Clinical nutrition最新文献

英文中文

Skeletal muscle density as a new predictor of abdominal infection in abdominal trauma patients 骨骼肌密度是腹部创伤患者腹腔感染的新预测指标。

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-10-26 DOI: 10.1016/j.clnu.2024.10.035

Fengchan Xi , Nan Zheng , Bing Xiong , Di Wang , Ran Teng , Xinxing Zhang , Tongtong Zhang , Caiyun Wei , Xiling Wang , Shanjun Tan

Background and aims

Skeletal muscle density (SMD) is a valuable prognostic indicator in various conditions such as cancer, liver cirrhosis. Yet, the connection between SMD and intra-abdominal infection in individuals who have suffered abdominal injuries is still unclear. The purpose of this research is to examine how well SMD can predict intra-abdominal infection in patients who have suffered abdominal trauma.

Methods

Participants with abdominal injuries were included in this research from January 2015 to April 2023. Based on the sex-specific cut off values of SMD, the entire population was split into two categories. Prognostic factors were identified through logistic regression analysis. ROC was used to assess the predictive accuracy of SMD and its combinations with other biomarkers for clinical outcomes.

Results

A total of 220 patients were ultimately included in the study. Patients in the group with low SMD exhibited a higher incidence of intra-abdominal infection, longer hospital stays, and increased hospital costs. In patients with abdominal trauma, low SMD was identified as a significant independent predictor of intra-abdominal infection (OR 2.397; 95 % CI 1.117–5.141, p = 0.025). Low SMD had a higher area under the curve (AUC) in ROC analysis compared to TRF, NRS2002 score, and APACHEII score for predicting intra-abdominal infection (AUC 0.70, 95 % CI 0.61–0.78, p = 0.002). Moreover, low SMD showed associations with clinical outcomes such as hospital stay length and costs (p < 0.01).

Conclusions

Low SMD is recognized as an independent risk factor for predicting intra-abdominal infections in this patient population. Notably, SMD is emerging as a novel predictor of abdominal infections in patients with abdominal trauma.

背景和目的：骨骼肌密度（SMD）是癌症、肝硬化等多种疾病的重要预后指标。然而，SMD 与腹部受伤者腹腔内感染之间的联系仍不清楚。本研究的目的是探讨SMD如何预测腹部创伤患者的腹腔内感染：本研究纳入了 2015 年 1 月至 2023 年 4 月期间腹部受伤的参与者。根据SMD的性别特异性截断值，将全部人群分为两类。通过逻辑回归分析确定了预后因素。ROC用于评估SMD及其与其他生物标志物组合对临床结果的预测准确性：最终共有220名患者被纳入研究。低SMD组患者腹腔内感染发生率较高，住院时间较长，住院费用增加。在腹部创伤患者中，低 SMD 被确定为腹腔内感染的重要独立预测因素（OR 2.397; 95 % CI 1.117-5.141, p = 0.025）。在预测腹腔内感染的 ROC 分析中，与 TRF、NRS2002 评分和 APACHEII 评分相比，低 SMD 具有更高的曲线下面积（AUC）（AUC 0.70，95 % CI 0.61-0.78，p = 0.002）。此外，低 SMD 与住院时间和费用等临床结果也有关联（p 结论：低 SMD 被认为是一种独立的临床指标：低 SMD 被认为是预测此类患者腹腔内感染的独立风险因素。值得注意的是，SMD 正在成为腹部创伤患者腹腔感染的一个新的预测因素。

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引用次数: 0

Effectiveness of N-3 fatty acids supplementation on spondyloarthritis: A systematic review and meta-analysis 补充 N-3 脂肪酸对脊柱关节炎的疗效：系统回顾和荟萃分析

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-10-23 DOI: 10.1016/j.clnu.2024.10.024

Elpida Skouvaklidou , Xenophon Theodoridis , Eleni Tziona , Periklis Vounotrypidis , Theodoros Dimitroulas , Michail Chourdakis

Background & aims

The study aims to systematically review and meta-analyze randomized controlled trials (RCTs) assessing the effects of n-3 fatty acids (FA) supplementation on spondyloarthritis (SpA) disease activity, inflammatory markers, and imaging.

Methods

The study protocol was developed and registered online in advance. The PubMed, SCOPUS, and Cochrane Central Register of Controlled Trials (CENTRAL) electronic databases were systematically searched for RCTs up to April 2024. Two independent reviewers screened, assessed for eligibility, and extracted data from the eligible RCTs. The revised Cochrane Risk of Bias tool was used to assess the quality of trials. The random-effects model was used to calculate the pooled estimates.

