Clinical nutrition ESPEN最新文献_第2页

The effect of myopenia, myosteatosis and visceral obesity on postoperative complications and inflammation in colorectal surgery 结直肠手术中肌萎缩、肌骨化和内脏肥胖对术后并发症和炎症的影响。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2026-04-01 Epub Date: 2026-01-20 DOI: 10.1016/j.clnesp.2026.102934

S.M.M. Vaes , E.G. Peters , J. Nors , C.H. Back , W.K.G. Leclercq , T.S. de Vries Reilingh , M.D.P. Luyer , B.J.J. Smeets

Introduction

Despite advancements in perioperative care, patients undergoing colorectal surgery remain at significant risk of developing postoperative complications. Myopenia, myosteatosis and visceral obesity may impair postoperative recovery, however the exact effects are unclear. This substudy from a prospective, randomized controlled trial investigates the effects of myopenia, myosteatosis and visceral obesity on postoperative outcomes and inflammatory markers following colorectal surgery.

Methods

Adult patients undergoing elective colorectal surgery were included from a previous randomized controlled trial (SANICS II; NCT02175979). Preoperative CT images were analyzed to determine skeletal muscle index (SMI), visceral adipose tissue index (VATI) and mean skeletal muscle attenuation. Clinical outcomes and systemic inflammatory markers (interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-alpha and C-reactive protein (CRP)) were prospectively registered. Univariate and multivariate linear regression analyses were performed to identify significant associations.

Results

This study included 219 patients. After adjusting for confounding factors, mean skeletal muscle attenuation (p = 0.038) and VATI (p = 0.003) were significantly associated with the occurrence of any complication. Also, VATI was significantly associated with the occurrence of minor (Clavien-Dindo <3) complications (p = 0.010). In addition, VATI was associated with elevated CRP concentrations on postoperative day 2 (p = 0.020). However, the effect size was small, and all other analyses were not significant.

Conclusion

Although myosteatosis and visceral obesity affected some postoperative outcomes, these effects were small and did not include major complications following colorectal surgery. The clinical relevance of myopenia, myosteatosis and visceral obesity in surgical convalescence appears to be limited.

导读：尽管围手术期护理取得了进步，但接受结肠直肠手术的患者仍然存在发生术后并发症的显著风险。肌萎缩症、肌骨化症和内脏性肥胖可能影响术后恢复，但确切的影响尚不清楚。本亚研究来自一项前瞻性随机对照试验，研究了肌萎缩症、肌骨增生症和内脏肥胖对结直肠手术后预后和炎症标志物的影响。方法：接受择期结直肠手术的成年患者纳入先前的随机对照试验（SANICS II; NCT02175979）。分析术前CT图像，确定骨骼肌指数（SMI）、内脏脂肪组织指数（VATI）和平均骨骼肌衰减。临床结果和全身炎症标志物(白细胞介素(IL)-6、IL-8、肿瘤坏死因子（TNF)- α和c反应蛋白（CRP））进行前瞻性登记。进行单变量和多变量线性回归分析以确定显著相关性。结果：本研究纳入219例患者。在校正混杂因素后，平均骨骼肌衰减（p=0.038）和VATI （p=0.003）与任何并发症的发生均显著相关。结论：尽管肌骨增生症和内脏肥胖会影响一些术后结果，但这些影响很小，并且不包括结直肠手术后的主要并发症。手术恢复期肌萎缩、肌骨化症和内脏性肥胖的临床相关性似乎有限。

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引用次数: 0

Association between phase angle and one-year heart failure rehospitalization and all-cause mortality in patients with heart failure 心衰患者相位角与一年心衰再住院和全因死亡率的关系。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2026-04-01 Epub Date: 2026-01-17 DOI: 10.1016/j.clnesp.2026.102928

Masaya Hori , Koya Takino , Takuji Adachi , Yoji Kuze , Takashi Nagai , Nao Ichiba , Kenya Usui , Tsuyoshi Tanabe , Misuzu Ide , Masayasu Nakagawa , Hitoshi Matsuo

Background & aims

Phase angle (PhA) reflects cellular health and nutritional status. Although PhA has been linked to mortality in various populations, its prognostic value for heart failure (HF), especially rehospitalization, remains unclear. This study investigated the association between PhA and the composite outcome of HF rehospitalization and all-cause mortality after discharge in patients hospitalized for acute HF.

