Clinical nutrition ESPEN最新文献_第10页

Body composition and phase angle as prognostic factors in adults with acute lymphoblastic leukemia 成人急性淋巴细胞白血病的体成分和相位角与预后的关系。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2025-10-20 DOI: 10.1016/j.clnesp.2025.10.006

Víctor Itaí Urbalejo Ceniceros , Omar Eduardo Fernandez Vargas , Erendira Baltazar Luna , Evelin Valeria Moreno Vargas , Mistral Castellanos Mares , Patricia Carolina Figueroa Hernández , Dana Aline Pérez Camargo

Introduction

The prognostic role of body composition and phase angle (PhA) in adult patients with acute lymphoblastic leukemia (ALL) remains unclear. This study evaluates the impact of body composition parameters and PhA on overall survival (OS) and disease-free survival (DFS) in ALL patients receiving intensive chemotherapy.

Methods

We conducted a retrospective analysis of 81 adult ALL patients. Baseline body composition was assessed at ALL diagnosis and before therapy using bioelectrical impedance analysis (BIA), including body fat mass (BFM), fat mass index (FMI), fat-free mass (FFM), fat free mass index (FFMI), and PhA. Kaplan–Meier curves and log-rank tests were employed to compare survival outcomes across body composition and PhA categories. Cox regression was used for multivariate analysis to confirm findings.

Results

The median age at diagnosis was 25 years (range: 16–67), with 56.8 % being male and 91.3 % having B-cell ALL. A significant association was observed between lower PhA (≤4°) and poorer OS (p = 0.02). Similarly, patients with a FFMI <16 kg/m² had inferior OS (p = 0.0163). A body mass index (BMI) ≥25 showed a trend toward worse OS but was not statistically significant. Multivariate Cox regression confirmed that PhA ≤4° (HR 3.148, 95%CI 1.55–6.27), hypoalbuminemia (HR 2.233, 95%CI 1.09–4.54), and very high-risk cytogenetics (HR 2.310, 95%CI 1.15–4.62) were independent prognostic factors for worse OS.

Conclusion

PhA and FFMI serve as prognostic markers in adult ALL patients. Lower PhA and reduced FFMI are associated with poorer survival, underscoring the need for early nutritional assessment and potential interventions. Further prospective studies are needed to validate these findings and explore best strategies of management.

体成分和相位角（PhA）在成年急性淋巴细胞白血病（ALL）患者中的预后作用尚不清楚。本研究评估了体成分参数和PhA对接受强化化疗的ALL患者总生存期（OS）和无病生存期（DFS）的影响。方法：对81例成人ALL患者进行回顾性分析。在ALL诊断时和治疗前，使用生物电阻抗分析（BIA）评估基线身体组成，包括体脂质量（BFM）、脂肪质量指数（FMI）、无脂质量（FFM）、无脂质量指数（FFMI）和PhA。Kaplan-Meier曲线和log-rank检验用于比较不同身体成分和PhA类别的生存结果。采用Cox回归进行多因素分析以证实研究结果。结果：诊断时的中位年龄为25岁（范围：16-67岁），56.8%为男性，91.3%为b细胞ALL。较低的PhA（≤4°）与较差的OS之间存在显著相关性（p=0.02）。同样，ffmi2患者的OS较差（p=0.0163）。体重指数(BMI)≥25有加重OS的趋势，但无统计学意义。多因素Cox回归证实，PhA≤4°（HR 3.148, 95%CI 1.55 ~ 6.27）、低白蛋白血症（HR 2.233, 95%CI 1.09 ~ 4.54）和高危细胞遗传学（HR 2.310, 95%CI 1.15 ~ 4.62）是导致OS恶化的独立预后因素。结论：PhA和FFMI可作为成人ALL患者的预后指标。较低的PhA和较低的FFMI与较差的生存率相关，强调了早期营养评估和潜在干预措施的必要性。需要进一步的前瞻性研究来验证这些发现并探索最佳的管理策略。

