Pub Date : 2024-11-12DOI: 10.1016/j.clnu.2024.11.011
Jingxin Yan
{"title":"Letter to Editor–Dietary and lifestyle inflammation scores in relation to colorectal cancer recurrence and all-cause mortality: A longitudinal analysis","authors":"Jingxin Yan","doi":"10.1016/j.clnu.2024.11.011","DOIUrl":"10.1016/j.clnu.2024.11.011","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 327-328"},"PeriodicalIF":6.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-12DOI: 10.1016/j.clnu.2024.11.012
Jie Qin, Yan Feng, Bei Feng
{"title":"Letter to the Editor–“Dietary and lifestyle inflammation scores in relation to colorectal cancer recurrence and all-cause mortality: A longitudinal analysis”","authors":"Jie Qin, Yan Feng, Bei Feng","doi":"10.1016/j.clnu.2024.11.012","DOIUrl":"10.1016/j.clnu.2024.11.012","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 329-330"},"PeriodicalIF":6.6,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-10DOI: 10.1016/j.clnu.2024.11.009
Alexandra Karachaliou , Maria Bletsa , Gerassimos J. Mantzaris , Emmanuel Archavlis , George Karampekos , Maria Tzouvala , Eirini Zacharopoulou , Giorgos Bamias , George Kokkotis , Meropi D. Kontogianni
Background & aims
Limited data exist regarding the implementation of the Global Leadership Initiative on Malnutrition (GLIM) criteria for diagnosing malnutrition in Crohn's disease (CD), and its association with CD prognosis. In the present study eighteen GLIM combinations and a combined one were implemented to identify differences in the prevalence of malnutrition and to investigate potential associations with clinical outcomes at 6 months.
Methods
Different methodologies to diagnose malnutrition were used at baseline, namely the Subjective Global Assessment (SGA), eighteen different combinations of phenotypic and etiologic GLIM criteria and a combined version based on all GLIM combinations (GLIMcv) to test differences in the estimated prevalence and outcomes’ prognosis. At 6 months, data for clinical outcomes were collected (i.e. hospitalization, antibiotics use, intensification/change of biologic agent, initiation of biologic agent/corticosteroids, surgery, disease activity), and an overall adverse clinical outcome index was created.
Results
250 people with CD (54.8 % males, mean age 41.2 ± 14.1 years, 37.2 % with active disease) were enrolled. Prevalence of malnutrition based on SGA and GLIMcv was 23 % and 52 %, respectively, and 5.8–63 % based on different GLIM combinations. Malnutrition diagnosed with GLIMcv was associated with an increased likelihood of intensification/change of biologic agent [Odds ratio (OR): 1.82, 95 % Confidence interval (CI): 1.00–3.42, p = 0.05] and an overall adverse clinical outcome (OR: 2.18, 95 % CI: 1.23–3.87, p = 0.008) at 6 months, after adjustment for age, sex, disease location and duration. Malnutrition diagnosed through SGA was not associated with clinical outcomes at 6 months.
Conclusions
Based on GLIMcv, half of the sample was diagnosed with malnutrition. Malnutrition significantly increased the likelihood of uncontrolled disease requiring treatment upgrading and leading to an overall adverse clinical outcome short term.
{"title":"Implementing the Global Leadership Initiative on Malnutrition (GLIM) criteria in Crohn's disease: Prevalence of malnutrition and association with clinical outcomes","authors":"Alexandra Karachaliou , Maria Bletsa , Gerassimos J. Mantzaris , Emmanuel Archavlis , George Karampekos , Maria Tzouvala , Eirini Zacharopoulou , Giorgos Bamias , George Kokkotis , Meropi D. Kontogianni","doi":"10.1016/j.clnu.2024.11.009","DOIUrl":"10.1016/j.clnu.2024.11.009","url":null,"abstract":"<div><h3>Background & aims</h3><div>Limited data exist regarding the implementation of the Global Leadership Initiative on Malnutrition (GLIM) criteria for diagnosing malnutrition in Crohn's disease (CD), and its association with CD prognosis. In the present study eighteen GLIM combinations and a combined one were implemented to identify differences in the prevalence of malnutrition and to investigate potential associations with clinical outcomes at 6 months.</div></div><div><h3>Methods</h3><div>Different methodologies to diagnose malnutrition were used at baseline, namely the Subjective Global Assessment (SGA), eighteen different combinations of phenotypic and etiologic GLIM criteria and a combined version based on all GLIM combinations (GLIMcv) to test differences in the estimated prevalence and outcomes’ prognosis. At 6 months, data for clinical outcomes were collected (i.e. hospitalization, antibiotics use, intensification/change of biologic agent, initiation of biologic agent/corticosteroids, surgery, disease activity), and an overall adverse clinical outcome index was created.