Methods

Patients hospitalized with HF who underwent rehabilitation during hospitalization. The primary outcome was a composite of HF rehospitalization and all-cause mortality within one year. Associations were evaluated with multivariate Cox proportional hazards models. Receiver operating characteristic analysis determined the optimal PhA cut-off. The cumulative incidence of the composite outcome and all-cause mortality were estimated using Kaplan–Meier analysis with log-rank tests. For HF rehospitalization, the cumulative incidence was calculated using Gray's test, with death as a competing risk.

Results

The one-year incidence of the composite outcome was 23.3 % (n = 97) among the 417 patients. In multivariate models, PhA independently predicted the composite outcome (hazard ratio: 0.74; 95 % confidence interval: 0.55–0.99, p = 0.048). The optimal PhA cut-off was 3.8. Patients with PhA <3.8 had significantly higher rates of HF rehospitalization (p = 0.033), composite outcomes (p = 0.001), and all-cause mortality (p = 0.002).

Conclusions

In patients with HF, PhA assessed during hospitalization was significantly associated with HF rehospitalization and all-cause mortality within one year. These findings support PhA as a useful biomarker for prognostic assessment in clinical practice.

背景与目的：相位角（PhA）反映细胞的健康和营养状况。尽管PhA与各种人群的死亡率有关，但其对心力衰竭（HF）的预后价值，特别是再住院，仍不清楚。本研究探讨了PhA与急性HF住院患者HF再住院和出院后全因死亡率的综合结局之间的关系。方法：住院期间接受康复治疗的心衰患者。主要终点是一年内HF再住院和全因死亡率的综合结果。采用多变量Cox比例风险模型评估相关性。接收机工作特性分析确定了最佳PhA截止值。综合结果的累积发生率和全因死亡率使用Kaplan-Meier分析和log-rank检验进行估计。对于心衰再住院，使用Gray试验计算累积发病率，死亡作为竞争风险。结果：417例患者中，复合结局的1年发生率为23.3% （n = 97）。在多变量模型中，PhA独立预测复合结局（风险比：0.73；95%置信区间：0.53-0.99,p = 0.042）。最佳PhA临界值为3.8。结论：在HF患者中，住院期间评估的PhA与HF再住院和一年内全因死亡率显著相关。这些发现支持PhA在临床实践中作为一种有用的预后评估生物标志物。

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引用次数: 0

The association between body water compartments and muscle mechanical properties: A correlational study using bioimpedance and myotonometry 身体水室和肌肉力学特性之间的关系：一项使用生物阻抗和肌张力测量的相关研究。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2026-04-01 Epub Date: 2026-01-17 DOI: 10.1016/j.clnesp.2026.102927

Martyna Sochor, Marcelina Mrowiec, Dawid Bączkowicz

Background and aims

Water plays a vital role in muscle function, and its distribution between intracellular (ICW) and extracellular (ECW) compartments serves as a key indicator of muscle quality. Bioelectrical impedance analysis (BIA) quantifies body water (BW), while myotonometry measures muscle mechanical properties; however, the relationship between these measures remains underexplored. This study aimed to assess the association between BW compartments and the resting mechanical properties of lower limb muscles.

Methods

A total of 158 healthy adults (97 men, 61 women; mean age 20.8 years) participated. BW compartments, including total body water (TBW), ICW, and ECW, were measured using a multi-frequency body composition analyser (TANITA MC-780 MA). A MyotonPRO® device assessed the mechanical properties (e.g. tone, stiffness) in the tibialis anterior, peroneus longus, and gastrocnemius muscles. Spearman's rank correlation and multiple linear regression models were used to analyse the relationships between BIA and myotonometry.