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引用次数: 0

Evaluation and management of chemosensory, trigeminal, and salivary dysfunctions in patients with post coronavirus disease 冠状病毒感染后患者化学感觉、三叉神经和唾液功能障碍的评估和管理

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2025-10-20 DOI: 10.1016/j.clnesp.2025.10.018

Preet Bano Singh , Simon Vivan Singh , Per Ole Iversen , Janicke Liaaen Jensen

Background & aims

While the management of olfactory disorders among patients with post Coronavirus Disease (COVID-19) is well elucidated, treatment of taste dysfunction, oral burning, and oral dryness is less extensively studied among post-COVID-19 patients. This prospective study aimed (i) to assess the prevalence of chemosensory, trigeminal, and salivary dysfunctions in patients at two different time points following COVID-19 infection, and (ii) to evaluate the recovery process over time.

Methods

In this cross-sectional study, 54 Early-post-COVID-19 (3–11 months since COVID-19), 46 Late-post-COVID-19 (≥12 months since COVID-19) and 76 Non-COVID-19 controls were recruited. Participants’ olfactory, gustatory, trigeminal, and salivary status were investigated. Depending on the test outcomes, tailored treatments were administered, and patients were monitored every 3–6 months.

Results

The findings indicated that none of these dysfunctions improved on their own over time. Patients in both post-COVID-19 groups demonstrated significantly reduced smell, trigeminal and salivary functions compared to the control group. Taste impairment was significantly more severe in Late-post-COVID-19 patients compared to Early-post-COVID-19 patients. Follow-up evaluations revealed significant improvement in both smell and taste functions at each follow-up visit across both patient groups.

Conclusion

Chemosensory, trigeminal, and salivary disorders in post-COVID-19 patients may not resolve with time alone, underscoring the need for tailored treatments to achieve significant improvements.

背景与目的：虽然对冠状病毒病（COVID-19）后患者嗅觉障碍的处理已经很清楚，但对COVID-19后患者的味觉功能障碍、口腔灼烧和口腔干燥的治疗研究较少。本前瞻性研究旨在(i)评估COVID-19感染后患者在两个不同时间点的化学感觉、三叉神经和唾液功能障碍的患病率，以及（ii）评估随时间推移的恢复过程。方法：在本横断面研究中，招募了54例新冠肺炎早期（3-11个月）、46例新冠肺炎晚期（≥12个月）和76例非新冠肺炎对照组。研究了参与者的嗅觉、味觉、三叉神经和唾液状态。根据测试结果，进行量身定制的治疗，并每3-6个月对患者进行监测。结果：研究结果表明，这些功能障碍都没有随着时间的推移而自行改善。与对照组相比，两组患者的嗅觉、三叉神经和唾液功能均显著降低。与covid -19后早期患者相比，晚期患者的味觉障碍明显更严重。随访评估显示，在每次随访中，两组患者的嗅觉和味觉功能都有显著改善。结论：covid -19后患者的化学感觉、三叉神经和唾液疾病可能不会随着时间的推移而消失，因此需要量身定制的治疗来实现显着改善。

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引用次数: 0

Comment on “Optimizing weight loss with artificial intelligence: A randomized controlled trial of dietary-supplement prescriptions in adults with overweight and obesity” 评论“用人工智能优化减肥：超重和肥胖成人膳食补充剂处方的随机对照试验”。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2025-10-18 DOI: 10.1016/j.clnesp.2025.10.014

Prajnasini Satapathy, Rachana Mehta, Ranjana Sah

引用次数: 0

Anterior thigh muscle thickness normalized by body mass index is associated with falls in community-dwelling adults 以体重指数归一化的大腿前肌厚度与社区居民跌倒有关。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2025-10-17 DOI: 10.1016/j.clnesp.2025.10.019

Koki Nishino , Tatsuro Inoue , Sota Kobayashi , Kazuki Hotta , Tohru Izumi , Kentaro Kamiya , Akari Kasai , Mei Furusawa , Yui Funayama , Atsuhiro Tsubaki , Anna Kubota , Takanori Fujita , Hiroaki Miyata

Background & aims

This study aimed to determine whether anterior thigh muscle thickness, normalized by height, weight, and Body Mass Index (BMI), is associated with falls in community-dwelling adults.