</div></div><div><h3>Results</h3><div>250 people with CD (54.8 % males, mean age 41.2 ± 14.1 years, 37.2 % with active disease) were enrolled. Prevalence of malnutrition based on SGA and GLIMcv was 23 % and 52 %, respectively, and 5.8–63 % based on different GLIM combinations. Malnutrition diagnosed with GLIMcv was associated with an increased likelihood of intensification/change of biologic agent [Odds ratio (OR): 1.82, 95 % Confidence interval (CI): 1.00–3.42, p = 0.05] and an overall adverse clinical outcome (OR: 2.18, 95 % CI: 1.23–3.87, p = 0.008) at 6 months, after adjustment for age, sex, disease location and duration. Malnutrition diagnosed through SGA was not associated with clinical outcomes at 6 months.</div></div><div><h3>Conclusions</h3><div>Based on GLIMcv, half of the sample was diagnosed with malnutrition. Malnutrition significantly increased the likelihood of uncontrolled disease requiring treatment upgrading and leading to an overall adverse clinical outcome short term.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 296-307"},"PeriodicalIF":6.6,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-09DOI: 10.1016/j.clnu.2024.11.008
Jarson Pedro da Costa Pereira , Amanda de Sousa Rebouças , Carla M. Prado , Maria Cristina Gonzalez , Poliana Coelho Cabral , Alcides da Silva Diniz , Ana Paula Trussardi Fayh , Flávia Moraes Silva
<div><h3>Background & aims</h3><div>Phase angle (PhA) is a biomarker derived from raw bioelectrical impedance analysis (BIA) values: resistance (R) and reactance (Xc). PhA reflects cellular membrane integrity and, as a result, has been considered a marker of fluid distribution, making it a potential prognostic indicator. A growing body of research demonstrates independent associations between PhA and muscle strength, mass, and composition. In this context, PhA has the extra potential to serve as a marker of muscle quality. However, the evidence supporting its use for this purpose is not well established. This study aimed to investigate the relationship between PhA and markers of muscle quality.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis (Internal Prospective Register of Systematic Reviews – PROSPERO on a registration code: CRD42024507853) focused on observational studies assessing the relationship between PhA and markers of both concepts of muscle quality: the muscle quality index (MQI: strength by a unit of mass) and the muscle composition (i.e., skeletal muscle radiodensity [SMD], muscle echogenicity, muscle fat fraction, inter- and intramuscular adiposity). Risk of bias was assessed using the Newcastle–Ottawa Scale (NOS) and Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2), while the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Meta-analyses with a random-effects model were conducted.</div></div><div><h3>Results</h3><div>Seventeen studies were included in this systematic review, encompassing 2710 participants. Meta-analyses demonstrated that PhA had a moderate positive correlation coefficient with SMD (4 studies, 924 participants; r = 0.54, 95 % confidence interval (CI) 0.38 to 0.69, heterogeneity (I<sup>2</sup>) = 92 %) and good accuracy (85 %) for classifying low SMD (2 studies, 390 participants; Area Under the Curve – AUC<sub>pooled</sub> 0.85, 95 % CI 0.78 to 0.92, I<sup>2</sup> = 0 %). PhA was inversely-moderately correlated with muscle echogenicity (8 studies, 1401 participants; r = - 0.42, 95 % CI - 0.57 to - 0.24, I<sup>2</sup> = 82 %) and positively-weakly correlated with MQI (2 studies, 191 participants; r = 0.36, 95 % CI 0.21 to 0.49, I<sup>2</sup> = 17 %). All studies had a higher risk of bias. The certainty of evidence ranged from low to very low.</div></div><div><h3>Conclusion</h3><div>Despite technical challenges, this study demonstrates the potential of PhA as a surrogate marker for muscle quality, particularly expressing muscle composition (SMD). Future studies should utilize BIA with standardized protocols to potentially establish specific cutoff values for PhA, thereby enhancing its diagnostic accuracy and clinical applicability. These studies could additionally explore the mechanisms underlying the associations between PhA and muscle quality aspects. In cases where technical factors are
