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The effects of nutritional supplementation for children and adolescents with sickle cell disease: A systematic review and meta-analyses
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-17 DOI: 10.1016/j.clnu.2025.02.016
Bruna C. Orsi , Daniela Gorski , Naila E. Krul , Astrid Wiens , Miguel Brito , Fernanda S. Tonin , Roberto Pontarolo

Background & aims

Sickle cell disease (SCD), a neglected chronic genetic blood disorder that severely impacts the pediatric population, often leading to premature death, is associated with compromised nutritional status. This study aimed to evaluate the effect of nutritional supplementation in SCD-related complications.

Methods

A systematic review with searches in PubMed, Scopus and Web of Science was performed. Randomized controlled trials (RCT) assessing diet or supplements as complementary therapy for children and adolescents with SCD were included (PROSPERO:CRD42024532369). The data for outcomes of interest (efficacy, safety) were pooled by means of pairwise and network meta-analyses with ranking (p-score) analysis. The results were presented as odds ratio or mean differences with 95 % confidence intervals (NMAstudio2.0).

Results

Twenty RCTs were included (2002–2023) (n = 2058), analyzing 9 dietary supplements on different regimens. All patients were in use of hydroxyurea as active treatment. Supplementation with fatty acids (n = 3 studies) and l-arginine (n = 4) presented higher efficacy and safety, significantly improving pain intensity, vaso-occlusive crises (VOC) and inflammation when compared to usual care/placebo (p < 0.05). Vitamin D3 (n = 6) at different dosages may reduce respiratory complications and length of hospital stay, yet further studies are needed to confirm its significant effects. Evidence is limited and of poor quality regarding the effects of add-on vitamin A (n = 2), magnesium sulfate (n = 2) and zinc (n = 4) for this population.

Conclusions

The complementary use of certain supplements (fatty acids, l-arginine, vitamin D3) can enhance the management of VOC and improve patients' physiological functions. These supplements are often affordable and can contribute towards the reduction of opioid use and shorten patients' hospital stays - especially in low/middle-income countries where resources are scarce. Although further studies are needed to refine these findings (e.g., appropriate doses/regimens), practical guidelines and decision-makers may benefit from updated evidence.
{"title":"The effects of nutritional supplementation for children and adolescents with sickle cell disease: A systematic review and meta-analyses","authors":"Bruna C. Orsi ,&nbsp;Daniela Gorski ,&nbsp;Naila E. Krul ,&nbsp;Astrid Wiens ,&nbsp;Miguel Brito ,&nbsp;Fernanda S. Tonin ,&nbsp;Roberto Pontarolo","doi":"10.1016/j.clnu.2025.02.016","DOIUrl":"10.1016/j.clnu.2025.02.016","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Sickle cell disease (SCD), a neglected chronic genetic blood disorder that severely impacts the pediatric population, often leading to premature death, is associated with compromised nutritional status. This study aimed to evaluate the effect of nutritional supplementation in SCD-related complications.</div></div><div><h3>Methods</h3><div>A systematic review with searches in PubMed, Scopus and Web of Science was performed. Randomized controlled trials (RCT) assessing diet or supplements as complementary therapy for children and adolescents with SCD were included (PROSPERO:CRD42024532369). The data for outcomes of interest (efficacy, safety) were pooled by means of pairwise and network meta-analyses with ranking (p-score) analysis. The results were presented as odds ratio or mean differences with 95 % confidence intervals (NMAstudio2.0).</div></div><div><h3>Results</h3><div>Twenty RCTs were included (2002–2023) (n = 2058), analyzing 9 dietary supplements on different regimens. All patients were in use of hydroxyurea as active treatment. Supplementation with fatty acids (n = 3 studies) and <span>l</span>-arginine (n = 4) presented higher efficacy and safety, significantly improving pain intensity, vaso-occlusive crises (VOC) and inflammation when compared to usual care/placebo (p &lt; 0.05). Vitamin D3 (n = 6) at different dosages may reduce respiratory complications and length of hospital stay, yet further studies are needed to confirm its significant effects. Evidence is limited and of poor quality regarding the effects of add-on vitamin A (n = 2), magnesium sulfate (n = 2) and zinc (n = 4) for this population.</div></div><div><h3>Conclusions</h3><div>The complementary use of certain supplements (fatty acids, <span>l</span>-arginine, vitamin D3) can enhance the management of VOC and improve patients' physiological functions. These supplements are often affordable and can contribute towards the reduction of opioid use and shorten patients' hospital stays - especially in low/middle-income countries where resources are scarce. Although further studies are needed to refine these findings (e.g., appropriate doses/regimens), practical guidelines and decision-makers may benefit from updated evidence.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 157-168"},"PeriodicalIF":6.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511490","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}
引用次数: 0
Real-world experience of Teduglutide use in adults with short bowel syndrome: A seven-year international multicenter survey
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-17 DOI: 10.1016/j.clnu.2025.01.026
Francisca Joly , Denise Jezerski , Ulrich-Frank Pape , Adriana Crivelli , Elisabeth Hütterer , Charlotte Bergoin , Anna S. Sasdelli , Umberto Aimasso , Stéphane M. Schneider , Florian Poullenot , David Seguy , Brooke Chapman , Jacek Sobocki , Nunzia Regano , Georg Lamprecht , Sabrina Layec , Lidia Santarpia , Nada Rotovnik Kozjek , Livia Gallitelli , Rafael Lopez-Urdiales , Loris Pironi

Background and aim

Teduglutide is a glucagon-like peptide-2 analogue used to promote intestinal rehabilitation and decrease the dependence from intravenous supplementation (IVS) in patients with short bowel syndrome and intestinal failure (SBS-IF). The aim of this study was to gain a better understanding of international real-world Teduglutide use since its launch.

Methods

Data from an international multicenter database for chronic IF were analysed. All the adult patients with SBS-IF included by centers that treated at least one patient with Teduglutide during the study period (2015–2022) were investigated. The baseline characteristics and the outcome of patients treated with Teduglutide (n.269) were compared to those of patients not receiving the drug (Controls, n.3081). The center experience was categorized based on the number of patients treated with Teduglutide: <10 or ≥10.

