{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T05:49:28Z","timestamp":1789192168211,"version":"build-2803163510"},"reference-count":23,"publisher":"Asian Spine Journal (ASJ)","issue":"6","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Medtronic Sofamor Danek Inc."},{"name":"Japan Medical Dynamic Marketing Inc."},{"name":"Meitoku Medical Institution Jyuzen Memorial Hospital"}],"content-domain":{"domain":["asianspinejournal.org"],"crossmark-restriction":true},"short-container-title":["Asian Spine J"],"published-print":{"date-parts":[[2025,12,31]]},"abstract":"<jats:p>Study Design: A prospective cohort study.Purpose: To determine the age-specific normative values of the prognostic nutritional index (PNI) among elderly residents in Japan and explore the relationship between malnutrition and spinal alignment.Overview of Literature: Nutritional status affects postoperative recovery, with malnourished patients often experiencing severe postoperative complications. PNI is a known nutritional indicator based on serological value; however, there is a dearth of age-specific normative values for PNI, with even less research on the impact of malnutrition on spinal alignment.Methods: We included 237 participants from a 2-yearly resident health checkup conducted in Toei, Aichi, Japan. Participants underwent blood tests and whole-spine standing radiography, and were stratified based on age (60s, 70s, and 80s) and sex to determine age-specific normative PNI values. Additionally, participants were categorized into a lower PNI (PNI &lt;50) or higher PNI (PNI \u226550) group to compare spinal alignment.Results: The average PNI values for different age groups were: 60s: males (n=13): 50.7, females (n=31): 50.9; 70s: males (n=55): 50.3, females (n=57): 50.1; 80s: males (n=28): 49.1, females (n=53): 48.3. For females, the radiographic spinal alignment parameters were comparable between the lower and higher PNI groups; however, in males, significant differences were noted for pelvic tilt (20\u00b0 vs. 16\u00b0, p=0.020), lumbar lordosis (35\u00b0 vs. 44\u00b0, p&lt;0.001), and pelvic incidence minus lumbar lordosis (10\u00b0 vs. 4\u00b0, p=0.013).Conclusions: Malnutrition in males negatively impacts their lumbar-pelvic alignment. While the normative PNI value decreases with age, the two variables show a very weak correlation.<\/jats:p>","DOI":"10.31616\/asj.2024.0547","type":"journal-article","created":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T23:58:11Z","timestamp":1756684691000},"page":"987-1000","update-policy":"https:\/\/doi.org\/10.31616\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A prospective study on age-specific normative values of the prognostic nutritional index and the effects of malnutrition on spinal alignment using health checkup data of elderly 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