Results

The analysis revealed a consistent bipolar pattern of associations. Absolute hydration volumes (TBW, ICW, ECW expressed in kilograms) were positively correlated with muscle tone and stiffness, with correlations ranging from weak to high (r ≈ 0.30–0.70, p < 0.001). ICW was the strongest determinant. In contrast, relative ECW (expressed as a percentage) showed moderate negative correlations with tone and stiffness. This pattern was consistent across all muscles and between limbs.

Conclusions

In healthy young adults, the resting mechanical properties of lower limb muscles are significantly associated not only with TBW but, more importantly, with its compartmental distribution. Higher ICW corresponds to greater muscle tone and stiffness, whereas a high ECW proportion is linked to lower values.

背景与目的：水在肌肉功能中起着至关重要的作用，其在细胞内（ICW）和细胞外（ECW）间的分布是肌肉质量的关键指标。生物电阻抗分析（BIA）量化身体水分（BW），而肌张力测量测量肌肉的力学性能；然而，这些措施之间的关系仍未得到充分探讨。本研究旨在评估BW隔室与下肢肌肉静息力学特性之间的关系。方法：158名健康成人（男性97人，女性61人，平均年龄20.8岁）参与。使用多频身体成分分析仪（TANITA MC-780 MA）测量BW隔间，包括总身体水分（TBW）， ICW和ECW。MyotonPRO®设备评估胫骨前肌、腓骨长肌和腓肠肌的力学特性（如张力、僵硬度）。采用Spearman秩相关和多元线性回归模型分析BIA与肌张力测量的关系。结果：分析揭示了一个一致的双相模式的关联。绝对水合体积（TBW、ICW、ECW，单位为kg）与肌肉张力和僵硬度呈正相关，相关性由弱到高（r≈0.30-0.70,p < 0.001）。ICW是最强的决定因素。相比之下，相对ECW（以百分比表示）与音调和僵硬度呈中度负相关。这种模式在所有肌肉和四肢之间都是一致的。结论：在健康的年轻人中，下肢肌肉的静息力学特性不仅与TBW显著相关，更重要的是与TBW的室间分布有关。较高的ICW对应较大的肌肉张力和僵硬，而较高的ECW比例与较低的值相关。

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引用次数: 0

Why obesity is a disease - Pathogenesis and diagnosis 为什么肥胖是一种疾病——发病机制和诊断。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2026-04-01 Epub Date: 2026-01-17 DOI: 10.1016/j.clnesp.2026.102922

Maria D. Ballesteros-Pomar , Rocco Barazzoni

Obesity is currently recognized as a complex, multifactorial chronic disease, marking a significant shift from the historical, simplistic view of mere voluntary behavior attributed solely to “excessive intake and lack of physical activity”. Formal declarations by organizations such as the American Medical Association (2013) and the European Commission (2021) formally established obesity as a non-communicable, chronic, relapsing disease, acknowledging its profound health and societal implications. This recognition is crucial, as it shifts the focus away from moral judgments and weight bias toward understanding and treating the underlying physiological dysregulation.

The pathogenesis of obesity is intricate and extends beyond the classical energy balance model. It involves complex neuroendocrine circuitries that regulate appetite, including homeostatic, hedonic, and emerging microbiota-driven hunger mechanisms. Adipose tissue functions as a vital endocrine organ, and its dysfunction—often involving inflammation, oxidative stress, and mitochondrial impairment—lead to ectopic lipid accumulation and chronic low-grade inflammation, driving associated metabolic comorbidities. Furthermore, the disease is shaped by multiple determinants integrated into the “exposome hypothesis,” including genetic susceptibility, circadian rhythm disruptions, chronic stress, and environmental exposures such as endocrine-disrupting chemicals.

Up-to-date diagnosis must reflect this complexity. Relying solely on Body Mass Index is insufficient due to its inability to differentiate between muscle and fat mass or account for crucial fat distribution. The European Association for the Study of Obesity (EASO) 2024 framework defines obesity as an adiposity-based chronic disease, emphasizing that accurate diagnosis must include both the anthropometric component (excess fat accumulation) and the clinical component, analyzing the present and potential health effects (medical, functional, and psychological impairments). Recognizing obesity as a chronic, progressive process is vital for developing targeted and effective prevention and treatment strategies.