{"title":"Phase angle as a marker of muscle quality: A systematic review and meta-analysis","authors":"Jarson Pedro da Costa Pereira , Amanda de Sousa Rebouças , Carla M. Prado , Maria Cristina Gonzalez , Poliana Coelho Cabral , Alcides da Silva Diniz , Ana Paula Trussardi Fayh , Flávia Moraes Silva","doi":"10.1016/j.clnu.2024.11.008","DOIUrl":"10.1016/j.clnu.2024.11.008","url":null,"abstract":"<div><h3>Background & aims</h3><div>Phase angle (PhA) is a biomarker derived from raw bioelectrical impedance analysis (BIA) values: resistance (R) and reactance (Xc). PhA reflects cellular membrane integrity and, as a result, has been considered a marker of fluid distribution, making it a potential prognostic indicator. A growing body of research demonstrates independent associations between PhA and muscle strength, mass, and composition. In this context, PhA has the extra potential to serve as a marker of muscle quality. However, the evidence supporting its use for this purpose is not well established. This study aimed to investigate the relationship between PhA and markers of muscle quality.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis (Internal Prospective Register of Systematic Reviews – PROSPERO on a registration code: CRD42024507853) focused on observational studies assessing the relationship between PhA and markers of both concepts of muscle quality: the muscle quality index (MQI: strength by a unit of mass) and the muscle composition (i.e., skeletal muscle radiodensity [SMD], muscle echogenicity, muscle fat fraction, inter- and intramuscular adiposity). Risk of bias was assessed using the Newcastle–Ottawa Scale (NOS) and Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2), while the certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Meta-analyses with a random-effects model were conducted.</div></div><div><h3>Results</h3><div>Seventeen studies were included in this systematic review, encompassing 2710 participants. Meta-analyses demonstrated that PhA had a moderate positive correlation coefficient with SMD (4 studies, 924 participants; r = 0.54, 95 % confidence interval (CI) 0.38 to 0.69, heterogeneity (I<sup>2</sup>) = 92 %) and good accuracy (85 %) for classifying low SMD (2 studies, 390 participants; Area Under the Curve – AUC<sub>pooled</sub> 0.85, 95 % CI 0.78 to 0.92, I<sup>2</sup> = 0 %). PhA was inversely-moderately correlated with muscle echogenicity (8 studies, 1401 participants; r = - 0.42, 95 % CI - 0.57 to - 0.24, I<sup>2</sup> = 82 %) and positively-weakly correlated with MQI (2 studies, 191 participants; r = 0.36, 95 % CI 0.21 to 0.49, I<sup>2</sup> = 17 %). All studies had a higher risk of bias. The certainty of evidence ranged from low to very low.</div></div><div><h3>Conclusion</h3><div>Despite technical challenges, this study demonstrates the potential of PhA as a surrogate marker for muscle quality, particularly expressing muscle composition (SMD). Future studies should utilize BIA with standardized protocols to potentially establish specific cutoff values for PhA, thereby enhancing its diagnostic accuracy and clinical applicability. These studies could additionally explore the mechanisms underlying the associations between PhA and muscle quality aspects. In cases where technical factors are ","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 308-326"},"PeriodicalIF":6.6,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-07DOI: 10.1016/j.clnu.2024.11.004
T. Schmitz, D. Freuer, J. Linseisen, C. Meisinger
Aims
The pathophysiology of diabetes is not fully understood; recent research indicates close relations with immunological alterations. Therefore, the aim of this study was to investigate the associations between markers of glucose metabolism and characteristics of blood lymphocytes in a population-based cohort.
Methods
The analysis was based on data from 219 non-diabetic participants of the MEGA study in Augsburg, Germany, who were recruited between 2018 and 2021. The majority of participants were examined two different times with a time lag of 9 months. Fasting venous blood samples were taken and oral glucose tolerance tests (OGTT) were performed at both visits. Immune cells were analyzed from fresh blood using flow cytometry. The associations between fasting blood glucose levels, glucose levels at 2 h after oral glucose bolus and glycated hemoglobin (HbA1c) concentrations and the quantity of different lymphocyte subsets were analyzed using linear mixed regression models with random intercept. P values were FDR-adjusted.
Results
HbA1c was negatively associated with the marginal zone B cells (IgD + CD27+ B cells). Fasting glucose was positively associated with natural killer (NK) cells and 2-h OGTT glucose was positively associated with NKT cells. Finally, HbA1c showed significantly negative associations with the CD57-PD1-NKT cell subset.
Conclusion
Markers of glucose metabolism showed significant associations with B cell, NK cell and NKT cell subsets, which clearly indicates a relation between glucose metabolism and the adaptive immune system.
