Relationship of prognostic nutritional index with anemia and all-cause mortality: a NHANES study

Background The present study systematically explores the correlation between the Prognostic Nutritional Index (PNI) and anemia, and further analysis of its association with all-cause mortality among populations affected by anemia.Methods Data were taken from the National Health and Nutrition Examina...

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Main Authors: Yongjin Zhi, Shuojing Bao, Jingcheng Mao, Hui Zhu, Jianfeng Zhu
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Hematology
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Online Access:https://www.tandfonline.com/doi/10.1080/16078454.2025.2536402
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author Yongjin Zhi
Shuojing Bao
Jingcheng Mao
Hui Zhu
Jianfeng Zhu
author_facet Yongjin Zhi
Shuojing Bao
Jingcheng Mao
Hui Zhu
Jianfeng Zhu
author_sort Yongjin Zhi
collection DOAJ
description Background The present study systematically explores the correlation between the Prognostic Nutritional Index (PNI) and anemia, and further analysis of its association with all-cause mortality among populations affected by anemia.Methods Data were taken from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. We utilized multiple logistic regression models, Cox proportional hazards models, restricted cubic spline (RCS) analysis, and time-dependent receiver operating characteristic (ROC) analysis. As for the verification of the result robustness, subgroup and sensitivity analyses were implemented.Results A cohort of 28,511 participants was examined, of whom 2647 (9.28%) had anemia. An inverse relationship of PNI with anemia was detected in the fully adjusted model (OR = 0.82, 95%CI: 0.80–0.84). Cox regression showed that lower PNI levels were linked to higher all-cause mortality in people with anemia (HR = 0.91, 95%CI: 0.88–0.95). A non-linear correlation between PNI and mortality was detected through RCS analysis (P < 0.001). Significant interaction effects of PNI with mortality were observed across diabetes and BMI subgroups (P < 0.05). The predictive power of PNI for all-cause mortality among anemia individuals showed areas under the curve (AUC) values of 0.702, 0.806, and 0.813 for 3-, 5-, and 10-year predictions, respectively.Conclusion PNI demonstrates a negative association with anemia and a similar negative relationship with all-cause mortality in individuals with anemia. Future studies are warranted to substantiate these findings.
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spelling doaj-art-ee50e34b95e5423da9f304c8253122c42025-08-20T03:55:54ZengTaylor & Francis GroupHematology1607-84542025-12-0130110.1080/16078454.2025.2536402Relationship of prognostic nutritional index with anemia and all-cause mortality: a NHANES studyYongjin Zhi0Shuojing Bao1Jingcheng Mao2Hui Zhu3Jianfeng Zhu4Department of Hematology, Taizhou People’s Hospital Affiliated to Nanjing Medical University, Taizhou, People’s Republic of ChinaDepartment of General Practice, Zhangdian People’s Hospital, Taizhou, People’s Republic of ChinaDepartment of Hematology, Taizhou People’s Hospital Affiliated to Nanjing Medical University, Taizhou, People’s Republic of ChinaDepartment of Hematology, Taizhou People’s Hospital Affiliated to Nanjing Medical University, Taizhou, People’s Republic of ChinaDepartment of Hematology, Taizhou People’s Hospital Affiliated to Nanjing Medical University, Taizhou, People’s Republic of ChinaBackground The present study systematically explores the correlation between the Prognostic Nutritional Index (PNI) and anemia, and further analysis of its association with all-cause mortality among populations affected by anemia.Methods Data were taken from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018. We utilized multiple logistic regression models, Cox proportional hazards models, restricted cubic spline (RCS) analysis, and time-dependent receiver operating characteristic (ROC) analysis. As for the verification of the result robustness, subgroup and sensitivity analyses were implemented.Results A cohort of 28,511 participants was examined, of whom 2647 (9.28%) had anemia. An inverse relationship of PNI with anemia was detected in the fully adjusted model (OR = 0.82, 95%CI: 0.80–0.84). Cox regression showed that lower PNI levels were linked to higher all-cause mortality in people with anemia (HR = 0.91, 95%CI: 0.88–0.95). A non-linear correlation between PNI and mortality was detected through RCS analysis (P < 0.001). Significant interaction effects of PNI with mortality were observed across diabetes and BMI subgroups (P < 0.05). The predictive power of PNI for all-cause mortality among anemia individuals showed areas under the curve (AUC) values of 0.702, 0.806, and 0.813 for 3-, 5-, and 10-year predictions, respectively.Conclusion PNI demonstrates a negative association with anemia and a similar negative relationship with all-cause mortality in individuals with anemia. Future studies are warranted to substantiate these findings.https://www.tandfonline.com/doi/10.1080/16078454.2025.2536402Prognostic nutritional indexanemiaall-cause mortalityNHANES
spellingShingle Yongjin Zhi
Shuojing Bao
Jingcheng Mao
Hui Zhu
Jianfeng Zhu
Relationship of prognostic nutritional index with anemia and all-cause mortality: a NHANES study
Hematology
Prognostic nutritional index
anemia
all-cause mortality
NHANES
title Relationship of prognostic nutritional index with anemia and all-cause mortality: a NHANES study
title_full Relationship of prognostic nutritional index with anemia and all-cause mortality: a NHANES study
title_fullStr Relationship of prognostic nutritional index with anemia and all-cause mortality: a NHANES study
title_full_unstemmed Relationship of prognostic nutritional index with anemia and all-cause mortality: a NHANES study
title_short Relationship of prognostic nutritional index with anemia and all-cause mortality: a NHANES study
title_sort relationship of prognostic nutritional index with anemia and all cause mortality a nhanes study
topic Prognostic nutritional index
anemia
all-cause mortality
NHANES
url https://www.tandfonline.com/doi/10.1080/16078454.2025.2536402
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