肥胖目前被认为是一种复杂的、多因素的慢性疾病，标志着从历史上简单的将仅仅是自愿行为归因于“过量摄入和缺乏身体活动”的观点的重大转变。美国医学协会（2013年）和欧洲委员会（2021年）等组织的正式声明正式将肥胖确定为一种非传染性、慢性、复发性疾病，承认其对健康和社会的深远影响。这种认识是至关重要的，因为它将焦点从道德判断和体重偏见转移到理解和治疗潜在的生理失调上。肥胖的发病机制是复杂的，超出了经典的能量平衡模型。它涉及调节食欲的复杂神经内分泌回路，包括稳态、享乐和新兴的微生物群驱动的饥饿机制。脂肪组织作为一种重要的内分泌器官，其功能障碍通常涉及炎症、氧化应激和线粒体损伤，导致异位脂质积累和慢性低度炎症，驱动相关的代谢合并症。此外，这种疾病是由“暴露假说”中整合的多种决定因素形成的，包括遗传易感性、昼夜节律中断、慢性压力和环境暴露，如内分泌干扰化学物质。最新的诊断必须反映这种复杂性。仅仅依靠身体质量指数是不够的，因为它无法区分肌肉和脂肪的质量，也无法解释关键的脂肪分布。欧洲肥胖研究协会（EASO） 2024框架将肥胖定义为一种基于脂肪的慢性疾病，强调准确的诊断必须包括人体测量成分（过量脂肪积累）和临床成分，分析当前和潜在的健康影响（医学、功能和心理障碍）。认识到肥胖是一个慢性的、渐进的过程，对于制定有针对性和有效的预防和治疗策略至关重要。

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引用次数: 0

Body mass index-adjusted calf circumference and mid-arm muscle circumference are associated with hospital stay in overweight patients: A cohort study 体重指数调整后的小腿围和中臂肌肉围与超重患者住院时间相关：一项队列研究。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2026-04-01 Epub Date: 2026-01-12 DOI: 10.1016/j.clnesp.2026.102916

Victória Silva Chites , Allanis Krieger Ramos , Juliana Araújo de Menezes Costa , Giulia Bacim de Araujo e Silva , Flávia Moraes Silva , Jussara Carnevale de Almeida

Background & aims

Reduced muscle mass (MM) is frequently underdiagnosed in hospitalized overweight patients due to assessment challenges. This study aimed to examine the association between anthropometric indicators of MM and clinical outcomes, including length of stay (LOS), readmission, and six-month mortality in overweight hospitalized patients.

Methods

This cohort study included adults and older adults admitted to a university hospital in southern Brazil, with body mass index (BMI) thresholds of ≥25 kg/m² and ≥27 kg/m², respectively. Within 72 h of admission, body weight, height, mid-arm muscle circumference (MAMC), adductor pollicis muscle thickness (APMT), and calf circumference (CC) were measured; CC was also adjusted for BMI due to the adiposity influence in this accuracy to estimate MM. Patients were classified as having low or normal MM according to each indicator. LOS was categorized as prolonged using the sample upper quartile. Post-discharge follow-up for readmission and six-month mortality was conducted by telephone. Logistic regression analyses assessed associations between anthropometric indicators and clinical outcomes. The study was approved by the institutional ethics committee (CAAE: 6397222.9.0000.5327).

Results

A total of 475 patients were included (56 ± 14 years; 52 % women, BMI: 31.7 ± 4.4 kg/m²). The majority underwent surgery (84 %), and 23 % had a cancer diagnosis. The prevalence of low MM was 49.9 % based on BMI-adjusted CC, 5.0 % using unadjusted CC, 26.8 % based on APMT, and 8.7 % based on MAMC. Low BMI-adjusted CC was independently associated with 1.63-fold higher odds of prolonged hospitalization (95%CI: 1.04–2.56), while low MAMC was associated with 2.21-fold higher odds (95%CI: 1.10–4.43). No anthropometric measure was associated with readmission or six-month mortality.