目的：糖尿病的病理生理学尚不完全清楚；最近的研究表明其与免疫学改变密切相关。因此，本研究旨在调查人群中葡萄糖代谢标志物与血液淋巴细胞特征之间的关系：分析基于德国奥格斯堡 MEGA 研究的 219 名非糖尿病参与者的数据，这些参与者是在 2018 年至 2021 年期间招募的。大多数参与者接受了两次不同的检查，时间间隔为 9 个月。两次检查均采集了空腹静脉血样本，并进行了口服葡萄糖耐量试验（OGTT）。使用流式细胞术分析了新鲜血液中的免疫细胞。使用带随机截距的线性混合回归模型分析了空腹血糖水平、口服葡萄糖栓后 2 小时的血糖水平和糖化血红蛋白 (HbA1c) 浓度与不同淋巴细胞亚群数量之间的关系。P值经FDR调整：结果：HbA1c 与边缘区 B 细胞（IgD + CD27+ B 细胞）呈负相关。空腹血糖与自然杀伤（NK）细胞呈正相关，2 小时 OGTT 血糖与 NKT 细胞呈正相关。最后，HbA1c 与 CD57-PD1-NKT 细胞亚群呈显著负相关：结论：糖代谢指标与 B 细胞、NK 细胞和 NKT 细胞亚群有明显的相关性，这清楚地表明了糖代谢与适应性免疫系统之间的关系。
{"title":"Associations between blood markers of glucose metabolism and characteristics of circulating lymphocytes","authors":"T. Schmitz, D. Freuer, J. Linseisen, C. Meisinger","doi":"10.1016/j.clnu.2024.11.004","DOIUrl":"10.1016/j.clnu.2024.11.004","url":null,"abstract":"<div><h3>Aims</h3><div>The pathophysiology of diabetes is not fully understood; recent research indicates close relations with immunological alterations. Therefore, the aim of this study was to investigate the associations between markers of glucose metabolism and characteristics of blood lymphocytes in a population-based cohort.</div></div><div><h3>Methods</h3><div>The analysis was based on data from 219 non-diabetic participants of the MEGA study in Augsburg, Germany, who were recruited between 2018 and 2021. The majority of participants were examined two different times with a time lag of 9 months. Fasting venous blood samples were taken and oral glucose tolerance tests (OGTT) were performed at both visits. Immune cells were analyzed from fresh blood using flow cytometry. The associations between fasting blood glucose levels, glucose levels at 2 h after oral glucose bolus and glycated hemoglobin (HbA1c) concentrations and the quantity of different lymphocyte subsets were analyzed using linear mixed regression models with random intercept. P values were FDR-adjusted.</div></div><div><h3>Results</h3><div>HbA1c was negatively associated with the marginal zone B cells (IgD + CD27+ B cells). Fasting glucose was positively associated with natural killer (NK) cells and 2-h OGTT glucose was positively associated with NKT cells. Finally, HbA1c showed significantly negative associations with the CD57-PD1-NKT cell subset.</div></div><div><h3>Conclusion</h3><div>Markers of glucose metabolism showed significant associations with B cell, NK cell and NKT cell subsets, which clearly indicates a relation between glucose metabolism and the adaptive immune system.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 285-295"},"PeriodicalIF":6.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-06DOI: 10.1016/j.clnu.2024.11.001
Ruihua Yang , Weiling Han , Wei Zheng , Dong Xu , Jing He , Xianxian Yuan , Li Zhang , Zhihong Tian , Guanghui Li
Background and aims
There have been limited studies on the application of a diabetes-specific formula in gestational diabetes mellitus (GDM), the role of which has not been well studied. We explored the effect of a diabetes-specific formula on blood glucose levels, insulin use and pregnancy outcomes in GDM patients.
Methods
In this randomized controlled study, 112 GDM patients were randomly assigned to the intervention group (56) and the control group (56). Both groups received individualized dietary counseling. The intervention group consumed a soy-protein-based, high-monounsaturated-fatty-acid, and multi-fiber diabetes-specific formula as milk replacement for breakfast and an extra meal after dinner. All participants were followed up every two weeks until delivery. The blood glucose levels, insulin use and pregnancy outcomes between the groups were compared.
Results
Compared to the control group, the intervention group had significantly lower 2h postprandial blood glucose levels after breakfast (5.84 ± 0.56 vs. 6.15 ± 0.44 mmol/L, p = 0.008), and exhibited higher postprandial time in range values (83.80 % vs. 78.95 %, p = 0.045). The intervention group used insulin later (33 vs. 28 weeks, p = 0.015) and for fewer days (36 vs 78 days, p = 0.024), but no differences in the proportion, dose or frequency of insulin use between the groups. There were no significant differences in pregnancy outcomes between the groups.
Conclusions
The diabetes-specific formula significantly decreased postprandial blood glucose levels and improved postprandial glycemic control in GDM patients. Moreover, it delayed the initiation of insulin use and reduced the duration of insulin therapy. Our findings may offer a potential new approach for achieving better personalized blood glucose control in GDM patients.