Results

We included four RCTs, involving 245 patients with SpA. Supplementation with n-3 FA did not improve physician-reported outcomes [number of tender joints (four trials, standardized mean difference (SMD): −0.22; 95 % confidence interval (CI): −0.74 to 0.29; I² = 61 %), number of swollen joints (two trials, SMD: −0.13; 95 % CI: −0.42 to 0.15; I² = 0 %)], and patient-reported outcomes [pain (three trials, SMD: −0.16; 95 % CI: −1.03 to 0.70; I² = 74 %), Health Assessment Questionnaire (three trials, SMD: −0.04; 95 % CI: −0.78 to 0.70; I² = 71 %). The other nine pre-specified outcomes were not analyzed due to lack of information from the original RCTs which were evaluated as «some concerns» or «high risk» of bias.

Conclusions

In the present systematic review and meta-analysis including placebo-controlled RCTs, n-3 FA supplementation did not show improvement in the reported outcomes. Future RCTs should be conducted with homogenous intervention, placebo, and outcomes to re-examine possible beneficial effects.

背景& 目的本研究旨在系统回顾和荟萃分析评估补充 n-3 脂肪酸（FA）对脊柱关节炎（SpA）疾病活动、炎症标志物和影像学影响的随机对照试验（RCT）。在PubMed、SCOPUS和Cochrane对照试验中央注册中心（CENTRAL）电子数据库中系统检索了截至2024年4月的RCTs。两名独立审稿人对符合条件的 RCT 进行筛选、资格评估和数据提取。修订版 Cochrane 偏倚风险工具用于评估试验质量。结果我们纳入了四项RCT，涉及245名SpA患者。补充 n-3 FA 并未改善医生报告的结果[触痛关节的数量（四项试验，标准化平均差 (SMD)：-0.22；95 % 置信度）]：-0.22；95% 置信区间 (CI)：-疼痛（三项试验，SMD：-0.16；95 % CI：-1.03 至 0.70；I2 = 74 %），健康评估问卷（三项试验，SMD：-0.04；95 % CI：-0.78 至 0.70；I2 = 71 %）。结论在本系统综述和荟萃分析（包括安慰剂对照的 RCTs）中，补充 n-3 FA 并未改善所报告的结果。今后应采用同质干预、同质安慰剂和同质结果进行 RCT 研究，以重新审查可能的有益效果。

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引用次数: 0

Reply – “Letter to the Editor–Very-low calorie diet and Semaglutide: Synergy and long-term impact on type 2 diabetes management” 回复--"致编辑的信--超低卡路里饮食和塞马鲁肽：协同作用和对 2 型糖尿病管理的长期影响"。

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-10-22 DOI: 10.1016/j.clnu.2024.10.033

Oluwaseun Anyiam, Bethan Phillips, Katie Quinn, Daniel Wilkinson, Kenneth Smith, Philip Atherton , Iskandar Idris

引用次数: 0

The potential of body mass index-adjusted calf circumference as a proxy for low muscle mass in the global leadership initiative on malnutrition criteria 体重指数调整后的小腿围度作为全球营养不良领导倡议标准中低肌肉质量替代指标的潜力

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-10-22 DOI: 10.1016/j.clnu.2024.10.025

Shuzo Miyahara , Keisuke Maeda , Akiyuki Yasuda , Shosuke Satake , Hidenori Arai

Background & aims

Reduced muscle mass is one of the diagnostic components for Global Leadership Initiative on Malnutrition (GLIM), with various assessment methods proposed. Calf circumference (CC), a representative anthropometric marker of skeletal muscle mass, is now recommended to adjustment based on body mass index (BMI). This study aimed to evaluate the validity and efficacy of BMI-adjusted CC in very older adults, compared with other methods of assessing muscle mass.

Methods

This prospective cohort study included 284 patients aged 65 years and older who were admitted to the Department of Geriatric Medicine at the National Center for Geriatrics and Gerontology Hospital. Health indicators, including nutritional status, were assessed upon admission. Three months after discharge, a telephone survey was conducted to assess patients’ living conditions and survival status. Skeletal muscle mass was estimated using a dual-energy X-ray absorptiometry (DXA); moreover, anthropometric measurements (unadjusted and BMI-adjusted CC) were used as markers of muscle mass. Logistic regression analysis was performed to examine the association between mortality and GLIM-based malnutrition, using each muscle mass assessment method.

Results

The mean age of the patients was 86.2 ± 6.2 years, and 60.9 % were women. The prevalence of GLIM-based malnutrition ranged from 55.3 % to 58.8 % across the three methods used to assess reduced muscle mass. Three months after discharge, 244 patients were followed up, of whom 29 (11.9 %) died. Multivariate logistic regression analysis, adjusted for age, sex, and comorbidities, showed that all methods significantly predicted 3-month mortality, with odds ratios of 5.67, 5.44, and 4.90 for unadjusted CC, BMI-adjusted CC, and appendicular skeletal muscle mass index using DXA, respectively. The prevalence and survival-predictive ability were similar across all methods.