Conclusions

Low MM was common among overweight hospitalized patients, particularly when assessed by BMI-adjusted CC, which accounts for adiposity. Among the measures, BMI-adjusted CC and MAMC were independently associated with prolonged hospital stay.

背景与目的：由于评估的挑战，住院超重患者的肌肉质量减少（MM）经常被误诊。本研究旨在探讨MM的人体测量指标与临床结果之间的关系，包括超重住院患者的住院时间（LOS）、再入院和6个月死亡率。方法：本队列研究纳入巴西南部一所大学医院的成人和老年人，体重指数（BMI）阈值分别为≥25 kg/m2和≥27 kg/m2。入院72小时内，测量体重、身高、臂中肌围（MAMC）、拇内收肌厚度（APMT）和小腿围（CC）；由于肥胖对估计MM的准确性有影响，CC也根据BMI进行了调整。根据每个指标将患者分为低MM或正常MM。使用样本上四分位数将LOS归类为延长。出院后电话随访再入院和6个月死亡率。逻辑回归分析评估了人体测量指标与临床结果之间的关联。该研究已获得机构伦理委员会批准（CAAE: 6397222.9.00 .5327）。结果：共纳入475例患者（56±14岁，女性52%，BMI: 31.7±4.4 kg/m2）。大多数人接受了手术（84%），23%的人被诊断患有癌症。基于bmi调整CC的低MM患病率为49.9%，未调整CC为5.0%，基于APMT为26.8%，基于MAMC为8.7%。低bmi调整后的CC与1.63倍高的延长住院的几率独立相关（95%CI: 1.04-2.56），而低MAMC与2.21倍高的几率相关（95%CI: 1.10-4.43）。没有人体测量测量与再入院或6个月死亡率相关。结论：低MM在超重住院患者中很常见，特别是当通过bmi调整的CC评估时，这是肥胖的原因。其中，bmi调整后的CC和MAMC与住院时间延长独立相关。

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引用次数: 0

Association between preoperative isopentenyl pyrophosphate and emergence delirium in patients undergoing kidney transplantation 肾移植患者术前焦磷酸异戊烯酯与出现性谵妄的关系

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2026-04-01 Epub Date: 2026-01-13 DOI: 10.1016/j.clnesp.2026.102908

Lei Zhu , Lin Zhu , Youzhuang Zhu , Junwei Zhang , Junwei Fang , Lei Zhang , Dongyue Chai

Background and aims

Emergence delirium (ED) is common after general anesthesia, but preoperative metabolic risk factors are not well defined. This study investigated the association between preoperative serum metabolites and ED in kidney transplant recipients (KTRs).

Methods

Adult KTRs treated between 2023 and 2024 were retrospectively analyzed. ED was defined as a Richmond Agitation–Sedation Scale score of +1 to +4 in the post-anesthesia care unit (PACU). Preoperative serum metabolites were quantified using targeted metabolomics. Metabolites were screened using univariable logistic regression, selected using least absolute shrinkage and selection operator (LASSO) regression, and evaluated using multivariable logistic regression models. Dose–response relationships were assessed across quartiles of selected metabolites.

Results

Among 107 patients, 28 (26 %) developed ED. Six metabolites were retained by LASSO. Higher preoperative isopentenyl pyrophosphate (IPP) levels were independently associated with ED after adjustment for perioperative covariates (adjusted OR 3.16, 95 % CI 1.16–6.40; P = 0.002). ED risk increased progressively across IPP quartiles (P for trend = 0.007).

Conclusion

Elevated preoperative serum IPP levels were associated with an increased risk of ED in KTRs. Further studies are required to confirm these findings.

Trial registration

Chinese Clinical Trial Registry, ChiCTR2500097624 (https://www.chictr.org.cn/).

