Zercan KALI, Pınar KIRICI, Fatma Tanılır ÇAĞIRAN
European Journal of Therapeutics - 2026;32(3):315-324
Objective: This study investigated the association between the prognostic nutritional index (PNI) and vasomotor symptoms (VMS) in women with natural and surgical menopause, and evaluated whether PNI can independently predict moderate-to-severe VMS. Methods: This cross-sectional study included 84 menopausal women (39 surgical, 45 natural). Demographic and clinical characteristics and VMS were recorded. PNI was calculated using serum albumin and lymphocyte counts. Participants were stratified by menopausal type and VMS severity. Multivariate logistic regression identified independent predictors of moderate/severe VMS, and receiver operating characteristic (ROC) analysis assessed the discriminative performance of PNI. Results: PNI levels were significantly lower in women with surgical menopause compared to natural menopause (39.6 +/- 14.6 vs 50.4 +/- 16.8, p = 0.002). While the prevalence of moderate/severe VMS was similar between groups, symptom severity was higher in surgical menopause. Women with moderate/severe VMS had significantly lower PNI levels than those with mild symptoms (39.8 +/- 14.9 vs 52.1 +/- 15.4, p = 0.001). Lower PNI independently predicted moderate/severe VMS (OR = 0.93, 95% CI: 0.89-0.97, p = 0.001), with each unit increase associated with a 7% risk reduction. Surgical menopause was also independently associated with greater symptom severity (OR = 2.27, p = 0.035). ROC analysis showed moderate discrimination in the overall cohort (AUC = 0.74) and stronger performance in the surgical menopause subgroup (AUC = 0.86). Conclusion: Lower PNI is independently associated with increased VMS severity. Its predictive value is stronger in surgical menopause, suggesting a more prominent role of immune-nutritional status under abrupt estrogen decline. PNI may serve as a practical biomarker for VMS risk stratification.
