联。

研究方法
本研究纳入了某神经内科共806名参与者，所有参与者均接受了颅脑MRI扫描与营养评估。由资深神经科医师对脑小血管病的影像学标志物（包括脑白质高信号、腔隙性病灶、血管周围间隙扩大及脑微出血）进行评定。采用老年营养风险指数（Geriatric Nutritional Risk Index, GNRI）与营养控制状态评分（Controlling Nutritional Status, CONUT）评估参与者的营养不良风险。通过Logistic回归分析、亚组分析及交互作用分析，探究营养不良风险与脑小血管病及其常见影像学标志物之间的关联。

结果与讨论
在校正潜在混杂因素后，经GNRI与CONUT评分均判定为存在营养不良风险的患者，其脑小血管病及常见影像学标志物的严重程度更高。进一步分析显示，GNRI评分与吸烟行为存在交互作用，提示吸烟可能对营养不良风险与脑小血管病之间的关联存在修饰效应。综合来看，经客观营养指标评估的营养不良风险与脑小血管病及其常见影像学标志物独立相关。本研究结果强调了在脑小血管病的预防与管理中重视营养不良干预的重要性。