Methods

This cross-sectional study recruited community-dwelling adults aged ≥40 years living in Sado City, Niigata Prefecture, Japan. Anterior thigh muscle thickness (rectus femoris and vastus intermedius muscles) was measured using ultrasound and normalized by height², weight, and BMI. The primary outcome was self-reported falls in the past year, assessed via a questionnaire. Logistic regression analysis was conducted to examine the relationship between anterior thigh muscle thickness and falls, with age, sex, Mini-Mental State Examination (MMSE) score, grip strength, gait speed, fear of falling, comorbidities, and medications included as confounding factors.

Results

A total of 310 participants (110 males, 200 females) were included in the analysis. The median age was 71.0 years for males and 67.0 years for females, with a BMI of 23.8 kg/m² for males and 22.5 kg/m² for females. The prevalence of falls in the past year was 15.5 %. Logistic regression analysis revealed that anterior thigh muscle thickness normalized by BMI was significantly associated with falls (OR 2.270, 95 % CI 1.130–4.550, p = 0.021) after adjusting for confounding factors. However, other adjustments were not significant.

Conclusion

Anterior thigh muscle thickness normalized by BMI was significantly associated with falls. Because this study was cross-sectional, causal relationships cannot be established. Thus, the association between anterior thigh muscle thickness and fall risk should be interpreted cautiously. Longitudinal studies are needed to confirm its predictive validity for future fall incidents.

背景与目的：本研究旨在确定大腿前肌厚度（按身高、体重和身体质量指数（BMI）归一化）是否与社区居住成年人跌倒有关。方法：本横断面研究招募了日本新泻县佐渡市年龄≥40岁的社区居民。用超声测量大腿前肌厚度（股直肌和股中间肌），并按身高、体重和BMI归一化。主要结果是通过问卷评估过去一年的自我报告跌倒情况。采用Logistic回归分析来检验大腿前肌厚度与跌倒之间的关系，并将年龄、性别、最小精神状态检查（MMSE）评分、握力、步态速度、对跌倒的恐惧、合并症和药物作为混杂因素。结果：共纳入310名受试者，其中男性110人，女性200人。年龄中位数男性为71.0岁，女性为67.0岁，BMI男性为23.8 kg/m2，女性为22.5 kg/m2。过去一年的跌倒率为15.5%。Logistic回归分析显示，经BMI归一化的大腿前肌厚度与跌倒显著相关（OR 2.270, 95% CI 1.130 - 4.550, p = 0.021）。然而，其他调整并不显著。结论：经BMI归一化的大腿前肌厚度与跌倒有显著相关性。因为这项研究是横断面的，所以不能建立因果关系。因此，应谨慎解释大腿前肌厚度与跌倒风险之间的关系。需要进行纵向研究来证实其对未来跌倒事件的预测有效性。

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引用次数: 0

Risk factors for intensive care unit admission in hospitalized patients with acute pancreatitis 急性胰腺炎住院患者入住重症监护病房的危险因素：Sivanathan等：急性胰腺炎ICU治疗。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2025-10-16 DOI: 10.1016/j.clnesp.2025.10.011

Visvakanth Sivanathan , Lukas Hobohm , Volker H. Schmitt , Omar Hahad , Christian Labenz , Christoph Brochhausen , Markus Möhler , Karsten Keller

Background

Acute pancreatitis (AP) is afflicted by substantial morbidity and mortality. Besides local/systemic complications and pancreatic necrosis, patients’ comorbidities might be underrated as risk factor for intensive care unit (ICU) admission in AP.

Methods

We screened the German nationwide inpatient statistics identifying patients admitted due to AP (ICD-code K85) 2005–2019. AP hospitalizations were stratified for necessity of ICU admission and risk-factors for ICU admission were investigated.

