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90 Tsunou et al. | Journal of Clinical and Translational Research 2024; 10(1): 85-92
were arranged in descending order of PNI value, the PNI cutoff 5. Conclusion
value of 50 for patients with NI shown in this study was next to the
cutoff value for non-ST segment elevation myocardial infarction, The PNI was found to be the strongest determinant of
which was 50.7 [18]. The PNI cutoff in this study was the second osteoporosis in patients with NI. The PNI instead of serum
highest. The cutoff value to identify osteoporosis in patients Vitamin D levels can potentially be used as a surrogate for BMD
with NI was 50, which is the second highest among non-cancer in institutionalized and homebound patients who do not have
diseases. It has been suggested that this may be largely due to the BMD measurement devices.
loss of mobility. However, there is insufficient evidence to conclude Acknowledgments
that the magnitude of the PNI cutoff indicates the magnitude of
inflammation underlying the target disease. Therefore, it is necessary We are grateful to Professor Eiji Yamato from the Department
to investigate whether diseases with the same PNI cutoff can be of Food Science and Nutrition, Mukogawa Women’s University,
considered equivalent in terms of the incidence of inflammation and Japan, for his collaboration on all parts of this study.
inflammation-related adverse events based on other aspects, such Funding
as cytokine storm parameters.
None to declare.
4.4. Strengths and limitations
Conflicts of Interest
To the best of our knowledge, this is the first study to report
that PNI can be used to diagnose osteoporosis in patients with The authors declare no conflicts of interest.
NI. We added the PNI cutoff value for patients with NI who are
bedridden in hospitals. If these patients have osteoporosis with a Ethics Approval and Consent to Participate
PNI lower than the cutoff value, they may have a high probability Informed consent was obtained using the opt-out method
of developing osteoporosis and experiencing adverse events. This and the study was approved by the Research Center’s Ethics
information can notify caregivers to pay care-related attention to Committee (R04-001).
them to avoid adverse events such as aspiration pneumonia or
choking during eating or drinking. In addition, for patients living Consent for Publication
at home or in facilities without BMD measurement equipment,
PNI can be a feasible substitute if it can be measured through The authors obtained the written informed consent from the
blood testing instead of a bone density scan. In subsequent care, subjects for publishing their data.
this may help screen for osteoporosis and prevent complications, Availability of Data
such as aspiration or pneumonia.
This study has several limitations. In the first study, the PNI was Datasets generated during and/or analyzed during the present
shown to be effective in predicting adverse events in patients with study, as well as the list of 1000 PNI-related articles and the
cancer [4,16,17]. Since the publication of the first article, there extracted PNI cutoff values from 76 articles, are available from
have been at least 76 reports on the efficacy of PNI to establish it the corresponding author on reasonable request.
as a predictor of noncancerous AEs (Figure 2). The present study References
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DOI: https://doi.org/10.36922/jctr.00110