Results

Teduglutide cohort exhibited higher male prevalence, younger age, longer duration of HPN, higher percentage of SBS with jejunocolonic anastomosis, lower IVS volume, improved oral intake, and higher percentage of patients weaned from IVS. Controls showed higher percentages of patients deceased or lost to follow up. Centers with ≥10 patients treated with Teduglutide showed higher weaning rates and lower mortality rates.

Conclusions

This is the largest analysis of Teduglutide's real-world setting in SBS-IF. Clinicians preferentially selected for treatment patients with better prognostic indicators. Outcomes were significantly better in centers with higher Teduglutide treatment volumes, emphasizing the need for specialized referral centers to optimize care for SBS-IF patients.
{"title":"Real-world experience of Teduglutide use in adults with short bowel syndrome: A seven-year international multicenter survey","authors":"Francisca Joly ,&nbsp;Denise Jezerski ,&nbsp;Ulrich-Frank Pape ,&nbsp;Adriana Crivelli ,&nbsp;Elisabeth Hütterer ,&nbsp;Charlotte Bergoin ,&nbsp;Anna S. Sasdelli ,&nbsp;Umberto Aimasso ,&nbsp;Stéphane M. Schneider ,&nbsp;Florian Poullenot ,&nbsp;David Seguy ,&nbsp;Brooke Chapman ,&nbsp;Jacek Sobocki ,&nbsp;Nunzia Regano ,&nbsp;Georg Lamprecht ,&nbsp;Sabrina Layec ,&nbsp;Lidia Santarpia ,&nbsp;Nada Rotovnik Kozjek ,&nbsp;Livia Gallitelli ,&nbsp;Rafael Lopez-Urdiales ,&nbsp;Loris Pironi","doi":"10.1016/j.clnu.2025.01.026","DOIUrl":"10.1016/j.clnu.2025.01.026","url":null,"abstract":"<div><h3>Background and aim</h3><div>Teduglutide is a glucagon-like peptide-2 analogue used to promote intestinal rehabilitation and decrease the dependence from intravenous supplementation (IVS) in patients with short bowel syndrome and intestinal failure (SBS-IF). The aim of this study was to gain a better understanding of international real-world Teduglutide use since its launch.</div></div><div><h3>Methods</h3><div>Data from an international multicenter database for chronic IF were analysed. All the adult patients with SBS-IF included by centers that treated at least one patient with Teduglutide during the study period (2015–2022) were investigated. The baseline characteristics and the outcome of patients treated with Teduglutide (n.269) were compared to those of patients not receiving the drug (Controls, n.3081). The center experience was categorized based on the number of patients treated with Teduglutide: &lt;10 or ≥10.</div></div><div><h3>Results</h3><div>Teduglutide cohort exhibited higher male prevalence, younger age, longer duration of HPN, higher percentage of SBS with jejunocolonic anastomosis, lower IVS volume, improved oral intake, and higher percentage of patients weaned from IVS. Controls showed higher percentages of patients deceased or lost to follow up. Centers with ≥10 patients treated with Teduglutide showed higher weaning rates and lower mortality rates.</div></div><div><h3>Conclusions</h3><div>This is the largest analysis of Teduglutide's real-world setting in SBS-IF. Clinicians preferentially selected for treatment patients with better prognostic indicators. Outcomes were significantly better in centers with higher Teduglutide treatment volumes, emphasizing the need for specialized referral centers to optimize care for SBS-IF patients.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 54-67"},"PeriodicalIF":6.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464075","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}
引用次数: 0
An umbrella review of meta-analyses on the effects of microbial therapy in metabolic dysfunction-associated steatotic liver disease
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-15 DOI: 10.1016/j.clnu.2025.02.007
Yuanyue Yao , Qing Hong , Siqi Ding , Jie Cui , Wenhui Li , Jian Zhang , Ye Sun , Yiyang Yu , Mingzhou Yu , Chengcheng Zhang , Lianmin Chen , Jinchi Jiang , Yonghong Hu

Background

Current pharmacological treatments for metabolic dysfunction-associated steatotic liver disease (MASLD) are often accompanied by adverse side effects. Consequently, probiotics, prebiotics, and synbiotics, which are bioactive compounds from fermented foods and offer fewer side effects, have garnered significant attention as alternative therapeutic strategies.

Objective

This study aims to assess the efficacy of microbial therapies—probiotics, prebiotics, and synbiotics—in managing MASLD and to identify the optimal treatment modality for various clinical indicators through a comprehensive umbrella review of meta-analyses.

Methods

A thorough literature search was conducted across PubMed, Web of Science, EMBASE, Cochrane Library, and Scopus to identify 23 meta-analyses over 18,999 MASLD patients as of November 2024.

Results

The findings indicate that microbial treatments positively influence levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), homeostasis model assessment of insulin resistance (HOMA-IR), insulin, tumour necrosis factor-alpha (TNF-α), C-reactive protein (CRP), and body mass index (BMI) in MASLD patients. Notably, probiotics were most effective in reducing TC, ALT, AST, GGT, insulin, TNF-α, and BMI; prebiotics were most effective in reducing TG; and synbiotics were most effective in reducing LDL-C, HOMA-IR, and CRP.