Results

Overall, 797,364 patient-hospitalizations due to AP (median age 56.0 [IQR 44.0–71.0] years, 39.2% females) were detected in Germany 2005–2019. Among these, 78,437 (9.8 %) were treated at an ICU. AP patients admitted to an ICU were significantly older (59.0 [46.0–73.0] vs. 56.0 [44.0–71.0], P < 0.001), less often female (35.4 % vs. 39.6 %, P < 0.001), showed an aggravated comorbidity-profile and higher case-fatality than those without ICU admission (13.7 % vs. 1.6 %, P < 0.001). ICU admission was independently associated with increased in-hospital case-fatality (OR 9.82 [95%CI 9.54–10.12], P < 0.001).

Strongest independent risk factors for ICU admission regarding patient-characteristics were male sex (OR 1.26 [95%CI 1.23–1.28], P < 0.001), obesity (OR 1.53 [95%CI 1.49–1.57], P < 0.001), diabetes mellitus (OR 1.35 [95%CI 1.33–1.38], P < 0.001), heart failure (OR 2.43 [95%CI 2.37–2.49], P < 0.001) and atrial fibrillation/flutter (OR 1.87 [95%CI 1.82–1.91], P < 0.001).

Conclusions

Approximately 10 % of the hospitalized AP patients had to be admitted on an ICU. Besides AP complications, male sex, obesity, diabetes mellitus, heart failure and atrial fibrillation/flutter were associated with ICU admission.

背景：急性胰腺炎（AP）的发病率和死亡率都很高。除了局部/全身并发症和胰腺坏死外，患者的合并症可能被低估为AP重症监护室（ICU）入住的危险因素。方法：我们筛选了2005-2019年德国全国因AP （icd代码K85）入院的住院患者统计数据。根据住院ICU的必要性对AP住院进行分层，并对住院ICU的危险因素进行调查。结果：2005-2019年，德国共检测到797,364例因AP住院的患者（中位年龄56.0 [IQR 44.0-71.0]岁，39.2%为女性）。其中重症监护病房78,437例（9.8%）。入住ICU的AP患者年龄明显增加（59.0 [46.0-73.0]vs.56.0[44.0-71.0]）。结论：大约10%的住院AP患者不得不入住ICU。除AP并发症外，男性、肥胖、糖尿病、心力衰竭和心房颤动/扑动与ICU住院相关。

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引用次数: 0

Letter to the editor: Unlocking the fat factor: How adiposity shapes survival in colorectal cancer–A comprehensive meta-analysis 致编辑：解锁脂肪因素：肥胖如何影响结直肠癌患者的生存——一项综合荟萃分析。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2025-10-15 DOI: 10.1016/j.clnesp.2025.10.013

Ajay Guru , Renuka Sharma

引用次数: 0

Gastrointestinal tolerance, healthcare resource utilization, and cost analysis of whey peptide-based enteral formula in pediatric post-acute care: A retrospective study 胃肠耐受性，医疗资源利用和成本分析乳清肽肠内配方在儿科急症后护理：一项回顾性研究。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2025-10-14 DOI: 10.1016/j.clnesp.2025.10.004

Senthilkumar Sankararaman , Cynthia Lowen , Amarsinh Desai , Pamela Cekola , Pradeep Kumar , Sayan Mondal , Yashashree Vijay Kadam , Chidananda Samal , Abby Klosterbuer

Background and aims

Peptide-based formulas (PBF) are characterized by partially hydrolyzed proteins and are often used in patients with gastrointestinal (GI) intolerance receiving enteral nutrition. More evidence is needed on the clinical and economic benefits of whey as a protein source for PBF in children with GI dysfunction.

Using real-world data, this study aimed to compare clinical (i.e. GI intolerance occurrence and symptoms) and health economic outcomes (i.e. healthcare resource utilization [HCRU] and costs) in the 12 months before and after the initiation of 100% whey protein PBF (w-PBF) in children with GI dysfunction receiving EN in a post-acute care setting.