背景与目的：全麻后突发性谵妄（ED）很常见，但术前代谢危险因素尚未明确。本研究探讨了肾移植受者术前血清代谢物与ED之间的关系。方法：回顾性分析2023 ~ 2024年收治的成人ktr病例。ED定义为麻醉后护理单元（PACU）的Richmond激动-镇静量表评分+1至+4。术前血清代谢物定量使用靶向代谢组学。使用单变量逻辑回归筛选代谢物，使用最小绝对收缩和选择算子（LASSO）回归进行选择，并使用多变量逻辑回归模型进行评估。在所选代谢物的四分位数中评估剂量-反应关系。结果：107例患者中，28例（26%）发生ED。LASSO保留了6种代谢物。围手术期协变量校正后，术前较高的焦磷酸异戊烯基（IPP）水平与ED独立相关（校正OR 3.16, 95% CI 1.16-6.40; P = 0.002）。ED风险在IPP四分位数中逐渐增加（趋势P = 0.007）。结论：术前血清IPP水平升高与ktr患者发生ED的风险增加有关。需要进一步的研究来证实这些发现。试验注册：中国临床试验注册中心，ChiCTR2500097624 （https://www.chictr.org.cn/）。

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引用次数: 0

Joint association of triglyceride-glucose index and body roundness index for sarcopenia risk: A national cohort study 甘油三酯-葡萄糖指数和身体圆度指数与肌肉减少症风险的联合关联：一项国家队列研究。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2026-04-01 Epub Date: 2025-11-29 DOI: 10.1016/j.clnesp.2025.11.161

BoWen Zeng , ZhiHong Xu , Qiang Xu , ChangSong Lin

Background

Sarcopenia is an age-related condition that severely impacts the lives of older adults. The role of combined metabolic and body composition measures in sarcopenia risk is not well understood. We investigated the Triglyceride-Glucose Index (TyG) and Body Roundness Index (BRI) in relation to sarcopenia risk.

Methods

This study utilized data from a national cohort study, including 4367 middle-aged and older participants. Sarcopenia was assessed based on the 2019 Asian Working Group for Sarcopenia (AWGS 2019) criteria. Cox proportional hazards regression models were employed to examine the independent and joint associations of Triglyceride-Glucose Index (TyG) and Body Roundness Index (BRI) with the risk of sarcopenia, as well as potential interaction effects. Sensitivity analyses and subgroup analyses were further conducted to evaluate the robustness and consistency of the findings.

Results

During a 4-year follow-up, both high TyG (HR: 0.74; 95 % CI: 0.56–0.99) and high BRI (HR: 0.27; 95 % CI: 0.19–0.37) were independently associated with reduced sarcopenia risk. The high TyG/high BRI group showed the strongest protective effect (HR: 0.22; 95 % CI: 0.14–0.35). Additive interaction analysis revealed synergistic effects between TyG and BRI (RERI: 0.32; 95 % CI: 0.10–0.54). These associations remained consistent across sensitivity analyses.

Conclusion

We found that both TyG and BRI were significantly associated with sarcopenia risk. Combined assessment of TyG and BRI enhanced the predictive capacity for sarcopenia, emphasizing their potential role in identifying high-risk individuals for targeted prevention.

背景：肌肉减少症是一种与年龄相关的疾病，严重影响老年人的生活。代谢和体成分联合测量在肌肉减少症风险中的作用尚不清楚。我们调查了甘油三酯-葡萄糖指数（TyG）和身体圆度指数（BRI）与肌肉减少症风险的关系。方法：本研究利用了一项国家队列研究的数据，包括4367名中老年参与者。根据2019年亚洲肌肉减少症工作组（AWGS 2019）的标准对肌肉减少症进行评估。采用Cox比例风险回归模型检验甘油三酯-葡萄糖指数（TyG）和身体圆度指数（BRI）与肌肉减少症风险的独立和联合关系，以及潜在的相互作用效应。进一步进行敏感性分析和亚组分析，以评价研究结果的稳健性和一致性。结果：在4年的随访中，高TyG （HR: 0.74; 95% CI: 0.56-0.99）和高BRI （HR: 0.27; 95% CI: 0.19-0.37）与肌少症风险降低独立相关。高TyG/高BRI组的保护作用最强（HR: 0.22; 95% CI: 0.14 ~ 0.35）。加性相互作用分析显示TyG和BRI之间存在协同效应（rei: 0.32; 95% CI: 0.10-0.54）。这些关联在敏感性分析中保持一致。结论：我们发现TyG和BRI都与肌少症风险显著相关。TyG和BRI的联合评估增强了对肌肉减少症的预测能力，强调了它们在识别高危人群以进行针对性预防方面的潜在作用。