Conclusion

Our study provides robust evidence for microbial treatments of MASLD, enabling targeted interventions for different indicators.
{"title":"An umbrella review of meta-analyses on the effects of microbial therapy in metabolic dysfunction-associated steatotic liver disease","authors":"Yuanyue Yao ,&nbsp;Qing Hong ,&nbsp;Siqi Ding ,&nbsp;Jie Cui ,&nbsp;Wenhui Li ,&nbsp;Jian Zhang ,&nbsp;Ye Sun ,&nbsp;Yiyang Yu ,&nbsp;Mingzhou Yu ,&nbsp;Chengcheng Zhang ,&nbsp;Lianmin Chen ,&nbsp;Jinchi Jiang ,&nbsp;Yonghong Hu","doi":"10.1016/j.clnu.2025.02.007","DOIUrl":"10.1016/j.clnu.2025.02.007","url":null,"abstract":"<div><h3>Background</h3><div>Current pharmacological treatments for metabolic dysfunction-associated steatotic liver disease (MASLD) are often accompanied by adverse side effects. Consequently, probiotics, prebiotics, and synbiotics, which are bioactive compounds from fermented foods and offer fewer side effects, have garnered significant attention as alternative therapeutic strategies.</div></div><div><h3>Objective</h3><div>This study aims to assess the efficacy of microbial therapies—probiotics, prebiotics, and synbiotics—in managing MASLD and to identify the optimal treatment modality for various clinical indicators through a comprehensive umbrella review of meta-analyses.</div></div><div><h3>Methods</h3><div>A thorough literature search was conducted across PubMed, Web of Science, EMBASE, Cochrane Library, and Scopus to identify 23 meta-analyses over 18,999 MASLD patients as of November 2024.</div></div><div><h3>Results</h3><div>The findings indicate that microbial treatments positively influence levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), homeostasis model assessment of insulin resistance (HOMA-IR), insulin, tumour necrosis factor-alpha (TNF-α), C-reactive protein (CRP), and body mass index (BMI) in MASLD patients. Notably, probiotics were most effective in reducing TC, ALT, AST, GGT, insulin, TNF-α, and BMI; prebiotics were most effective in reducing TG; and synbiotics were most effective in reducing LDL-C, HOMA-IR, and CRP.</div></div><div><h3>Conclusion</h3><div>Our study provides robust evidence for microbial treatments of MASLD, enabling targeted interventions for different indicators.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 1-13"},"PeriodicalIF":6.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143438121","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}
引用次数: 0
Life events triggered frailty-related eating behaviors of older adults
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-15 DOI: 10.1016/j.clnu.2025.02.013
Sayaka Nagao-Sato , Yui Kawasaki , Rie Akamatsu , Kahori Fujisaki , Nanami Taniuchi

Background & aims

Support to improve eating behavior could be an effective strategy for preventing frailty, if support is provided at the appropriate time. This study aimed to explore the life events that affect the eating behaviors associated with frailty.

Methods

A cross-sectional, web-based survey was conducted in 2023, and 1200 older adults aged 65–74 years participated. The Kihon Checklist was used to assess frailty status: robustness, prefrailty, or frailty. Thirteen potential frailty-related eating behaviors, adapted from a previous qualitative study, were evaluated for associations with frailty status using ordinal logistic regression models with adjustments. Life events that affected frailty-related behaviors were summarized.

Results

Overall, the proportions of individuals with robustness, prefrailty, and frailty were 40.5 %, 39.1 %, and 20.4 %, respectively. The men with frailty were more likely to have light lunches (adjusted odds ratio (aOR) [95 % confidence interval]: 2.13 [1.26–3.60]) and were less likely to have Westernized meals (aOR: 0.52 [0.30–0.90]), eat together (aOR: 0.39 [0.18–0.85]), go shopping (aOR: 0.44 [0.20–0.97]), and habituate to clean-up (aOR: 0.47 [0.26–0.86]), which were affected mainly by being married or retired. The women with frailty were less likely to have protein-rich foods (aOR: 0.10 [0.02–0.41]), eat together (aOR: 0.43 [0.20–0.93]), and go shopping (aOR: 0.19 [0.06–0.58]), which were affected mainly by getting married.

