Clinical nutrition ESPEN最新文献

{"title":"Early supplemental parenteral nutrition shortens ventilation and intensive care unit stay in ICU patients aged ≥60 Years requiring mechanical ventilation: A randomized controlled trial","authors":"Feng Tang ,&nbsp;Peng Guo ,&nbsp;Wei Zhang ,&nbsp;Huan Qin ,&nbsp;Huan Xu","doi":"10.1016/j.clnesp.2026.102933","DOIUrl":"10.1016/j.clnesp.2026.102933","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>This study aimed to assess the effects of early supplemental parenteral nutrition (E-SPN) on clinical outcomes in older adults Intensive Care Unit (ICU) patients receiving mechanical ventilation who failed to meet their nutritional requirements through enteral feeding alone.</div></div><div><h3>Methods</h3><div>In this prospective randomized controlled trial (RCT), ICU patients aged ≥60 years who achieved &lt;50 % of prescribed energy or protein targets from enteral nutrition (EN) by ICU day 3 were enrolled. EN was initiated within 24 h of ICU admission (prescribed energy target: up to 25 kcal/kg/day based on actual body weight (ABW); protein: 1.2–1.5 g/kg/day) and advanced progressively according to tolerance and metabolic monitoring. Eligible patients were randomized to either the E-SPN group (early supplemental parenteral nutrition, initiated on ICU day 3) or the L-SPN group (late supplemental parenteral nutrition, initiated on ICU day 7).</div></div><div><h3>Results</h3><div>Ninety-two patients completed the study (E-SPN: 45; L-SPN: 47). Baseline characteristics were comparable between groups. The E-SPN group achieved significantly higher energy and protein intake than the L-SPN group until day 7 (P &lt; 0.05). By day 10, serum albumin and prealbumin levels and diaphragm thickness and phosphate levels were higher in the E-SPN group (P &lt; 0.05). Early SPN significantly reduced the duration of mechanical ventilation (157.8 ± 54.6 vs. 183.6 ± 61.0 h, P = 0.035) and ICU stay (240 vs. 288 h, P = 0.015), without affecting mortality.</div></div><div><h3>Conclusion</h3><div>In ICU patients aged ≥60 years at high nutritional risk requiring mechanical ventilation, initiating supplemental PN on ICU day 3 rather than day 7 improved energy and protein delivery, preserved diaphragm thickness, and shortened ventilation and ICU stay, without increasing mortality. These findings support a proactive, individualized nutrition strategy in older adults ICU patients with limited EN tolerance.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"72 ","pages":"Article 102933"},"PeriodicalIF":2.6,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017132","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}

{"title":"Why obesity is a disease - Pathogenesis and diagnosis","authors":"Maria D. Ballesteros-Pomar ,&nbsp;Rocco Barazzoni","doi":"10.1016/j.clnesp.2026.102922","DOIUrl":"10.1016/j.clnesp.2026.102922","url":null,"abstract":"<div><div>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.</div><div>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.</div><div>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.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"72 ","pages":"Article 102922"},"PeriodicalIF":2.6,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146002821","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}

{"title":"The association between body water compartments and muscle mechanical properties: A correlational study using bioimpedance and myotonometry","authors":"Martyna Sochor,&nbsp;Marcelina Mrowiec,&nbsp;Dawid Bączkowicz","doi":"10.1016/j.clnesp.2026.102927","DOIUrl":"10.1016/j.clnesp.2026.102927","url":null,"abstract":"<div><h3>Background and aims</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 &lt; 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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"72 ","pages":"Article 102927"},"PeriodicalIF":2.6,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146002854","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}

