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Association between prognostic nutritional index and complications in children with immunoglobulin A vasculitis

Xiao Xiong¹, Zezheng Liu¹, Huan Li¹

¹Department of Pediatrics, Xiangtan Central Hospital Affiliated to Hunan University, Xiangtan, China.

Frontiers in Nutrition

|September 1, 2026

Abstract

Objective:

This study aimed to evaluate the correlation between prognostic nutritional index (PNI) and complications in immunoglobulin A vasculitis (IgAV) children, including vomiting, abdominal pain, bloody stools, and proteinuria.

Methods:

A retrospective study was conducted on 732 children diagnosed with IgAV at the Xiangtan Central Hospital of the Hunan University between 2014 and 2025. Logistic regression analyses, subgroup analysis, sensitivity analysis, and receiver operating characteristic (ROC) curves were employed to evaluate the association between PNI and vomiting, abdominal pain, bloody stool, and proteinuria.

Results:

Multivariate logistic regression analysis indicated that, each unit increase and one standard deviation (SD) increase in the PNI was associated with a 9.4% reduction (OR = 0.906) and a 50.5% reduction (OR = 0.495) in the risk of vomiting, respectively. Compared to the low PNI group, the high PNI group exhibited a 55.4% reduction in the risk of vomiting (OR = 0.446). Additionally, each unit increase and one SD increase in PNI were linked to a 6.7% (OR = 0.933) and a 38.9% (OR = 0.611) reduction in the risk of abdominal pain, respectively. Furthermore, the high PNI group demonstrated a 60.4% reduction in the risk of abdominal pain (OR = 0.396). For each unit increase and one SD increase in PNI, the risk of bloody stools decreased by 4.9% (OR = 0.951) and 30.3% (OR = 0.697), respectively. Moreover, the high PNI group exhibited a 52.2% reduction in the risk of bloody stools (OR = 0.478). Additionally, for each unit increase and one SD increase in PNI, the risk of proteinuria decreased by 6.6% (OR = 0.934) and 38.5% (OR = 0.615), respectively. Compared to the low PNI group, the high PNI group exhibited a 47.0% reduction in the risk of proteinuria (OR = 0.530). And Most subgroup and sensitivity analyses confirmed the stability of the results (p < 0.05). ROC analysis indicated that PNI was significantly correlated with vomiting, abdominal pain, bloody stools, and proteinuria (p < 0.05).

Conclusion:

Higher levels of PNI were significantly associated with a lower risk of vomiting, abdominal pain, bloody stools, and proteinuria in IgAV children.

Keywords:

abdominal pain bloody stool immunoglobulin A vasculitis prognostic nutritional index proteinuria vomiting

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