Conclusion

Nutritional support at retirement and changes in marital status may be effective ways to prevent unfavorable eating behaviors that contribute to frailty. Further studies are needed to capture the whole picture of the life events that affect frailty-related eating behaviors.
{"title":"Life events triggered frailty-related eating behaviors of older adults","authors":"Sayaka Nagao-Sato ,&nbsp;Yui Kawasaki ,&nbsp;Rie Akamatsu ,&nbsp;Kahori Fujisaki ,&nbsp;Nanami Taniuchi","doi":"10.1016/j.clnu.2025.02.013","DOIUrl":"10.1016/j.clnu.2025.02.013","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Support to improve eating behavior could be an effective strategy for preventing frailty, if support is provided at the appropriate time. This study aimed to explore the life events that affect the eating behaviors associated with frailty.</div></div><div><h3>Methods</h3><div>A cross-sectional, web-based survey was conducted in 2023, and 1200 older adults aged 65–74 years participated. The Kihon Checklist was used to assess frailty status: robustness, prefrailty, or frailty. Thirteen potential frailty-related eating behaviors, adapted from a previous qualitative study, were evaluated for associations with frailty status using ordinal logistic regression models with adjustments. Life events that affected frailty-related behaviors were summarized.</div></div><div><h3>Results</h3><div>Overall, the proportions of individuals with robustness, prefrailty, and frailty were 40.5 %, 39.1 %, and 20.4 %, respectively. The men with frailty were more likely to have light lunches (adjusted odds ratio (aOR) [95 % confidence interval]: 2.13 [1.26–3.60]) and were less likely to have Westernized meals (aOR: 0.52 [0.30–0.90]), eat together (aOR: 0.39 [0.18–0.85]), go shopping (aOR: 0.44 [0.20–0.97]), and habituate to clean-up (aOR: 0.47 [0.26–0.86]), which were affected mainly by being married or retired. The women with frailty were less likely to have protein-rich foods (aOR: 0.10 [0.02–0.41]), eat together (aOR: 0.43 [0.20–0.93]), and go shopping (aOR: 0.19 [0.06–0.58]), which were affected mainly by getting married.</div></div><div><h3>Conclusion</h3><div>Nutritional support at retirement and changes in marital status may be effective ways to prevent unfavorable eating behaviors that contribute to frailty. Further studies are needed to capture the whole picture of the life events that affect frailty-related eating behaviors.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 129-135"},"PeriodicalIF":6.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143508322","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}
引用次数: 0
Evidence-based dietary recommendations for patients with psoriasis: A systematic review
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-15 DOI: 10.1016/j.clnu.2025.02.005
Qingyun Wang , Jiao Wang , Xiaoying Sun , Liu Liu , Miao Zhang , Yuanting Yu , Pengbo Gao , Seokgyeong Hong , Xin Li
Psoriasis is a chronic recurrent inflammatory skin disease mediated by immune, genetic, and environmental factors. Numerous studies have demonstrated that the excessive consumption of certain pro-inflammatory foods, including alcohol, dairy products, high-sugar foods, and gluten, can exacerbate psoriasis. Thus, modifying one's dietary habits can alleviate psoriasis symptoms. However, high-quality evidence regarding the relationship between diet and psoriasis is currently lacking. This review provides insight into the dietary management of psoriasis by reviewing previous dietary therapies. An extensive search of the PubMed, Embase, and Cochrane databases for clinical studies of psoriasis and diet revealed that diets meeting Mediterranean, gluten-free, or calorie-restricted principles, dietary fiber, probiotic, prebiotic, and n-3 fatty acid contents may be associated with improved psoriasis outcomes. Additionally, patients with psoriasis should avoid consuming alcohol and high amounts of salt. Overall, based on findings from the current literature, this review aimed to guide dietary treatment options for patients with psoriasis.
{"title":"Evidence-based dietary recommendations for patients with psoriasis: A systematic review","authors":"Qingyun Wang ,&nbsp;Jiao Wang ,&nbsp;Xiaoying Sun ,&nbsp;Liu Liu ,&nbsp;Miao Zhang ,&nbsp;Yuanting Yu ,&nbsp;Pengbo Gao ,&nbsp;Seokgyeong Hong ,&nbsp;Xin Li","doi":"10.1016/j.clnu.2025.02.005","DOIUrl":"10.1016/j.clnu.2025.02.005","url":null,"abstract":"<div><div>Psoriasis is a chronic recurrent inflammatory skin disease mediated by immune, genetic, and environmental factors. Numerous studies have demonstrated that the excessive consumption of certain pro-inflammatory foods, including alcohol, dairy products, high-sugar foods, and gluten, can exacerbate psoriasis. Thus, modifying one's dietary habits can alleviate psoriasis symptoms. However, high-quality evidence regarding the relationship between diet and psoriasis is currently lacking. This review provides insight into the dietary management of psoriasis by reviewing previous dietary therapies. An extensive search of the PubMed, Embase, and Cochrane databases for clinical studies of psoriasis and diet revealed that diets meeting Mediterranean, gluten-free, or calorie-restricted principles, dietary fiber, probiotic, prebiotic, and n-3 fatty acid contents may be associated with improved psoriasis outcomes. Additionally, patients with psoriasis should avoid consuming alcohol and high amounts of salt. Overall, based on findings from the current literature, this review aimed to guide dietary treatment options for patients with psoriasis.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 68-82"},"PeriodicalIF":6.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464157","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}
引用次数: 0
Glucosamine supplementation attenuates progression of metabolic dysfunction-associated steatotic liver disease and related comorbidities
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-14 DOI: 10.1016/j.clnu.2025.02.012
Tom Ryu , Young Chang , Jeong-Ju Yoo , Sae Hwan Lee , Soung Won Jeong , Sang Gyune Kim , Young Seok Kim , Hong Soo Kim , Keungmo Yang , Jae Young Jang

Background & aims

This study examines the impact of glucosamine on the progression and outcomes of metabolic dysfunction-associated steatotic liver disease (MASLD), and metabolic dysfunction and alcohol-associated liver disease (MetALD) using a large scale cohort.

Methods

Present study utilized inverse probability of treatment weighting (IPTW) to adjust for confounders in this cohort study. Participants were classified based on glucosamine use, and primary and secondary outcomes included all-cause mortality, liver cirrhosis, cardiovascular disease, cerebrovascular disease, and chronic kidney disease (CKD) incidences. Cox proportional hazards models were used to assess hazard ratios and 95 % confidence intervals.

Results

We found that glucosamine significantly reduces all-cause mortality in MASLD and MetALD cohorts after IPTW adjustment (P < 0.001). Additionally, glucosamine use was associated with lower liver cirrhosis incidence in MASLD both before (P = 0.003) and after IPTW adjustment (P = 0.046). Glucosamine also decreased cardiovascular disease risk in MASLD (P < 0.001) and MetALD (P = 0.037) cohorts, though it showed no significant impact on cerebrovascular disease incidence. Furthermore, glucosamine use was associated with a significantly lower incidence of CKD in the MASLD cohort (P = 0.034) and the entire cohort (P = 0.030), but not in the No steatotic liver disease cohort or MetALD cohort.