{"title":"Association between phase angle and one-year heart failure rehospitalization and all-cause mortality in patients with heart failure","authors":"Masaya Hori ,&nbsp;Koya Takino ,&nbsp;Takuji Adachi ,&nbsp;Yoji Kuze ,&nbsp;Takashi Nagai ,&nbsp;Nao Ichiba ,&nbsp;Kenya Usui ,&nbsp;Tsuyoshi Tanabe ,&nbsp;Misuzu Ide ,&nbsp;Masayasu Nakagawa ,&nbsp;Hitoshi Matsuo","doi":"10.1016/j.clnesp.2026.102928","DOIUrl":"10.1016/j.clnesp.2026.102928","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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, <em>p</em> = 0.048). The optimal PhA cut-off was 3.8. Patients with PhA &lt;3.8 had significantly higher rates of HF rehospitalization (<em>p</em> = 0.033), composite outcomes (<em>p</em> = 0.001), and all-cause mortality (<em>p</em> = 0.002).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"72 ","pages":"Article 102928"},"PeriodicalIF":2.6,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003275","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}

{"title":"Diet, inflammatory skin disorders, and mental health: A scoping review of current evidence","authors":"Bochen Li ,&nbsp;Ruotong Zhang ,&nbsp;Rachel Gibson ,&nbsp;Rebecca A. Hillier ,&nbsp;Thivi Maruthappu ,&nbsp;Alex Dregan ,&nbsp;Christopher E.M. Griffiths ,&nbsp;Wendy L. Hall","doi":"10.1016/j.clnesp.2026.102926","DOIUrl":"10.1016/j.clnesp.2026.102926","url":null,"abstract":"<div><h3>Background &amp; aim</h3><div>Chronic inflammatory skin disorders (CISDs)—including acne, psoriasis, and atopic dermatitis—are linked to substantial psychological distress and social stigma, often resulting in comorbid mental health conditions and contributing to the global disease burden. Diet, as a modifiable factor, has drawn growing attention for its potential impact on both CISDs and mental health. This systematic scoping review aimed to evaluate the current evidence on the interrelationships among dietary factors, CISDs, and mental health conditions.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was performed across six databases (from inception to April 2024): MEDLINE, CINAHL, Embase, Scopus, Cochrane CENTRAL, and PROSPERO. After duplicate removal, 1739 unique records were identified. Titles, abstracts, and full texts were screened using predefined eligibility criteria. 22 studies met inclusion criteria and were included in the final synthesis. Data were extracted and synthesized according to study design, population characteristics, dietary factors, CISDs, and mental health conditions.</div></div><div><h3>Results</h3><div>Of the 22 included studies, 11 were cross-sectional. Among the three focal domains, acne (n = 12) was the most frequently studied CISD; food consumption and frequency (n = 8) were the most common dietary exposures; and depression (n = 13) was the most frequently assessed mental health condition. Across studies, consistent associations were observed: beneficial dietary factors, including guideline-aligned dietary patterns, components, and behaviours characterised by nutrient-dense and health-promoting profiles, were positively linked to reduced risk or severity of both CISDs and mental health conditions. A strong positive correlation between CISDs and mental health outcomes was also evident. Two major gaps were identified in the current literature. First, the overall strength of evidence remains limited, with only three cohort studies and two randomized controlled trials among the 22 included. Second, few studies concurrently examined the interrelationships among diet, CISDs, and mental health. The most promising conceptual framework for future mediation analysis appears to be the pathway: Diet → CISDs (mediator) → Mental health outcomes.</div></div><div><h3>Conclusions</h3><div>Diet represents a modifiable and potentially cost-effective factor within the interconnected system linking dietary factors, CISDs, and mental health conditions. Current evidence supports associations across all three domains, highlighting the need for integrated research and intervention strategies that simultaneously address diet, skin health, and mental health. Future studies using large-scale and integrated data sources are needed to clarify these complex interrelationships.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"72 ","pages":"Article 102926"},"PeriodicalIF":2.6,"publicationDate":"2026-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146003240","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}

{"title":"Letter to the editor: Association of diabetes with sarcopenia in patients on hemodialysis: A nationwide cross-sectional study in Portugal.","authors":"Grandhi Surendra, Monika Srivastav, Ajay Guru","doi":"10.1016/j.clnesp.2026.102929","DOIUrl":"https://doi.org/10.1016/j.clnesp.2026.102929","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"102929"},"PeriodicalIF":2.6,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997609","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}