{"title":"Administration of a diabetes-specific formula can improve postprandial glycemic control and delay insulin use in gestational diabetes mellitus: A randomized controlled trial from two centers","authors":"Ruihua Yang , Weiling Han , Wei Zheng , Dong Xu , Jing He , Xianxian Yuan , Li Zhang , Zhihong Tian , Guanghui Li","doi":"10.1016/j.clnu.2024.11.001","DOIUrl":"10.1016/j.clnu.2024.11.001","url":null,"abstract":"<div><h3>Background and aims</h3><div>There have been limited studies on the application of a diabetes-specific formula in gestational diabetes mellitus (GDM), the role of which has not been well studied. We explored the effect of a diabetes-specific formula on blood glucose levels, insulin use and pregnancy outcomes in GDM patients.</div></div><div><h3>Methods</h3><div>In this randomized controlled study, 112 GDM patients were randomly assigned to the intervention group (56) and the control group (56). Both groups received individualized dietary counseling. The intervention group consumed a soy-protein-based, high-monounsaturated-fatty-acid, and multi-fiber diabetes-specific formula as milk replacement for breakfast and an extra meal after dinner. All participants were followed up every two weeks until delivery. The blood glucose levels, insulin use and pregnancy outcomes between the groups were compared.</div></div><div><h3>Results</h3><div>Compared to the control group, the intervention group had significantly lower 2h postprandial blood glucose levels after breakfast (5.84 ± 0.56 vs. 6.15 ± 0.44 mmol/L, p = 0.008), and exhibited higher postprandial time in range values (83.80 % vs. 78.95 %, p = 0.045). The intervention group used insulin later (33 vs. 28 weeks, p = 0.015) and for fewer days (36 vs 78 days, p = 0.024), but no differences in the proportion, dose or frequency of insulin use between the groups. There were no significant differences in pregnancy outcomes between the groups.</div></div><div><h3>Conclusions</h3><div>The diabetes-specific formula significantly decreased postprandial blood glucose levels and improved postprandial glycemic control in GDM patients. Moreover, it delayed the initiation of insulin use and reduced the duration of insulin therapy. Our findings may offer a potential new approach for achieving better personalized blood glucose control in GDM patients.</div></div><div><h3>Registration number of clinical trial</h3><div>NCT03957603 (registered at <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 265-274"},"PeriodicalIF":6.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-06DOI: 10.1016/j.clnu.2024.10.039
Ching-Mao Chang , I-Ju Tsai , Cheng-Chia Yang , Wen-Chun Liu , Chun-Pai Yang
Background
Alpha-s1 casein hydrolysate (ACH; Lactium®) is recognized as a supplementary treatment to enhance sleep quality. However, limited studies utilizing objective sleep assessment tools have resulted in a lack of substantial validation. This study aimed to assess the effects of ACH on both subjective sleep assessments and objective polysomnography (PSG) recordings in a hospital-based cohort of Taiwanese individuals with chronic insomnia.
Methods
In this 4-week randomized, double-blind, placebo-controlled trial, 36 participants diagnosed with chronic insomnia were enrolled and randomly assigned to either the ACH or placebo groups. Initially, participants in the ACH group received 600 mg of ACH daily, which was reduced to 300 mg for the latter two weeks; the placebo group received maltodextrin capsules throughout the study. The study utilized polysomnography (PSG), along with detailed sleep questionnaires including the Insomnia Severity Index (ISI), Global Sleep Disorders Score (GSDS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Hospital Anxiety and Depression Scale (HADS), to assess improvements in sleep quality and related health markers. The efficacy of the intervention was assessed through measures of sleep efficiency, stage distribution, and psychological well-being, comparing results from before to after the treatment phase.
Results
The study demonstrated that ACH treatment notably enhanced sleep quality, evidenced by significant improvements in ISI, GSDS, PSQI, ESS, and HADS scores at both week 2 and 4 (all p-values <0.05) compared with baseline scores. When compared to the placebo group, the ACH group experienced a marked reduction in GSDS scores over time (p = 0.045). Furthermore, PSG data revealed a significant decrease in sleep onset latency from baseline in the ACH group compared to the placebo group (p = 0.012; −7.7 ± 16.0 min vs. 6.1 ± 17.7 min for ACH and placebo groups, respectively). These results indicate that ACH treatment effectively improved sleep initiation and overall sleep quality.
Conclusion
ACH Supplementation significantly improved sleep quality, particularly by reducing GSDS scores and sleep onset latency, demonstrating its potential as an effective intervention for chronic insomnia. Future studies with larger samples and exploration of long-term effects are needed to confirm these results.