Methods

We retrospectively analyzed US claims data on children with GI dysfunction receiving a PBF composed of 100 % whey protein in post-acute care. The overall population and subgroups with cerebral palsy (CP), gastroesophageal reflux disorder (GERD), gastroparesis (GP), and short bowel syndrome (SBS) were assessed. Clinical (GI intolerance and symptoms) and economic (HCRU and costs) outcomes were compared at 12 months pre-index and 1, 3, 6, and 12 months post-index. The index date was defined as the date of the first claim for the w-PBF.

Results

The study included 3,015 children. Compared with pre-index, significant reductions were observed in the proportion of patients experiencing any GI intolerance and abdominal distension up to 12 months post-index in the overall population and in children with CP, GERD, and SBS (all p < 0.05) and up to 6 months in children with GP (both p < 0.05). Nausea and vomiting were significantly reduced up to 12 months post-index in all patient groups (all p < 0.05). Fewer patients visited inpatient services for ≥6 months post-index in the study population and all disease subgroups (all p < 0.05). Healthcare costs savings were observed for up to 6 months post-index in all patient groups (all p < 0.001).

Conclusions

This study supports the clinical and economic benefits of w-PBF for enteral nutrition of children with GI dysfunction in post-acute care settings.

背景和目的：肽基配方（PBF）以部分水解蛋白为特征，常用于接受肠内营养的胃肠道（GI）不耐受患者。需要更多的证据来证明乳清作为胃肠道功能障碍儿童PBF的蛋白质来源的临床和经济效益。利用真实世界的数据，本研究旨在比较急性后护理环境中接受EN治疗的GI功能障碍儿童开始使用100%乳清蛋白PBF （w-PBF）前后12个月的临床（即GI不耐受的发生和症状）和健康经济结果（即医疗资源利用率[HCRU]和成本）。方法：我们回顾性分析了美国关于在急性后护理中接受100%乳清蛋白组成的PBF的胃肠道功能障碍儿童的索赔数据。对脑瘫（CP）、胃食管反流障碍（GERD）、胃轻瘫（GP）和短肠综合征（SBS）的总体人群和亚组进行评估。临床（GI不耐受和症状）和经济（HCRU和成本）结果在指数前12个月和指数后1、3、6和12个月进行比较。索引日期定义为w-PBF首次索赔的日期。结果：该研究包括3015名儿童。与指数实施前相比，在总体人群中以及患有CP、GERD和SBS的儿童中，在指数实施后12个月内出现任何胃肠道不耐受和腹胀的患者比例显著降低。结论：本研究支持w-PBF在急性后护理环境中用于胃肠道功能障碍儿童肠内营养的临床和经济效益。

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引用次数: 0

Comparison of dual X-ray absorptiometry and bioelectrical impedance analysis for fat-free mass and muscle mass assessment in obese older adults 双x线吸收仪和生物电阻抗分析在肥胖老年人无脂量和肌肉量评估中的比较。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2025-10-14 DOI: 10.1016/j.clnesp.2025.10.005

Pierre-Emmanuel Cailleaux , Najate Achamrah , Vanessa Folope , Sébastien Grigioni , Pierre Déchelotte , Moïse Coëffier

Background & aims

Dual Energy X-ray Absorptiometry (DXA) is a reference technique in fat-free mass (FFM) and muscle mass (MM) assessment. Bioelectrical Impedance Analysis (BIA) represents a more feasible alternative. BIA-derived equations raised to enhance FFM and MM estimation in specific populations.

We aimed to determine the most accurate BIA-derived equations for FFM and MM estimation in older adults with obesity.

Methods

We retrospectively included patients over 65 with body mass index (BMI)≥25 kg/m², who and had undergone in a row both DXA and BIA. FFM and MM was determined using BIA-derived equations. Pearson correlation, Lin's concordance correlation coefficient and the Bland&Altman method were used.

