To investigate the relationship of high-sensitivity C-reactive protein (hs-CRP), neutrophil/lymphocyte ratio (NLR), and inflammatory burden index (IBI) with malnutrition in patients with chronic heart failure (CHF).

A total of 128 patients with CHF diagnosed in the General Medicine Department of the Eastern Theater Command Hospital of the People's Liberation Army of China from June 2023 to November 2024 were selected. The patients were divided into a mild malnutrition group (CONUT score 2~4), a moderate malnutrition group (CONUT score 5~8), and a normal nutritional status group (CONUT score 0~1) based on the controlled nutritional status (CONUT score). General data, hs-CRP, neutrophils, lymphocytes, albumin, total cholesterol, and other related data of the three groups of patients were collected. The indicators were compared between groups, and Logistic regression analysis was conducted on the inflammatory indicators related to the nutritional status of patients with CHF. The area under the receiver operating characteristic curve (AUC) values of hs-CRP, NLR, and IBI were compared to evaluate their predictive effectiveness for the risk of malnutrition in patients with CHF.

There were statistically significant differences in lymphocyte count, NLR, and IBI between the normal nutritional status group and the mild malnutrition group, and between the moderate malnutrition group and the normal nutritional status group (P<0.05); in hs-CRP between the moderate malnutrition group and the normal nutritional status group (P<0.05); and in hs-CRP and IBI between the moderate malnutrition group and the mild malnutrition group (P<0.05). Malnutrition had significant negative correlations with hs-CRP and IBI (P<0.05). Total cholesterol was weakly negatively correlated with hs-CRP (r=-0.143, P=0.079), NLR (r=-0.081, P=0.323), and IBI (r=-0.155, P=0.057). hs-CRP predicted malnutrition in CHF patients with an AUC of 0.76, a sensitivity of 0.65, and a specificity of 0.86. NLR predicted malnutrition in CHF patients with an AUC of 0.73, a sensitivity of 0.65, and a specificity of 0.84. IBI predicted malnutrition in CHF patients with an AUC of 0.80, a sensitivity of 0.65, and a specificity of 0.86.

The levels of hs-CRP, NLR, and IBI are closely related to the nutritional status of CHF patients, and they have high predictive value for malnutrition in CHF patients. Moreover, the area under the curve of IBI for predicting malnutrition in CHF is larger.