背景：α-s1酪蛋白水解物（ACH；Lactium®）被认为是提高睡眠质量的辅助疗法。然而，利用客观睡眠评估工具进行的研究有限，因此缺乏实质性的验证。本研究旨在评估 ACH 对主观睡眠评估和客观多导睡眠图（PSG）记录的影响：在这项为期4周的随机、双盲、安慰剂对照试验中，36名被诊断为慢性失眠症的患者被随机分配到ACH组或安慰剂组。最初，ACH 组的参与者每天服用 600 毫克 ACH，后两周减至 300 毫克；安慰剂组在整个研究期间服用麦芽糊精胶囊。该研究利用多导睡眠图（PSG）和详细的睡眠问卷，包括失眠严重程度指数（ISI）、全球睡眠障碍评分（GSDS）、匹兹堡睡眠质量指数（PSQI）、埃普沃斯嗜睡量表（ESS）和医院焦虑抑郁量表（HADS），来评估睡眠质量和相关健康指标的改善情况。通过比较治疗前和治疗后的睡眠效率、阶段分布和心理健康状况，评估干预的效果：研究结果表明，ACH疗法显著提高了睡眠质量，第2周和第4周的ISI、GSDS、PSQI、ESS和HADS评分均有明显改善（所有P值均为结论值）：补充 ACH 能明显改善睡眠质量，特别是通过降低 GSDS 分数和睡眠开始潜伏期，证明了其作为慢性失眠症有效干预措施的潜力。今后还需要对更大样本进行研究，并探索长期效果，以证实这些结果。
{"title":"The impact of Alpha-s1 Casein hydrolysate on chronic insomnia: A randomized, double-blind controlled trial","authors":"Ching-Mao Chang , I-Ju Tsai , Cheng-Chia Yang , Wen-Chun Liu , Chun-Pai Yang","doi":"10.1016/j.clnu.2024.10.039","DOIUrl":"10.1016/j.clnu.2024.10.039","url":null,"abstract":"<div><h3>Background</h3><div>Alpha-s1 casein hydrolysate (ACH; Lactium®) is recognized as a supplementary treatment to enhance sleep quality. However, limited studies utilizing objective sleep assessment tools have resulted in a lack of substantial validation. This study aimed to assess the effects of ACH on both subjective sleep assessments and objective polysomnography (PSG) recordings in a hospital-based cohort of Taiwanese individuals with chronic insomnia.</div></div><div><h3>Methods</h3><div>In this 4-week randomized, double-blind, placebo-controlled trial, 36 participants diagnosed with chronic insomnia were enrolled and randomly assigned to either the ACH or placebo groups. Initially, participants in the ACH group received 600 mg of ACH daily, which was reduced to 300 mg for the latter two weeks; the placebo group received maltodextrin capsules throughout the study. The study utilized polysomnography (PSG), along with detailed sleep questionnaires including the Insomnia Severity Index (ISI), Global Sleep Disorders Score (GSDS), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Hospital Anxiety and Depression Scale (HADS), to assess improvements in sleep quality and related health markers. The efficacy of the intervention was assessed through measures of sleep efficiency, stage distribution, and psychological well-being, comparing results from before to after the treatment phase.</div></div><div><h3>Results</h3><div>The study demonstrated that ACH treatment notably enhanced sleep quality, evidenced by significant improvements in ISI, GSDS, PSQI, ESS, and HADS scores at both week 2 and 4 (all p-values <0.05) compared with baseline scores. When compared to the placebo group, the ACH group experienced a marked reduction in GSDS scores over time (p = 0.045). Furthermore, PSG data revealed a significant decrease in sleep onset latency from baseline in the ACH group compared to the placebo group (p = 0.012; −7.7 ± 16.0 min vs. 6.1 ± 17.7 min for ACH and placebo groups, respectively). These results indicate that ACH treatment effectively improved sleep initiation and overall sleep quality.</div></div><div><h3>Conclusion</h3><div>ACH Supplementation significantly improved sleep quality, particularly by reducing GSDS scores and sleep onset latency, demonstrating its potential as an effective intervention for chronic insomnia. Future studies with larger samples and exploration of long-term effects are needed to confirm these results.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 275-284"},"PeriodicalIF":6.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-06DOI: 10.1016/j.clnu.2024.10.037
Vittoria Zambon Azevedo , Pierre Bel Lassen , Judith Aron-Wisnewsky , Laurent Genser , Frederic Charlotte , Pierre Bedossa , Maharajah Ponnaiah , Raluca Pais , Karine Clément , Jean-Michel Oppert , Vlad Ratziu
Background & aims
Sarcopenic obesity (SO) is associated with cardiometabolic disorders and steatotic liver disease and carries major health risks. We assessed the hepatic and metabolic clinical phenotype associated with SO in patients with obesity undergoing bariatric surgery (BS). We also evaluated whether weight-loss and metabolic improvement post-surgery differ between patients with and without SO.
Methods
972 consecutive patients from a single-center BS cohort who underwent whole-body dual-energy X-ray absorptiometry (DXA) and peri-operative liver biopsy were included. SO was diagnosed using the AIM-SO score, an AI-assisted unbiased clustering algorithm based on body composition. One-year post-surgery, 862 patients were reassessed for AIM-SO score changes.
Results
Pre-operatively, 207 (21.3 %) patients were diagnosed with SO. These patients had significantly higher prevalence of type-2 diabetes (T2D), arterial hypertension and obstructive sleep apnea (OSA) compared to patients without SO (all p ≤ 0.003). Patients with SO had more severe liver damage: higher grades of moderate/advanced steatosis (64.2 % vs. 47.3 %), steatohepatitis (44.4 % vs. 32.3 %) and advanced fibrosis (12.1 % vs. 6.0 %) (all p ≤ 0.01). One-year post-BS, 58.5 % of patients had remission of SO. Patients with persistent SO exhibited less weight-loss than those with SO remission (−23.8 kg vs. −29.1 kg, p < 0.001) and had lower rates of remission for T2D (41.9 % vs. 69.8 %), arterial hypertension (20.8 % vs. 45.3 %), and metabolic syndrome (47.6 % vs. 75.0 %) (all p ≤ 0.009).