Conclusion

The findings suggest that glucosamine could be a beneficial supplementary therapy for managing steatotic liver diseases, particularly for patients at high risk for cardiovascular and renal complications. Further clinical trials are required to validate these potential benefits.
{"title":"Glucosamine supplementation attenuates progression of metabolic dysfunction-associated steatotic liver disease and related comorbidities","authors":"Tom Ryu ,&nbsp;Young Chang ,&nbsp;Jeong-Ju Yoo ,&nbsp;Sae Hwan Lee ,&nbsp;Soung Won Jeong ,&nbsp;Sang Gyune Kim ,&nbsp;Young Seok Kim ,&nbsp;Hong Soo Kim ,&nbsp;Keungmo Yang ,&nbsp;Jae Young Jang","doi":"10.1016/j.clnu.2025.02.012","DOIUrl":"10.1016/j.clnu.2025.02.012","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>This study examines the impact of glucosamine on the progression and outcomes of metabolic dysfunction-associated steatotic liver disease (MASLD), and metabolic dysfunction and alcohol-associated liver disease (MetALD) using a large scale cohort.</div></div><div><h3>Methods</h3><div>Present study utilized inverse probability of treatment weighting (IPTW) to adjust for confounders in this cohort study. Participants were classified based on glucosamine use, and primary and secondary outcomes included all-cause mortality, liver cirrhosis, cardiovascular disease, cerebrovascular disease, and chronic kidney disease (CKD) incidences. Cox proportional hazards models were used to assess hazard ratios and 95 % confidence intervals.</div></div><div><h3>Results</h3><div>We found that glucosamine significantly reduces all-cause mortality in MASLD and MetALD cohorts after IPTW adjustment (<em>P</em> &lt; 0.001). Additionally, glucosamine use was associated with lower liver cirrhosis incidence in MASLD both before (<em>P</em> = 0.003) and after IPTW adjustment (<em>P</em> = 0.046). Glucosamine also decreased cardiovascular disease risk in MASLD (<em>P</em> &lt; 0.001) and MetALD (<em>P</em> = 0.037) cohorts, though it showed no significant impact on cerebrovascular disease incidence. Furthermore, glucosamine use was associated with a significantly lower incidence of CKD in the MASLD cohort (<em>P</em> = 0.034) and the entire cohort (<em>P</em> = 0.030), but not in the No steatotic liver disease cohort or MetALD cohort.</div></div><div><h3>Conclusion</h3><div>The findings suggest that glucosamine could be a beneficial supplementary therapy for managing steatotic liver diseases, particularly for patients at high risk for cardiovascular and renal complications. Further clinical trials are required to validate these potential benefits.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 119-128"},"PeriodicalIF":6.6,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143508321","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}
引用次数: 0
Oral nutritional supplementation in cancer patients: A systematic review and dose–response meta-analysis
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-13 DOI: 10.1016/j.clnu.2025.02.011
Sajedeh Habibi , Sepide Talebi , Darya Khosravinia , Hamed Mohammadi

Background & aims

We performed this systematic review and dose–response meta-analysis of randomized clinical trials (RCTs) to determine the effects of oral nutritional supplements (ONS) in cancer patients undergoing chemo (radio) therapy on body weight, body mass index (BMI), serum albumin, fatigue, quality of life (QOL), patient-generated subjective global assessment (PG-SGA) score and C-reactive protein (CRP).

Methods

Appropriate search terms were used for systematic search in PubMed, Scopus, and Web of Science, till April 2024. Both pairwise and dose–response meta-analyses were done. Random effects model was applied for analyses.

Results

We found that ONS administration significantly improved weight gain [weighted mean difference (WMD): 1.18 kg; 95 % CI, 0.20 to 2.17, P = 0.019; I2 = 56.2 %, PQ-test = 0.002], fatigue scores [standard mean difference (SMD): −1.45; 95 % CI, −2.48 to −0.42, P = 0.006; I2 = 90.1 %, PQ-test< 0.001], PG-SGA scores (WMD: −1.11; 95 % CI, −2.93 to 0.70, P = 0.229; I2 = 72.4 %, PQ-test = 0.001), and QOL (SMD: 1.38; 95 % CI, 0.45 to 2.31; P < 0.001; I2 = 94.4 %, PQ-test< 0.001). The dose–response meta-analysis found a significant relationship between each 200 ml/d increase in ONS and improvement in fatigue (SMD: −7.30; 95 % CI, −10.17 to −4.42, P < 0.001; I2 = 97 %, PQ-test< 0.001) and QOL scores (SMD:7.01; 95 % CI, 3.89 to 10.12, P = 0.001; I2 = 98.3 %, PQ-test < 0.001). Based on a non-linear dose–response meta-analysis, the most significant reduction in fatigue was observed at ONS dosages of ≥400 ml/day, while the most significant improvement in QOL score was seen at ≥ 500 ml/day dosages. Our analysis also showed a significant association between higher albumin levels and ONS intake of ≥200 ml daily.

Conclusions

In conclusion, ONS can help improve various cancer-related complications; however, further good-quality research is still needed. The study found that ONS significantly improves QoL, reduces fatigue, and promotes body weight gain in cancer patients. However, there were no significant effects on BMI, serum albumin, CRP, or PG-SGA scores.
{"title":"Oral nutritional supplementation in cancer patients: A systematic review and dose–response meta-analysis","authors":"Sajedeh Habibi ,&nbsp;Sepide Talebi ,&nbsp;Darya Khosravinia ,&nbsp;Hamed Mohammadi","doi":"10.1016/j.clnu.2025.02.011","DOIUrl":"10.1016/j.clnu.2025.02.011","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>We performed this systematic review and dose–response meta-analysis of randomized clinical trials (RCTs) to determine the effects of oral nutritional supplements (ONS) in cancer patients undergoing chemo (radio) therapy on body weight, body mass index (BMI), serum albumin, fatigue, quality of life (QOL), patient-generated subjective global assessment (PG-SGA) score and C-reactive protein (CRP).</div></div><div><h3>Methods</h3><div>Appropriate search terms were used for systematic search in PubMed, Scopus, and Web of Science, till April 2024. Both pairwise and dose–response meta-analyses were done. Random effects model was applied for analyses.</div></div><div><h3>Results</h3><div>We found that ONS administration significantly improved weight gain [weighted mean difference (WMD): 1.18 kg; 95 % CI, 0.20 to 2.17, <em>P</em> = 0.019; <em>I</em><sup>2</sup> = 56.2 %, <em>P</em><sub><em>Q-test</em></sub> = 0.002], fatigue scores [standard mean difference (SMD): −1.45; 95 % CI, −2.48 to −0.42, <em>P</em> = 0.006; <em>I</em><sup><em>2</em></sup> = 90.1 %, <em>P</em><sub><em>Q-test</em></sub>&lt; 0.001], PG-SGA scores (WMD: −1.11; 95 % CI, −2.93 to 0.70, <em>P</em> = 0.229; <em>I</em><sup><em>2</em></sup> = 72.4 %, <em>P</em><sub><em>Q-test</em></sub> = 0.001), and QOL (SMD: 1.38; 95 % CI, 0.45 to 2.31; <em>P</em> &lt; 0.001; <em>I</em><sup><em>2</em></sup> = 94.4 %, <em>P</em><sub><em>Q-test</em></sub>&lt; 0.001). The dose–response meta-analysis found a significant relationship between each 200 ml/d increase in ONS and improvement in fatigue (SMD: −7.30; 95 % CI, −10.17 to −4.42, P &lt; 0.001; <em>I</em><sup><em>2</em></sup> = 97 %, <em>P</em><sub><em>Q-test</em></sub>&lt; 0.001) and QOL scores (SMD:7.01; 95 % CI, 3.89 to 10.12, P = 0.001; <em>I</em><sup><em>2</em></sup> = 98.3 %, <em>P</em><sub><em>Q-test</em></sub> &lt; 0.001). Based on a non-linear dose–response meta-analysis, the most significant reduction in fatigue was observed at ONS dosages of ≥400 ml/day, while the most significant improvement in QOL score was seen at ≥ 500 ml/day dosages. Our analysis also showed a significant association between higher albumin levels and ONS intake of ≥200 ml daily.</div></div><div><h3>Conclusions</h3><div>In conclusion, ONS can help improve various cancer-related complications; however, further good-quality research is still needed. The study found that ONS significantly improves QoL, reduces fatigue, and promotes body weight gain in cancer patients. However, there were no significant effects on BMI, serum albumin, CRP, or PG-SGA scores.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 28-39"},"PeriodicalIF":6.6,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454810","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}
引用次数: 0
Obesity-related osteopontin protein and methylation blood levels are differentially modulated by a very low-calorie ketogenic diet or bariatric surgery
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-11 DOI: 10.1016/j.clnu.2025.02.006
Paula M. Lorenzo , Andrea G. Izquierdo , Ignacio Sajoux , Maitane Nuñez-Garcia , Diego Gomez-Arbelaez , M. Angeles Zulet , Itziar Abete , Javier Baltar , Daniel de Luis , Francisco J. Tinahones , J. Alfredo Martinez , Felipe F. Casanueva , Ana B. Crujeiras