Results

Among the 178 patients (70.3 % women, mean age 67.90 ± 3.76, mean BMI 36.14 ± 5.44), we evaluated 7 equations for FFM assessment. Althought Pearson r were always greater than 0.8, especially in women, only Roubenoff and Deurenberg equations exhibited a bias <5 % and a Lin r>0.8 in women, such as in the whole sample. Roubenoff's was the only remaining equation in men (Lin-r = 0.67). However, all equations displayed wide levels of agreement ranges. For MM, we studied 8 equations, displaying lower Pearson r (0.61–0.67 in women and 0.38 to 0.65 in men) and bias greater than 10 % in both sexes. When studying differences in DXA/BIA agreement for MM thresholds used in sarcopenic obesity, we found inconclusive categorization with differences between DXA and every tested equation.

Conclusion

Roubenoff and Deurenberg equations remained the most accurate BIA-derived equations for FFM evaluation in obese older adults, when DXA is considered as the reference.

背景与目的：双能x线吸收仪（DXA）是一种评估无脂质量（FFM）和肌肉质量（MM）的参考技术。生物电阻抗分析（BIA）是一种更可行的替代方法。提出了bia推导方程，以增强特定种群的FFM和MM估计。我们的目的是确定老年肥胖患者FFM和MM估计的最准确的bia推导方程。方法：回顾性纳入65岁以上、体重指数(BMI)≥25kg/m2、连续行DXA和BIA的患者。FFM和MM采用bia推导方程确定。采用Pearson相关、Lin’s一致性相关系数和Bland&Altman方法。结果：178例患者中（70.3%为女性，平均年龄67.90±3.76，平均BMI 36.14±5.44），我们评估了7个FFM评估方程。尽管Pearson r总是大于0.8，特别是在女性中，但只有Roubenoff和Deurenberg方程在女性中表现出0.8的偏差，例如在整个样本中。Roubenoff方程是男性中仅存的方程（Lin-r=0.67）。然而，所有方程都显示出广泛的一致范围。对于MM，我们研究了8个方程，显示出较低的皮尔逊r（女性为0.61至0.67，男性为0.38至0.65），男女偏差均大于10%。当研究用于肌减少性肥胖的MM阈值的DXA/BIA一致性差异时，我们发现DXA和每个测试方程之间存在差异，分类不确定。结论：当以DXA为参考时，Roubenoff方程和Deurenberg方程仍然是评估肥胖老年人FFM最准确的bia推导方程。

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引用次数: 0

Maternal metabolic dysfunction-associated steatotic liver disease during pregnancy and its impact on offspring steatosis 妊娠期母体代谢功能障碍相关的脂肪变性肝病及其对后代脂肪变性的影响

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2025-10-14 DOI: 10.1016/j.clnesp.2025.10.009

Corie M. Klepper , Andrew T. Trout , Shun Dong , Lin Fei , Traci E. Stankiewicz , Jennifer Wayland , Maria E. Moreno-Fernandez , Senad Divanovic , Stavra A. Xanthakos , Emily DeFranco , Jessica G. Woo , Marialena Mouzaki

Background & aim

To investigate the yet unexplored links between maternal and offspring outcomes of pregnancy metabolic dysfunction-associated steatotic liver disease (MASLD).

Methods

Prospective observational study using magnetic resonance imaging with proton density fat fraction (MRI-PDFF) to determine the presence of maternal and offspring liver steatosis during gestation (3rd trimester) and in the first year postpartum. Women were deemed at high or low risk for MASLD if they had risk factors (pre-pregnancy obesity or MASLD, gestational diabetes, rapid weight gain during pregnancy). Multivariable regression and longitudinal mixed models assessed associations and changes in MRI-derived fat measures.

Results

We recruited 57 pregnant women; 47 (82 %) were high-risk for MASLD. MASLD was seen in 18 % (n = 10) of women (and 15 % [n = 7/47] of those high-risk), with a median PDFF of 5.9 % (IQR: 5.6–12.0 %). Maternal weight, BMI and HDL-C differed between groups. The fetal liver and placental PDFF of offspring of women with and without MASLD were not different. N = 7 (12 %) infants had clinically significant steatosis in utero, all offspring of mothers without gestational MASLD. Of the 30 mothers with repeat liver MRI-PDFF at 9 months postpartum, ten (33 %)had MASLD. N = 44 infants followed up at either 3 or 9 months of age, with only one still demonstrating significant steatosis 9 months. No infant exposed to gestational MASLD had significant steatosis in the first year.