Conclusion
The DXA-based AIM-SO score identifies patients with SO who are at greater risk of hepatic and cardiometabolic comorbidities, and predicts less favorable weight-loss and metabolic improvements post-BS.
背景与目的：肌肉松弛性肥胖（Sarcopenic obesity，SO）与心脏代谢紊乱和脂肪性肝病有关，具有重大的健康风险。我们评估了接受减肥手术（BS）的肥胖患者中与 SO 相关的肝脏和代谢临床表型。我们还评估了有 SO 和没有 SO 的患者在术后体重减轻和代谢改善方面是否存在差异。方法：我们纳入了来自单中心减肥手术队列的 972 名连续患者，他们都接受了全身双能 X 光吸收测定（DXA）和围手术期肝脏活检。SO采用AIM-SO评分进行诊断，这是一种基于身体成分的人工智能辅助无偏见聚类算法。术后一年，对862名患者的AIM-SO评分变化进行了重新评估：术前，207 名患者（21.3%）被诊断为 SO。与无 SO 患者相比，这些患者的 2 型糖尿病（T2D）、动脉高血压和阻塞性睡眠呼吸暂停（OSA）发病率明显更高（P 均≤ 0.003）。SO患者的肝损伤更严重：中度/重度脂肪变性（64.2% 对 47.3%）、脂肪性肝炎（44.4% 对 32.3%）和晚期纤维化（12.1% 对 6.0%）的程度更高（所有 p 均小于 0.01）。BS一年后，58.5%的患者SO症状缓解。与SO缓解的患者相比，SO持续存在的患者体重减轻幅度较小（-23.8千克对-29.1千克，P 结论：SO缓解的患者体重减轻幅度较小（-23.8千克对-29.1千克，P）：基于 DXA 的 AIM-SO 评分可识别出肝脏和心脏代谢合并症风险较高的 SO 患者，并预测 BBS 后体重减轻和代谢改善的情况。
{"title":"Metabolic and hepatic phenotypes in sarcopenic obesity and impact of bariatric surgery","authors":"Vittoria Zambon Azevedo , Pierre Bel Lassen , Judith Aron-Wisnewsky , Laurent Genser , Frederic Charlotte , Pierre Bedossa , Maharajah Ponnaiah , Raluca Pais , Karine Clément , Jean-Michel Oppert , Vlad Ratziu","doi":"10.1016/j.clnu.2024.10.037","DOIUrl":"10.1016/j.clnu.2024.10.037","url":null,"abstract":"<div><h3>Background & aims</h3><div>Sarcopenic obesity (SO) is associated with cardiometabolic disorders and steatotic liver disease and carries major health risks. We assessed the hepatic and metabolic clinical phenotype associated with SO in patients with obesity undergoing bariatric surgery (BS). We also evaluated whether weight-loss and metabolic improvement post-surgery differ between patients with and without SO.</div></div><div><h3>Methods</h3><div>972 consecutive patients from a single-center BS cohort who underwent whole-body dual-energy X-ray absorptiometry (DXA) and peri-operative liver biopsy were included. SO was diagnosed using the AIM-SO score, an AI-assisted unbiased clustering algorithm based on body composition. One-year post-surgery, 862 patients were reassessed for AIM-SO score changes.</div></div><div><h3>Results</h3><div>Pre-operatively, 207 (21.3 %) patients were diagnosed with SO. These patients had significantly higher prevalence of type-2 diabetes (T2D), arterial hypertension and obstructive sleep apnea (OSA) compared to patients without SO (all p ≤ 0.003). Patients with SO had more severe liver damage: higher grades of moderate/advanced steatosis (64.2 % vs. 47.3 %), steatohepatitis (44.4 % vs. 32.3 %) and advanced fibrosis (12.1 % vs. 6.0 %) (all p ≤ 0.01). One-year post-BS, 58.5 % of patients had remission of SO. Patients with persistent SO exhibited less weight-loss than those with SO remission (−23.8 kg vs. −29.1 kg, p < 0.001) and had lower rates of remission for T2D (41.9 % vs. 69.8 %), arterial hypertension (20.8 % vs. 45.3 %), and metabolic syndrome (47.6 % vs. 75.0 %) (all p ≤ 0.009).</div></div><div><h3>Conclusion</h3><div>The DXA-based AIM-SO score identifies patients with SO who are at greater risk of hepatic and cardiometabolic comorbidities, and predicts less favorable weight-loss and metabolic improvements post-BS.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 254-264"},"PeriodicalIF":6.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We have recently demonstrated that subcutaneous adipose tissue (SAT) expression of genes associated with thyroid hormone (TH) action is altered in obesity and insulin resistance. The aim of the present study was to examine the effect of diet-induced weight-loss on SAT expression of genes associated with TH action.