Background & aim

Osteopontin (OPN) was proposed to play a role in the pathophysiology of obesity and related disease, such as cancer. The aims were to evaluate the expression of OPN after caloric restriction-induced weight loss in adipose tissue (AT) from an animal model of diet-induced obesity (DIO) and to reflect these results on circulating OPN levels in patients with obesity (PWO); and to explore the effect of a very low-calorie ketogenic diet (VLCKD) on the circulating protein and DNA methylation levels of OPN, compared with a balanced hypocaloric diet (LCD) or bariatric surgery (BS) in PWO.

Methods

OPN/SPP1 expression was evaluated in subcutaneous (SAT) and visceral (VAT) AT derived from diet-induced obesity (DIO) mice and after a 4-week weight-loss protocol of calorie restriction (CR). Plasmatic OPN was also evaluated in 32 normal-weight volunteers (20 women) and 79 PWO (59 women) and after a 4–6 months follow up of a VLCKD (n = 20), BS (n = 39) or LCD (n = 20). DNA methylation levels of OPN were extracted from our Infinium HumanMethylation450 BeadChips data sets.

Results

OPN levels were higher in VAT of DIO mice and plasma of PWO than in normal-weight individuals and changed after weight loss. Particularly, circulating OPN increased 2 months after BS while it decreased at maximum ketosis-induced by VLCKD. A statistically significant decrease was also observed in methylation levels at cg11226901 after VLCKD.

Conclusions

OPN levels were reduced after VLCKD and severely increased after BS. Therefore, it could be a biomarker of the obesity-related metabolic stress and could be epigenetically regulated.
{"title":"Obesity-related osteopontin protein and methylation blood levels are differentially modulated by a very low-calorie ketogenic diet or bariatric surgery","authors":"Paula M. Lorenzo ,&nbsp;Andrea G. Izquierdo ,&nbsp;Ignacio Sajoux ,&nbsp;Maitane Nuñez-Garcia ,&nbsp;Diego Gomez-Arbelaez ,&nbsp;M. Angeles Zulet ,&nbsp;Itziar Abete ,&nbsp;Javier Baltar ,&nbsp;Daniel de Luis ,&nbsp;Francisco J. Tinahones ,&nbsp;J. Alfredo Martinez ,&nbsp;Felipe F. Casanueva ,&nbsp;Ana B. Crujeiras","doi":"10.1016/j.clnu.2025.02.006","DOIUrl":"10.1016/j.clnu.2025.02.006","url":null,"abstract":"<div><h3>Background &amp; aim</h3><div>Osteopontin (OPN) was proposed to play a role in the pathophysiology of obesity and related disease, such as cancer. The aims were to evaluate the expression of OPN after caloric restriction-induced weight loss in adipose tissue (AT) from an animal model of diet-induced obesity (DIO) and to reflect these results on circulating OPN levels in patients with obesity (PWO); and to explore the effect of a very low-calorie ketogenic diet (VLCKD) on the circulating protein and DNA methylation levels of OPN, compared with a balanced hypocaloric diet (LCD) or bariatric surgery (BS) in PWO.</div></div><div><h3>Methods</h3><div>OPN/SPP1 expression was evaluated in subcutaneous (SAT) and visceral (VAT) AT derived from diet-induced obesity (DIO) mice and after a 4-week weight-loss protocol of calorie restriction (CR). Plasmatic OPN was also evaluated in 32 normal-weight volunteers (20 women) and 79 PWO (59 women) and after a 4–6 months follow up of a VLCKD (n = 20), BS (n = 39) or LCD (n = 20). DNA methylation levels of OPN were extracted from our Infinium HumanMethylation450 BeadChips data sets.</div></div><div><h3>Results</h3><div>OPN levels were higher in VAT of DIO mice and plasma of PWO than in normal-weight individuals and changed after weight loss. Particularly, circulating OPN increased 2 months after BS while it decreased at maximum ketosis-induced by VLCKD. A statistically significant decrease was also observed in methylation levels at cg11226901 after VLCKD.</div></div><div><h3>Conclusions</h3><div>OPN levels were reduced after VLCKD and severely increased after BS. Therefore, it could be a biomarker of the obesity-related metabolic stress and could be epigenetically regulated.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 40-49"},"PeriodicalIF":6.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143454811","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}
引用次数: 0
Systematic analysis of relationships between serum lipids with all-cause and cause-specific mortality: Evidence from prospective cohort studies of UK Biobank and Women's Health Initiative
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-11 DOI: 10.1016/j.clnu.2025.02.009
Dongfang You , Yingdan Tang , Theis Lange , Yaqian Wu , Mengyi Lu , Fang Shao , Sipeng Shen , Ruyang Zhang , Hongwen Zhou , Hongyang Xu , Yongmei Yin , Yongyue Wei , Feng Chen , Hongbing Shen , David C. Christiani , Yang Zhao

Background & aims

Serum lipids, including lipoproteins, cholesterol, and triglycerides, are important modifiable factors influencing human health. However, the associations among different serum lipid profiles and mortality remain insufficiently understood, particularly regarding potential causality and population heterogeneity. This prospective study aims to systematically investigate the relationships between serum lipid concentrations of different densities and sizes with all-cause and cause-specific mortality.