Conclusions

Gestational MASLD is generally mild, but hepatic fat fraction increases postpartum. Clinically significant hepatic steatosis occurs as early as in utero but is not associated with maternal MASLD.

背景与目的：探讨妊娠代谢性功能障碍相关的脂肪变性肝病（MASLD）的母体和后代结局之间尚未被探索的联系。方法：前瞻性观察研究使用质子密度脂肪分数磁共振成像（MRI-PDFF）来确定妊娠（妊娠晚期）和产后第一年母体和子代肝脏脂肪变性的存在。如果妇女有危险因素（孕前肥胖或MASLD、妊娠期糖尿病、孕期体重快速增加），她们被认为是MASLD的高风险或低风险。多变量回归和纵向混合模型评估了mri衍生脂肪测量的关联和变化。结果：我们招募了57名孕妇；47例（82%）为MASLD高危患者。18% （n=10）的女性（15% [n=7/47]的高危女性）出现MASLD，中位PDFF为5.9% （IQR: 5.6-12.0%）。母亲体重、BMI和HDL-C在两组之间存在差异。有和没有MASLD的女性子代的胎儿肝脏和胎盘PDFF没有差异。N=7（12%）婴儿在子宫内有明显的临床脂肪变性，均为无妊娠期MASLD母亲的后代。在产后9个月复查肝脏MRI-PDFF的30名母亲中，10名（33%）患有MASLD。N=44名婴儿在3或9个月大时随访，只有1名婴儿在9个月大时仍表现出明显的脂肪变性。妊娠期暴露于MASLD的婴儿在第一年没有显著的脂肪变性。结论：妊娠期MASLD一般较轻，但产后肝脏脂肪分数增高。临床意义显著的肝脂肪变性早在子宫内就会发生，但与母体MASLD无关。

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引用次数: 0

Two cases of long-term zinc acetate hydrate administration in patients with a zinc deficiency taste disorder with copper deficiency after upper gastrointestinal resection 上消化道切除术后缺锌味觉障碍合并铜缺乏患者长期给予醋酸锌水合治疗2例。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2025-10-14 DOI: 10.1016/j.clnesp.2025.10.003

Tomoaki Shintani , Hiroyuki Tahara , Nami Obayashi , Toshinori Ando , Tetsuya Yoshimoto , Mai Yoshino , Shin Morimoto , Hideki Ohdan , Mikihito Kajiya

Background & aims

Long-term oral administration of zinc preparations to zinc-deficient patients has been shown to result in copper deficiency. Two patients who had zinc deficiency taste disorder and copper deficiency after upper gastrointestinal resection were treated with zinc acetate hydrate.

Methods

Two patients with abnormal taste were diagnosed as zinc deficiency taste disorder by an examination, and were treated with zinc replacement therapy. Case 1 (BMI 15.6 kg/mm²) was given 50 mg/day of zinc acetate hydrate for a year. On the other hand, case 2 (BMI 24.2 kg/mm²) started treatment with zinc acetate hydrate at a concentration of 100 mg/day, but due to pancytopenia, the dose was reduced to 25 mg/day, and the drug was administered for a total of 5 years.

Results

Both patients demonstrated an improvement in taste. In case 1, the serum zinc level reached 111 μg/dL after a year of zinc acetate hydrate treatment. There was no decrease in serum copper levels or blood cell counts. Case 2 had pancytopenia with neutrophils 320/mm³, Hb 7.1 g/dL, and platelets 164 × 10⁹/L one year after zinc acetate hydrate administration. The patient was given subcutaneous G-CSF and a transfusion of concentrated red blood cells and was started on oral administration of pure cocoa 10 g/day. However, pancytopenia did not improve; thus, discontinuing and reducing zinc acetate hydrate increased serum copper and improvement of pancytopenia. Due to the history of spinal canal stenosis surgery, it was difficult to evaluate the neurologic abnormalities.