Methods
The study group comprised 38 individuals with overweight/obesity, which completed 12-week dietary intervention program. Hyperinsulinemic-euglycemic clamp and SAT biopsy were performed before and after the program. Fifteen normal-weight individuals were examined at baseline only.
Results
Overweight/obese individuals had lower free thyroxine (fT4) and higher free triiodothyronine (fT3)/fT4 ratio, lower SAT TH receptor isoforms (TRα and TRβ, encoded by THRA and THRB, respectively) and peroxisome proliferator-activated receptor γ coactivator 1α (PPARGC1A) mRNA expression and higher SAT type II and type III iodothyronine deiodinase (encoded by DIO2 and DIO3, respectively) and nuclear receptor corepressor (NCOR1) mRNA expression in comparison with normal-weight individuals. Diet-induced weight loss resulted in a decrease in fT3 and fT3/fT4 ratio and an increase in SAT THRA, THRB and PPARGC1A. SAT NCOR1 and forkhead box protein O1 (FOXO1) decreased only in individuals, who lost at least 10 kg (n = 20). Higher increase in insulin sensitivity after weight loss was associated with a lower decrease in fT3/fT4 ratio.
Conclusions
Diet-induced weight loss partly reverses alterations in SAT expression of genes associated with TH action. Responses of circulating TH and SAT expression of genes associated with TH action to diet-induced weight loss are related to body weight and insulin sensitivity.
{"title":"The effect of diet-induced weight-loss on subcutaneous adipose tissue expression of genes associated with thyroid hormone action","authors":"Marek Strączkowski , Magdalena Stefanowicz , Agnieszka Nikołajuk , Monika Karczewska-Kupczewska","doi":"10.1016/j.clnu.2024.11.006","DOIUrl":"10.1016/j.clnu.2024.11.006","url":null,"abstract":"<div><h3>Background & aims</h3><div>We have recently demonstrated that subcutaneous adipose tissue (SAT) expression of genes associated with thyroid hormone (TH) action is altered in obesity and insulin resistance. The aim of the present study was to examine the effect of diet-induced weight-loss on SAT expression of genes associated with TH action.</div></div><div><h3>Methods</h3><div>The study group comprised 38 individuals with overweight/obesity, which completed 12-week dietary intervention program. Hyperinsulinemic-euglycemic clamp and SAT biopsy were performed before and after the program. Fifteen normal-weight individuals were examined at baseline only.</div></div><div><h3>Results</h3><div>Overweight/obese individuals had lower free thyroxine (fT4) and higher free triiodothyronine (fT3)/fT4 ratio, lower SAT TH receptor isoforms (TRα and TRβ, encoded by <em>THRA</em> and <em>THRB</em>, respectively) and peroxisome proliferator-activated receptor γ coactivator 1α (<em>PPARGC1A</em>) mRNA expression and higher SAT type II and type III iodothyronine deiodinase (encoded by <em>DIO2</em> and <em>DIO3</em>, respectively) and nuclear receptor corepressor (<em>NCOR1</em>) mRNA expression in comparison with normal-weight individuals. Diet-induced weight loss resulted in a decrease in fT3 and fT3/fT4 ratio and an increase in SAT <em>THRA</em>, <em>THRB</em> and <em>PPARGC1A</em>. SAT <em>NCOR1</em> and forkhead box protein O1 (<em>FOXO1</em>) decreased only in individuals, who lost at least 10 kg (n = 20). Higher increase in insulin sensitivity after weight loss was associated with a lower decrease in fT3/fT4 ratio.</div></div><div><h3>Conclusions</h3><div>Diet-induced weight loss partly reverses alterations in SAT expression of genes associated with TH action. Responses of circulating TH and SAT expression of genes associated with TH action to diet-induced weight loss are related to body weight and insulin sensitivity.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 245-250"},"PeriodicalIF":6.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-05DOI: 10.1016/j.clnu.2024.10.036
Mingchong Liu, Jiaming Wang, Chensong Yang, Guixin Sun
{"title":"Letter to the editor - “Association between caffeine metabolites in urine and muscle strength in young and older adults: A cross-sectional study from NHANES 2011–2012”","authors":"Mingchong Liu, Jiaming Wang, Chensong Yang, Guixin Sun","doi":"10.1016/j.clnu.2024.10.036","DOIUrl":"10.1016/j.clnu.2024.10.036","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 252-253"},"PeriodicalIF":6.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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