Methods

Cox proportional and Fine–Gray subdistribution hazard models were applied to investigate the associations of 54 lipid concentrations with all-cause and cause-specific mortality (including cardiovascular disease (CVD), cancer, and respiratory disease) in the UK Biobank cohort of 441,448 individuals with 17-year follow-up. Cohorts of 120,967 and 44,168 individuals from the Women's Health Initiative (WHI) with 16-year follow-up and a large-scale meta-analysis were utilized for external replication. We further assessed the underlying causality using Mendelian randomization (MR) and possible modifiers using multiple subgroup analyses.

Results

During a median follow-up of 13.8 years, 39,290 deaths occurred, including 7399 from CVD, 18,928 from cancer, and 2707 from respiratory disease. We identified 160 significant associations between lipid concentrations and all-cause and cause-specific mortality. Importantly, most were inverse, with decreased lipid levels linked to increased risk of premature death [hazard ratios (HRs): 0.70–0.98 per standard deviation (SD)]. In contrast, positives were observed for HDL (large/very large) and triglyceride concentrations [HRs: 1.02–1.25 per SD], indicating increased mortality risk with higher levels. Most lipoproteins and cholesterol exhibited nonlinearly correlations with mortality, especially the significant U-shaped in total/HDL. However, MR showed that elevations in several lipids were associated with increased all-cause and CVD-specific mortality risk. Multiple subgroup analyses revealed that age, sex, and lipid-modifying drugs modified the lipid-mortality relationship; specifically, higher lipid concentrations increased mortality risk in younger adults not taking lipid-modifying drugs, but decreased mortality in older adults taking lipid-modifying drugs. The majority of associations were replicated in the WHI and external cohorts.

Conclusion

Our study systematically reported a large number of associations between serum lipid concentrations and mortality. Subgroup-based population heterogeneity analysis suggests that age, sex, and lipid-modifying drugs could be modifiers for the lipid-mortality relationship. These findings provide more guidance for lipid management and individualized prevention.
{"title":"Systematic analysis of relationships between serum lipids with all-cause and cause-specific mortality: Evidence from prospective cohort studies of UK Biobank and Women's Health Initiative","authors":"Dongfang You ,&nbsp;Yingdan Tang ,&nbsp;Theis Lange ,&nbsp;Yaqian Wu ,&nbsp;Mengyi Lu ,&nbsp;Fang Shao ,&nbsp;Sipeng Shen ,&nbsp;Ruyang Zhang ,&nbsp;Hongwen Zhou ,&nbsp;Hongyang Xu ,&nbsp;Yongmei Yin ,&nbsp;Yongyue Wei ,&nbsp;Feng Chen ,&nbsp;Hongbing Shen ,&nbsp;David C. Christiani ,&nbsp;Yang Zhao","doi":"10.1016/j.clnu.2025.02.009","DOIUrl":"10.1016/j.clnu.2025.02.009","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Serum lipids, including lipoproteins, cholesterol, and triglycerides, are important modifiable factors influencing human health. However, the associations among different serum lipid profiles and mortality remain insufficiently understood, particularly regarding potential causality and population heterogeneity. This prospective study aims to systematically investigate the relationships between serum lipid concentrations of different densities and sizes with all-cause and cause-specific mortality.</div></div><div><h3>Methods</h3><div>Cox proportional and Fine–Gray subdistribution hazard models were applied to investigate the associations of 54 lipid concentrations with all-cause and cause-specific mortality (including cardiovascular disease (CVD), cancer, and respiratory disease) in the UK Biobank cohort of 441,448 individuals with 17-year follow-up. Cohorts of 120,967 and 44,168 individuals from the Women's Health Initiative (WHI) with 16-year follow-up and a large-scale meta-analysis were utilized for external replication. We further assessed the underlying causality using Mendelian randomization (MR) and possible modifiers using multiple subgroup analyses.</div></div><div><h3>Results</h3><div>During a median follow-up of 13.8 years, 39,290 deaths occurred, including 7399 from CVD, 18,928 from cancer, and 2707 from respiratory disease. We identified 160 significant associations between lipid concentrations and all-cause and cause-specific mortality. Importantly, most were inverse, with decreased lipid levels linked to increased risk of premature death [hazard ratios (HRs): 0.70–0.98 per standard deviation (SD)]. In contrast, positives were observed for HDL (large/very large) and triglyceride concentrations [HRs: 1.02–1.25 per SD], indicating increased mortality risk with higher levels. Most lipoproteins and cholesterol exhibited nonlinearly correlations with mortality, especially the significant U-shaped in total/HDL. However, MR showed that elevations in several lipids were associated with increased all-cause and CVD-specific mortality risk. Multiple subgroup analyses revealed that age, sex, and lipid-modifying drugs modified the lipid-mortality relationship; specifically, higher lipid concentrations increased mortality risk in younger adults not taking lipid-modifying drugs, but decreased mortality in older adults taking lipid-modifying drugs. The majority of associations were replicated in the WHI and external cohorts.</div></div><div><h3>Conclusion</h3><div>Our study systematically reported a large number of associations between serum lipid concentrations and mortality. Subgroup-based population heterogeneity analysis suggests that age, sex, and lipid-modifying drugs could be modifiers for the lipid-mortality relationship. These findings provide more guidance for lipid management and individualized prevention.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 94-102"},"PeriodicalIF":6.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143479600","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}
引用次数: 0
Taurine levels and long-term adverse cerebrovascular risk in moyamoya disease: A prognostic perspective study
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2025-02-11 DOI: 10.1016/j.clnu.2025.02.008
Zhiyao Zheng , Chenglong Liu , Siqi Mou , Junsheng Li , Qiheng He , Wei Liu , Bojian Zhang , Zhikang Zhao , Wei Sun , Qian Zhang , Rong Wang , Yan Zhang , Dong Zhang , Peicong Ge