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引用次数: 0

Impact of the global leadership initiative on malnutrition criteria on the quality of life of patients with ulcerative colitis 营养不良标准全球领导倡议对溃疡性结肠炎患者生活质量的影响。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2026-04-01 Epub Date: 2026-01-12 DOI: 10.1016/j.clnesp.2026.102919

Naoya Masuda , Takao Miwa , Kayoko Nishimura , Yoshiyuki Miwa , Kentaro Kojima , Sachiyo Onishi , Jun Takada , Masaya Kubota , Takashi Ibuka , Masahito Shimizu

Background & aims

Limited evidence is available regarding the Global Leadership Initiative on Malnutrition (GLIM), a standardized diagnostic criterion for malnutrition, in outpatients with ulcerative colitis (UC). This study aimed to investigate the prevalence and determinants of GLIM-defined malnutrition and their impact on the quality of life (QOL) in this population.

Methods

This multicenter, cross-sectional study included outpatients with UC from two institutes in Gifu, Japan. Malnutrition was diagnosed using the GLIM criteria and Malnutrition Universal Screening Tool for initial screening. QOL was assessed using the Japanese version of the Inflammatory Bowel Disease questionnaire (J-IBDQ). The malnutrition determinants were evaluated using a multivariate logistic regression model.

Results

Of the 240 outpatients, the median age was 53 years and 41.7 % were female. Extensive colitis was observed in 45.0 % of the patients, and 29.6 % experienced advanced therapy. With nutritional assessment, 28.3 % were at risk of malnutrition and 10.4 % were diagnosed with GLIM-defined malnutrition. Multivariable analysis identified female sex (odds ratio [OR] 3.24, 95 % confidence interval [CI] 1.35–8.28), extensive colitis (OR 2.75, 95 % CI 1.09–7.45), and a history of advanced therapy (OR 2.71, 95 % CI 1.11–6.67) as independent factors for malnutrition. Compared with those of well-nourished patients, those with malnutrition had significantly lower scores in all four domains and total J-IBDQ score.

Conclusions

Malnutrition, as defined by the GLIM criteria, was observed in 10.4 % of the outpatients with UC; female sex, extensive colitis, and advanced therapy were robust determinants. Furthermore, patients with malnutrition had a significantly poorer QOL than that of those who were well-nourished.

Clinical trial registration

N/A.

背景与目的：关于溃疡性结肠炎（UC）门诊患者营养不良的标准化诊断标准——全球营养不良领导倡议（GLIM），现有证据有限。本研究旨在调查该人群营养不良的患病率和决定因素及其对生活质量（QOL）的影响。方法：这项多中心横断面研究纳入了来自日本岐阜两所研究所的UC门诊患者。使用GLIM标准和营养不良通用筛查工具进行初始筛查诊断营养不良。使用日本版炎症性肠病问卷（J-IBDQ）评估生活质量。使用多元逻辑回归模型评估营养不良的决定因素。结果：240例门诊患者中位年龄53岁，女性占41.7%。45.0%的患者出现广泛结肠炎，29.6%的患者接受了晚期治疗。通过营养评估，28.3%的人有营养不良的风险，10.4%的人被诊断为营养不良。多变量分析确定女性（优势比[OR] 3.24, 95%可信区间[CI] 1.35-8.28）、广泛结肠炎（OR 2.75, 95% CI 1.09-7.45）和先进治疗史（OR 2.71, 95% CI 1.11-6.67）是营养不良的独立因素。与营养良好的患者相比，营养不良患者在所有四个领域的得分和J-IBDQ总分均显著低于营养不良患者。结论：根据GLIM标准，10.4%的UC门诊患者存在营养不良；女性、广泛的结肠炎和先进的治疗是强有力的决定因素。此外，营养不良患者的生活质量明显低于营养良好的患者。临床试验注册：无。