Conclusion

GLIM-based malnutrition, diagnosed using different methods for assessing muscle mass, similarly predicted 3-month mortality in patients admitted to an acute geriatric ward. These results suggest that BMI-adjusted CC are sufficient alternatives when technical measurements such as DXA are not feasible.

背景& 目的肌肉质量下降是全球领导力营养不良倡议（GLIM）的诊断内容之一，并提出了各种评估方法。小腿围（CC）是骨骼肌质量的代表性人体测量指标，目前建议根据体重指数（BMI）进行调整。这项前瞻性队列研究纳入了 284 名年龄在 65 岁及以上、入住国家老年医学和老年病学中心医院老年医学部的患者。入院时对包括营养状况在内的健康指标进行了评估。出院三个月后，对患者的生活条件和生存状况进行了电话调查。骨骼肌质量是通过双能 X 射线吸收测定法（DXA）估算出来的；此外，人体测量（未调整和 BMI 调整后的 CC）也被用作肌肉质量的标记。采用每种肌肉质量评估方法，对死亡率和基于 GLIM 的营养不良之间的关系进行了逻辑回归分析。结果患者的平均年龄为（86.2 ± 6.2）岁，60.9%为女性。在三种评估肌肉质量减少的方法中，基于 GLIM 的营养不良发生率从 55.3% 到 58.8% 不等。出院三个月后，对 244 名患者进行了随访，其中 29 人（11.9%）死亡。经年龄、性别和合并症调整后的多变量逻辑回归分析表明，所有方法都能显著预测 3 个月的死亡率，未调整的 CC、BMI 调整的 CC 和使用 DXA 的附属骨骼肌质量指数的几率比分别为 5.67、5.44 和 4.90。结论使用不同的肌肉质量评估方法诊断出的基于 GLIM 的营养不良同样可以预测入住老年病急症病房的患者 3 个月的死亡率。这些结果表明，在无法进行 DXA 等技术测量的情况下，BMI 调整后的 CC 足以作为替代方法。

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引用次数: 0

Reply–Letter to the editor–The prevalence and effects of sarcopenia in patients with metabolic dysfunction-associated steatotic liver disease (MASLD): A systematic review and meta-analysis 回复-致编辑的信-代谢功能障碍相关性脂肪性肝病（MASLD）患者中肌肉疏松症的患病率及其影响：系统回顾与荟萃分析

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-10-22 DOI: 10.1016/j.clnu.2024.10.032

Xiaoyan Li, Qiuhua Sun

引用次数: 0

Letter to the editor - “Western diet-induced cognitive and metabolic dysfunctions in aged mice are prevented by rosmarinic acid in a sex-dependent fashion" 致编辑的信--"迷迭香酸能以性别依赖的方式防止西方饮食引起的老年小鼠认知和代谢功能障碍

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-10-22 DOI: 10.1016/j.clnu.2024.10.034

Hua Zhao, Jiayue Xu, Yuejun Zhou

引用次数: 0

Reply–Letter to the Editor “Rethinking diet and cognitive health: Toward comprehensive methodological improvements” 回复-致编辑的信 "反思饮食与认知健康：全面改进方法"

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-10-22 DOI: 10.1016/j.clnu.2024.10.031

Natalia Ortega, Leona Schütte, Patricia O. Chocano-Bedoya

引用次数: 0

Unveiling the complex interplay between gut microbiota and polycystic ovary syndrome: A narrative review 揭示肠道微生物群与多囊卵巢综合征之间复杂的相互作用：叙述性综述

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-10-22 DOI: 10.1016/j.clnu.2024.10.028

Rohit Gautam , Pratibha Maan , Arbind Kumar Patel , Sudharsan Vasudevan , Taruna Arora

Background & aim

Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder that affects women throughout their reproductive age and characterised via polycystic ovaries, hyperandrogenism, and irregular menstruation. There is rising evidence that the pathophysiology of PCOS is significantly affected via the gut microbiota and its metabolic products.

Methods

This narrative review synthesizes current literature exploring the relationship between gut microbiota and PCOS. A comprehensive search of electronic databases was conducted to identify relevant studies. Further this review also analysed therapeutic options of probiotics, prebiotics, Fecal Microbiota Transplant (FMT), high fiber and poly phenol rich diet and novel therapeutic agents in treatment of PCOS.

Results

Emerging evidence suggests alterations in the composition and diversity of gut microbiota in women with PCOS. The current literature showed a complex relationship of gut microbiota, short chain fatty acids (SCFAs) metabolism, intestinal permeability and LPS (Lipid Polysaccharide) metabolism, gut-brain axis and bile acid (BA) pathway within etiology and pathophysiology of PCOS. Additionally, the factors such as diet, lifestyle, genetics, and environmental influences may all contribute to alterations in gut microbiota that could potentially exacerbate or mitigate PCOS symptoms.