Background

Taurine has been proven to play a significant role in cardiovascular and cerebrovascular diseases, but its relationship with moyamoya disease (MMD) remains unclear. This study aims to investigate the association between serum taurine levels and long-term adverse cerebrovascular events in patients with MMD after revascularization.

Methods

This study involved 352 patients with MMD, from whom comprehensive clinical data and blood samples were collected. Serum taurine levels were measured using liquid chromatography-tandem mass spectrometry, and the relationship between serum taurine concentration and various blood indices was evaluated. Cerebrovascular adverse events included transient ischemic attack, ischemic stroke, and hemorrhagic stroke. Taurine, analyzed as a continuous variable, was found to predict a cut-off for postoperative cerebrovascular adverse events in MMD patients at 842.52 μmol/L. The impact of serum taurine levels on the risk of cerebrovascular events was analyzed using Kaplan–Meier (KM) curves, and univariate and multivariate Cox regression analyses were performed to identify predictive factors for postoperative prognosis.

Results

Grouping MMD patients by serum taurine levels revealed that higher taurine levels were significantly associated with a lower proportion of hemorrhagic MMD (p = 0.044). Compared with ischemic MMD, patients with hemorrhagic MMD had lower taurine concentrations (p = 0.005). KM curves showed that the incidence of postoperative cerebrovascular adverse events in the high taurine group was significantly lower than in the low taurine group (p = 0.026). Univariate Cox regression analysis indicated that higher taurine concentrations significantly reduced the risk of postoperative cerebrovascular adverse events (Hazard Ratio [HR] = 0.334, 95 % Confidence Interval [CI] = 0.121–0.923, p = 0.035). Furthermore, the multivariate Cox regression model confirmed that taurine level is an independent predictor of long-term adverse cerebrovascular events, with the high concentration group showing a significantly reduced risk.

Conclusions

Low serum taurine levels are associated with a higher risk of long-term adverse cerebrovascular events following MMD revascularization. This suggests the significant potential of serum taurine as a prognostic biomarker for postoperative outcomes.

Clinical trial registry number

URL: https://www.chictr.org.cn/. Unique identifier: ChiCTR2200061889.
{"title":"Taurine levels and long-term adverse cerebrovascular risk in moyamoya disease: A prognostic perspective study","authors":"Zhiyao Zheng ,&nbsp;Chenglong Liu ,&nbsp;Siqi Mou ,&nbsp;Junsheng Li ,&nbsp;Qiheng He ,&nbsp;Wei Liu ,&nbsp;Bojian Zhang ,&nbsp;Zhikang Zhao ,&nbsp;Wei Sun ,&nbsp;Qian Zhang ,&nbsp;Rong Wang ,&nbsp;Yan Zhang ,&nbsp;Dong Zhang ,&nbsp;Peicong Ge","doi":"10.1016/j.clnu.2025.02.008","DOIUrl":"10.1016/j.clnu.2025.02.008","url":null,"abstract":"<div><h3>Background</h3><div>Taurine has been proven to play a significant role in cardiovascular and cerebrovascular diseases, but its relationship with moyamoya disease (MMD) remains unclear. This study aims to investigate the association between serum taurine levels and long-term adverse cerebrovascular events in patients with MMD after revascularization.</div></div><div><h3>Methods</h3><div>This study involved 352 patients with MMD, from whom comprehensive clinical data and blood samples were collected. Serum taurine levels were measured using liquid chromatography-tandem mass spectrometry, and the relationship between serum taurine concentration and various blood indices was evaluated. Cerebrovascular adverse events included transient ischemic attack, ischemic stroke, and hemorrhagic stroke. Taurine, analyzed as a continuous variable, was found to predict a cut-off for postoperative cerebrovascular adverse events in MMD patients at 842.52 μmol/L. The impact of serum taurine levels on the risk of cerebrovascular events was analyzed using Kaplan–Meier (KM) curves, and univariate and multivariate Cox regression analyses were performed to identify predictive factors for postoperative prognosis.</div></div><div><h3>Results</h3><div>Grouping MMD patients by serum taurine levels revealed that higher taurine levels were significantly associated with a lower proportion of hemorrhagic MMD (p = 0.044). Compared with ischemic MMD, patients with hemorrhagic MMD had lower taurine concentrations (p = 0.005). KM curves showed that the incidence of postoperative cerebrovascular adverse events in the high taurine group was significantly lower than in the low taurine group (p = 0.026). Univariate Cox regression analysis indicated that higher taurine concentrations significantly reduced the risk of postoperative cerebrovascular adverse events (Hazard Ratio [HR] = 0.334, 95 % Confidence Interval [CI] = 0.121–0.923, p = 0.035). Furthermore, the multivariate Cox regression model confirmed that taurine level is an independent predictor of long-term adverse cerebrovascular events, with the high concentration group showing a significantly reduced risk.</div></div><div><h3>Conclusions</h3><div>Low serum taurine levels are associated with a higher risk of long-term adverse cerebrovascular events following MMD revascularization. This suggests the significant potential of serum taurine as a prognostic biomarker for postoperative outcomes.</div></div><div><h3>Clinical trial registry number</h3><div>URL: <span><span>https://www.chictr.org.cn/</span><svg><path></path></svg></span>. Unique identifier: ChiCTR2200061889.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 83-93"},"PeriodicalIF":6.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143471452","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}
引用次数: 0
期刊
Clinical nutrition
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