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引用次数: 0

Comparing the eating attitudes test (EAT -26) and disorder examination questionnaire (EDE-Q) as screening tools for eating disorders among young adults: A population-specific analysis 比较饮食态度测试（EAT -26）和饮食失调检查问卷（ed - q）作为年轻人饮食失调筛查工具：一项人群特异性分析

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2026-04-01 Epub Date: 2026-01-13 DOI: 10.1016/j.clnesp.2026.102917

Lana M. Agraib , Islam Al-Shami , Buthaina Alkhatib , Aliaa Orabi

Background and aims

Eating disorders (EDs) are an emerging issue worldwide. The Eating Disorder Examination Questionnaire (EDE-Q) and the Eating Attitudes Test (EAT) are widely used research standards for evaluating EDs. This study aims to examine and determine the best ED scoring system, which tool demonstrates stronger associations for specific population subgroups, and the determinants for each scoring system in identifying EDs.

Methods

A total of 1267 young adults were enrolled in a cross-sectional study. Anthropometric and general characteristics were collected, and EDs were assessed using the EDE-Q and the EAT-26. Several inter-rater reliability indicators were computed, and a logistic regression model was employed to identify the determinants of EDs.

Results

Across both scoring systems, higher BMI categories were significantly related to a higher likelihood (OR) of disordered eating. Compared to the EAT-26, the EDE-Q found significantly more disordered behaviors, particularly among females and those who were overweight or obese. Moderate agreement (Po = 0.666; κ = 0.281) and significant asymmetry (p < 0.001) were found between the two scales, suggesting that they capture distinct symptom patterns. BMI, female sex, and physical inactivity were significant predictors of disordered eating in multivariable analyses; the EAT-26 showed stronger correlations with physical inactivity, and the EDE-Q showed stronger associations with weight-related symptoms and female sex.

Conclusion

The EAT-26 and EDE-Q captured different patterns of disordered eating, with the EDE-Q identifying more cases, especially among overweight and obese females. Agreement between tools was modest, and BMI, female sex, and physical inactivity were significant predictors of disordered-eating risk. These findings highlight the need to select screening tools based on population characteristics and symptom profiles.

背景和目的：饮食失调（EDs）是一个全球性的新兴问题。进食障碍检查问卷（ed - q）和进食态度测试（EAT）是目前广泛使用的进食障碍评估研究标准。本研究旨在研究和确定最佳ED评分系统，哪种工具与特定人群亚群的关联更强，以及每种评分系统在识别ED方面的决定因素。方法：共有1267名年轻人参加了一项横断面研究。收集人体测量和一般特征，并使用ed - q和EAT-26评估EDs。计算了几个评级间的信度指标，并采用逻辑回归模型来确定EDs的决定因素。结果：在两种评分系统中，较高的BMI类别与较高的饮食失调可能性（OR）显著相关。与EAT-26相比，EDE-Q发现了更多的紊乱行为，尤其是在女性和超重或肥胖的人群中。两个量表之间存在中度一致性（Po = 0.666; κ = 0.281）和显著不对称性（p < 0.001），表明它们捕获了不同的症状模式。在多变量分析中，BMI、女性性别和缺乏运动是饮食失调的显著预测因子；EAT-26与缺乏运动有更强的相关性，ed - q与体重相关症状和女性性别有更强的相关性。结论：EAT-26和ed - q捕获了不同的饮食失调模式，ed - q识别出更多的病例，尤其是超重和肥胖的女性。研究工具之间的一致性不高，BMI、女性性别和缺乏运动是饮食失调风险的重要预测因素。这些发现强调了根据人群特征和症状特征选择筛查工具的必要性。

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Reply - Letter to the editor. 回复-给编辑的信。

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN

Pub Date : 2026-04-01 Epub Date: 2025-12-11 DOI: 10.1016/j.clnesp.2025.102879

Camilla Wibrand, Anne Gaml-Sørensen, Anne Ahrendt Bjerregaard, Cecilia Ramlau-Hansen

引用次数: 0