Conclusion

The review provides valuable insights into the intricate interplay between the gut and female reproductive health. The present evidence suggested that alterations in diversity and function of the gut microbiota may lead to specific pathogenic changes that lead to development of PCOS. A comprehensive understanding of these microbial dynamics may lead to new therapeutic approaches that target the gut micro biome.

背景& 目的多囊卵巢综合症（PCOS）是一种复杂的内分泌失调症，影响整个育龄期的女性，其特点是多囊卵巢、高雄激素和月经不调。越来越多的证据表明，多囊卵巢综合征的病理生理学受到肠道微生物群及其代谢产物的显著影响。我们对电子数据库进行了全面检索，以确定相关研究。此外，本综述还分析了治疗多囊卵巢综合征的益生菌、益生元、粪便微生物群移植（FMT）、高纤维和富含多酚的饮食以及新型治疗药物等治疗方案。结果越来越多的证据表明，多囊卵巢综合征女性患者肠道微生物群的组成和多样性发生了改变。目前的文献显示，肠道微生物群、短链脂肪酸（SCFAs）代谢、肠道通透性和 LPS（脂质多糖）代谢、肠道-大脑轴和胆汁酸（BA）途径在多囊卵巢综合征的病因学和病理生理学中有着复杂的关系。此外，饮食、生活方式、遗传和环境影响等因素都可能导致肠道微生物群的改变，从而有可能加重或减轻多囊卵巢综合征的症状。目前的证据表明，肠道微生物群多样性和功能的改变可能会导致特定的致病性变化，从而导致多囊卵巢综合症的发生。对这些微生物动态的全面了解可能会带来针对肠道微生物群的新治疗方法。

{"title":"Unveiling the complex interplay between gut microbiota and polycystic ovary syndrome: A narrative review","authors":"Rohit Gautam , Pratibha Maan , Arbind Kumar Patel , Sudharsan Vasudevan , Taruna Arora","doi":"10.1016/j.clnu.2024.10.028","DOIUrl":"10.1016/j.clnu.2024.10.028","url":null,"abstract":"<div><h3>Background & aim</h3><div>Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder that affects women throughout their reproductive age and characterised via polycystic ovaries, hyperandrogenism, and irregular menstruation. There is rising evidence that the pathophysiology of PCOS is significantly affected via the gut microbiota and its metabolic products.</div></div><div><h3>Methods</h3><div>This narrative review synthesizes current literature exploring the relationship between gut microbiota and PCOS. A comprehensive search of electronic databases was conducted to identify relevant studies. Further this review also analysed therapeutic options of probiotics, prebiotics, Fecal Microbiota Transplant (FMT), high fiber and poly phenol rich diet and novel therapeutic agents in treatment of PCOS.</div></div><div><h3>Results</h3><div>Emerging evidence suggests alterations in the composition and diversity of gut microbiota in women with PCOS. The current literature showed a complex relationship of gut microbiota, short chain fatty acids (SCFAs) metabolism, intestinal permeability and LPS (Lipid Polysaccharide) metabolism, gut-brain axis and bile acid (BA) pathway within etiology and pathophysiology of PCOS. Additionally, the factors such as diet, lifestyle, genetics, and environmental influences may all contribute to alterations in gut microbiota that could potentially exacerbate or mitigate PCOS symptoms.</div></div><div><h3>Conclusion</h3><div>The review provides valuable insights into the intricate interplay between the gut and female reproductive health. The present evidence suggested that alterations in diversity and function of the gut microbiota may lead to specific pathogenic changes that lead to development of PCOS. A comprehensive understanding of these microbial dynamics may lead to new therapeutic approaches that target the gut micro biome.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 199-208"},"PeriodicalIF":6.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554405","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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Letter to the Editor–“Muscle matters: Prognostic implications of malnutrition and muscle health parameters in patients with cancer. A secondary analysis of a randomised trial” 致编辑的信--"肌肉很重要：癌症患者营养不良和肌肉健康参数的预后影响。随机试验的二次分析"

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-10-21 DOI: 10.1016/j.clnu.2024.10.026

Zhangbing Zhou, Liu Wang, Yunfeng Chen

引用次数: 0

Reply–Letter to the editor: The effect of time-restricted eating and low-carbohydrate diet on psychosocial health and appetite in individuals with metabolic syndrome 回复--致编辑：限时进食和低碳水化合物饮食对代谢综合征患者社会心理健康和食欲的影响。

IF 6.6 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition

Pub Date : 2024-10-21 DOI: 10.1016/j.clnu.2024.10.027

Yixuan Zheng, Bingyin Shi , Yanan Wang , Mingqian He

引用次数: 0

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