Conclusion

Long-term administration of zinc supplements should be administered with caution to patients with zinc deficiency-related taste disorders following upper gastrointestinal resection, particularly those with poor nutritional status.

背景与目的：锌缺乏症患者长期口服锌制剂可导致铜缺乏。对2例上消化道切除术后出现缺锌味觉障碍和铜缺乏的患者，应用水合乙酸锌治疗。方法：对2例味觉异常患者经检查诊断为缺锌性味觉障碍，采用锌替代疗法治疗。病例1 （BMI 15.6 kg/mm2）给予50 mg/天的水合醋酸锌治疗1年。另一方面，病例2 （BMI 24.2 kg/mm2）以100mg /天的浓度开始使用水合醋酸锌治疗，但由于全血细胞减少症，剂量降至25mg /天，药物治疗共5年。结果：两名患者都表现出味觉的改善。病例1经1年醋酸锌水合处理后血清锌水平达到111 μg/dL。血清铜水平和血细胞计数没有下降。病例2全血细胞减少，中性粒细胞320 /mm3，血红蛋白7.1 g/dL，血小板164 × 109 /L。患者皮下给予g - csf并输注浓缩红细胞，开始口服纯可可10克/天。然而，全血细胞减少症没有改善；因此，停用和减少醋酸水合锌可增加血清铜，改善全血细胞减少症。由于椎管狭窄手术史，神经系统异常难以评估。结论：对于上消化道切除术后出现锌缺乏相关味觉障碍的患者，尤其是营养状况不佳的患者，应谨慎长期服用锌补充剂。

{"title":"Two cases of long-term zinc acetate hydrate administration in patients with a zinc deficiency taste disorder with copper deficiency after upper gastrointestinal resection","authors":"Tomoaki Shintani , Hiroyuki Tahara , Nami Obayashi , Toshinori Ando , Tetsuya Yoshimoto , Mai Yoshino , Shin Morimoto , Hideki Ohdan , Mikihito Kajiya","doi":"10.1016/j.clnesp.2025.10.003","DOIUrl":"10.1016/j.clnesp.2025.10.003","url":null,"abstract":"<div><h3>Background & aims</h3><div>Long-term oral administration of zinc preparations to zinc-deficient patients has been shown to result in copper deficiency. Two patients who had zinc deficiency taste disorder and copper deficiency after upper gastrointestinal resection were treated with zinc acetate hydrate.</div></div><div><h3>Methods</h3><div>Two patients with abnormal taste were diagnosed as zinc deficiency taste disorder by an examination, and were treated with zinc replacement therapy. Case 1 (BMI 15.6 kg/mm<sup>2</sup>) was given 50 mg/day of zinc acetate hydrate for a year. On the other hand, case 2 (BMI 24.2 kg/mm<sup>2</sup>) started treatment with zinc acetate hydrate at a concentration of 100 mg/day, but due to pancytopenia, the dose was reduced to 25 mg/day, and the drug was administered for a total of 5 years.</div></div><div><h3>Results</h3><div>Both patients demonstrated an improvement in taste. In case 1, the serum zinc level reached 111 μg/dL after a year of zinc acetate hydrate treatment. There was no decrease in serum copper levels or blood cell counts. Case 2 had pancytopenia with neutrophils 320/mm<sup>3</sup>, Hb 7.1 g/dL, and platelets 164 × 10<sup>9</sup>/L one year after zinc acetate hydrate administration. The patient was given subcutaneous G-CSF and a transfusion of concentrated red blood cells and was started on oral administration of pure cocoa 10 g/day. However, pancytopenia did not improve; thus, discontinuing and reducing zinc acetate hydrate increased serum copper and improvement of pancytopenia. Due to the history of spinal canal stenosis surgery, it was difficult to evaluate the neurologic abnormalities.</div></div><div><h3>Conclusion</h3><div>Long-term administration of zinc supplements should be administered with caution to patients with zinc deficiency-related taste disorders following upper gastrointestinal resection, particularly those with poor nutritional status.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 309-313"},"PeriodicalIF":2.6,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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