{"title":"Comment on \"Impact of fish oil-enriched high protein peptide-based formula on free fatty acid profiles and metabolomic changes in home enterally fed patients: A pilot study\".","authors":"Prashant Ramdas Kokiwar, Ranjana Roy, Archana Dhyani","doi":"10.1016/j.clnesp.2026.102924","DOIUrl":"10.1016/j.clnesp.2026.102924","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"102924"},"PeriodicalIF":2.6,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997590","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}

{"title":"The effects of beta-hydroxy-beta-methylbutyrate on sarcopenia in stable decompensated cirrhosis: A pilot randomized controlled trial","authors":"Witsarut Manasirisuk ,&nbsp;Jittirat Jinchai ,&nbsp;Jaruta Inthanon ,&nbsp;Tanita Suttichaimongkol ,&nbsp;Kookwan Sawadpanich ,&nbsp;Wattana Sukeepaisarnjaroen ,&nbsp;Chitchai Rattananukrom ,&nbsp;Apichart Sangchan ,&nbsp;Pisaln Mairiang ,&nbsp;Veeradej Pisprasert ,&nbsp;Sornwichate Rattanachaiwong ,&nbsp;Pranithi Hongsprabhas ,&nbsp;Thunchanok Kuichanuan","doi":"10.1016/j.clnesp.2026.102915","DOIUrl":"10.1016/j.clnesp.2026.102915","url":null,"abstract":"<div><h3>Background and objective</h3><div>The effectiveness of beta-hydroxy-beta-methylbutyrate (HMB) for sarcopenia in decompensated cirrhosis patients remains unclear. This pilot trial investigated the effect of HMB-containing oral nutritional supplement (ONS) on muscle mass as the primary outcome. Secondary outcomes included changes in muscle strength, quality, and physical performance.</div></div><div><h3>Methods</h3><div>This randomized controlled trial included 21 patients with stable decompensated cirrhosis and sarcopenia (April 2022–January 2024). Participants received either an HMB-containing ONS (daily total of 1.48 g Calcium HMB, 21 g protein, 524 kcal) (HMB group, <em>n</em> = 12) or maltodextrin (control group, <em>n</em> = 9) for 12 weeks. The primary outcome was the 12-week change in muscle mass measured by bioelectrical impedance analysis. Secondary outcomes included handgrip strength, anthropometry, and physical performance.</div></div><div><h3>Results</h3><div>At 12 weeks, there were no significant between-group differences in muscle mass parameters (e.g., appendicular skeletal muscle mass index [ASMI], fat-free mass index [FFMI]) or handgrip strength. However, the HMB group demonstrated significant within-group improvements from baseline in phase angle (4.6°–5.0°, <em>p</em> = 0.015), mid-arm muscle circumference [MAMC] (23.3–24.4 cm, <em>p</em> = 0.008), and 5-time chair stand test performance (18.6–16.5 s, <em>p</em> = 0.047). The supplement was well-tolerated with no significant adverse events.</div></div><div><h3>Conclusion</h3><div>In patients with stable decompensated cirrhosis and sarcopenia, 12-week HMB-containing ONS was well-tolerated. While it did not significantly increase muscle mass or handgrip strength compared to the control group, HMB-containing ONS showed promise for improving key sarcopenia-related parameters—phase angle, mid-arm muscle circumference, and chair stand test performance when compared to baseline. Larger adequately powered randomized controlled trials are needed to confirm these findings. (Trial Registration: Thai Clinical Trials Registry on April 22, 2024, No. TCTR20240422012. The registration can be accessed at: <span><span>https://thaiclinicaltrials.org/</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"72 ","pages":"Article 102915"},"PeriodicalIF":2.6,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988133","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}

{"title":"Fermented and non-fermented pickles modulate gut microbiota in older adults with dysphagia: A pilot crossover study.","authors":"Tatsuya Mayama, Kazuharu Nakagawa, Yusuke Ogata, Kanako Yoshimi, Miki Ishii, Rieko Moritoyo, Ryosuke Yanagida, Kohei Yamaguchi, Haruka Tohara","doi":"10.1016/j.clnesp.2026.102918","DOIUrl":"10.1016/j.clnesp.2026.102918","url":null,"abstract":"<p><strong>Background & aims: </strong>Dysphagia is common among older adults and often leads to dietary restrictions, reduced appetite, malnutrition, and decreased quality of life. Although pickles are widely enjoyed by older adults, dysphagia-friendly pickles are often avoided owing to their texture. Moreover, many dysphagia-friendly foods are non-fermented and lack live lactic acid bacteria, and it remains unclear whether texture-modified, non-fermented pickles can favorably influence the gut microbiota. Therefore, this exploratory, microbiotal-focused study examined preliminary, taxon-level gut microbiotal signals associated with dysphagia-adapted non-fermented versus fermented pickles.</p><p><strong>Methods: </strong>In this pilot, single-blind, 2 × 2 crossover study, participants were alternately allocated to receive non-fermented or fermented pickles (finely shredded sauerkraut cut into 1-mm strips) first, with a 2-week washout between periods. Fecal samples were collected before and after each intervention. The gut microbiotal composition was analyzed using 16S rRNA gene amplicon sequencing and bioinformatic processing via QIIME2. Microbial diversity and taxonomic changes were analyzed using Wilcoxon's signed-rank test. Finally, α-diversity (Shannon, Chao1, Simpson), β-diversity (Bray-Curtis permutational multivariate analysis of variance), and taxon-level relative abundances for prespecified taxa (e.g., Bifidobacterium, SCFA-associated taxa) were evaluated.</p><p><strong>Results: </strong>Thirteen participants were enrolled. There were no significant post-intervention changes in α-diversity (e.g., shannon p = 0.273, 0.414) and β-diversity (p = 0.993, 0.999). However, consumption of non-fermented pickles significantly increased the abundance of Actinobacteriota, including Bifidobacteriales, Bifidobacteriaceae, and Bifidobacterium (p = 0.012). In contrast, consumption of fermented pickles significantly increased the abundance of several short-chain fatty acid-associated taxa, including [Eubacterium] coprostanoligenes group and Marvinbryantia genus.</p><p><strong>Conclusion: </strong>Texture-modified pickles and fermented pickles can be safely provided and feasibly consumed by older adults with dysphagia risk. Their consumption induced modest, taxon-specific shifts in gut microbial composition, without altering global diversity. These exploratory pilot findings demonstrate feasibility and suggest taxon-level trends requiring confirmation in larger, randomized trials with functional and clinical endpoints.</p><p><strong>Trial registration: </strong>UMIN-CTR UMIN000046319 (Japan).</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"102918"},"PeriodicalIF":2.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988039","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}

{"title":"Association between preoperative isopentenyl pyrophosphate and emergence delirium in patients undergoing kidney transplantation","authors":"Lei Zhu ,&nbsp;Lin Zhu ,&nbsp;Youzhuang Zhu ,&nbsp;Junwei Zhang ,&nbsp;Junwei Fang ,&nbsp;Lei Zhang ,&nbsp;Dongyue Chai","doi":"10.1016/j.clnesp.2026.102908","DOIUrl":"10.1016/j.clnesp.2026.102908","url":null,"abstract":"<div><h3>Background and aims</h3><div>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).</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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; <em>P</em> = 0.002). ED risk increased progressively across IPP quartiles (<em>P</em> for trend = 0.007).</div></div><div><h3>Conclusion</h3><div>Elevated preoperative serum IPP levels were associated with an increased risk of ED in KTRs. Further studies are required to confirm these findings.</div></div><div><h3>Trial registration</h3><div>Chinese Clinical Trial Registry, ChiCTR2500097624 (<span><span>https://www.chictr.org.cn/</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"72 ","pages":"Article 102908"},"PeriodicalIF":2.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145987975","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}