Clinical nutrition最新文献

{"title":"Comment on “ESPEN guidelines on nutrition and hydration”","authors":"Pinar Soysal, Cihan Heybeli","doi":"10.1016/j.clnu.2025.02.010","DOIUrl":"10.1016/j.clnu.2025.02.010","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 52-53"},"PeriodicalIF":6.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143464076","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}

{"title":"Muscle mass mediates the association between dietary diversity and mortality among the older adults: A prospective cohort study","authors":"Xiaotong Li,&nbsp;Fengdan Wang,&nbsp;Ruirui Guo,&nbsp;Yan Liu,&nbsp;Zibo Wu,&nbsp;Yu Han,&nbsp;Jing Zhao,&nbsp;Sitong Xin,&nbsp;Bo Li","doi":"10.1016/j.clnu.2025.02.004","DOIUrl":"10.1016/j.clnu.2025.02.004","url":null,"abstract":"<div><h3>Aims</h3><div>The association between dietary diversity and increased mortality risk is well-documented. However, it remains unclear whether and to what extent dietary diversity affects mortality through appendicular skeletal muscle mass (ASM). Therefore, we assessed whether ASM mediated the association between dietary diversity and mortality.</div></div><div><h3>Methods</h3><div>We used data from the Chinese longitudinal healthy longevity survey (CLHLS) (2011–2018). The baseline Dietary Diversity Score (DDS) was derived from 9 food items, and the Anti-inflammatory Dietary Diversity Score (AIDDS) was used to assess the diversity of anti-inflammatory foods in the diet. Cox regression models were employed to estimate the association of DDS and AIDDS with mortality. Interaction analysis was performed to analyze the association between DDS, AIDDS, and ASM in different groups. Subsequently, mediation analysis was performed to examine whether ASM partly accounted for the association.</div></div><div><h3>Results</h3><div>A total of 5422 participants (average age 85.99 years) were included in the analysis. Among them, 3241 participants died during the follow-up period. We observed that participants with higher DDS (HR = 0.907, 95 % CI: 0.842–0.977) and AIDDS scores (HR = 0.947, 95 % CI: 0.917–0.977) had lower mortality rates. Subgroup analyses showed no interaction between DDS, AIDDS, and ASM (<em>p</em> for interaction&gt;0.05). ASM mediated the 14.0 % association between DDS and mortality, and the 10.7 % association between AIDDS and mortality.</div></div><div><h3>Conclusions</h3><div>Dietary diversity and anti-inflammatory dietary diversity could reduce mortality risk and promote longevity in older adults. The association between these factors was partially mediated by an increase in muscle mass among older adults.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 21-27"},"PeriodicalIF":6.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444595","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}

{"title":"A new concept to establish protein requirements","authors":"Nicolaas E.P. Deutz ,&nbsp;Robert R. Wolfe ,&nbsp;Mariëlle P.K.J. Engelen","doi":"10.1016/j.clnu.2025.02.002","DOIUrl":"10.1016/j.clnu.2025.02.002","url":null,"abstract":"<div><div>There is an increased need to establish the protein requirements for body weight maintenance and optimal health in humans. Different methods were developed in the past to assess protein requirements in which known amounts of protein/amino acids were provided. The purpose of this paper is to propose a new concept of establishing protein requirements in healthy and diseased conditions using a novel stable isotope approach.</div><div>In the past years, we consistently found that when using a novel stable isotope pulse approach the intracellular production of amino acids (i.e., phenylalanine and tyrosine) is more than double the plasma rate of appearance, as measured by the commonly used primed constant infusion approach, leading to a net protein breakdown that is more than twice than estimated in the past. Net protein breakdown in the fasted state may provide a good estimation of the actual net protein loss that would take place during the day and thus can be used to estimate daily protein requirements. Our recent study found that a net protein breakdown ∼1 g protein/kg body weight/day was equal to the habitual protein intake, suggesting that there is a relation between habitual protein intake and protein requirements. As net protein breakdown is lower with advanced aging and in patient populations with comorbidities, a lower protein requirement for body weight maintenance is suggested.</div><div>We propose a new concept to establish actual protein requirements of healthy and disease conditions, using a pulse tracer administration and to consider individual habitual protein intake and health conditions.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"48 ","pages":"Pages 1-5"},"PeriodicalIF":6.6,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143628456","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}

{"title":"Serum tryptophan and kynurenine levels and risk of heart failure among patients with chronic kidney disease","authors":"Sara Mohiti ,&nbsp;Jacob Christensen ,&nbsp;Nino E. Landler ,&nbsp;Ida MH. Sørensen ,&nbsp;Jesper Qvist Thomassen ,&nbsp;Sasha S. Bjergfelt ,&nbsp;Ditte Hansen ,&nbsp;Bo Feldt-Rasmussen ,&nbsp;Susanne Bro ,&nbsp;Mehrangiz Ebrahimi-Mameghani ,&nbsp;Tor Biering-Sørensen ,&nbsp;Line S. Bisgaard ,&nbsp;Christina Christoffersen","doi":"10.1016/j.clnu.2025.01.028","DOIUrl":"10.1016/j.clnu.2025.01.028","url":null,"abstract":"<div><h3>Background and aims</h3><div>Chronic kidney disease (CKD) is often complicated by heart failure (HF), leading to increased mortality. Emerging evidence suggests that Tryptophan metabolites, through the Kynurenine pathway (KP), play a significant role in HF pathophysiology. Therefore, we explored the association of Tryptophan (TRP), Kynurenine (KYN), and the Kynurenine to Tryptophan ratio (KTR) with HF in CKD, hypothesizing a link between KP alterations and HF occurrence in this population.</div></div><div><h3>Methods</h3><div>673 non-dialysis patients aged 30 to 75 with CKD stages 1–5 were included. Incident HF data were collected through medical record reviews, and the median follow-up time was 3.9 years. Serum concentrations of KYN and TRP were measured using High-Performance Liquid Chromatography (HPLC).</div></div><div><h3>Results</h3><div>Patients with more advanced stages of CKD had higher levels of KYN and KTR, and lower levels of TRP (p &lt; 0.001). Following adjustments for age, sex, BMI, hypertension, and hypercholesterolemia, serum KYN and KTR remained significantly associated with prevalent HF in patients with CKD (p = 0.012, p = 0.028 respectively). Furthermore, Cox-regression analysis indicated that KTR concentration was associated with incident HF after adjusting for confounders such as age, sex, BMI, hypertension, hypercholesterolemia and diabetes (p = 0.019).</div></div><div><h3>Conclusion</h3><div>In conclusion, the present analysis suggests that changes in the kynurenine pathway may be a new biomarker for HF in patients with CKD. Thus, KTR concentration might be associated with prevalent and future HF in patients with CKD. Further research is needed to understand the mechanisms and potential of these metabolites in refining HF risk prediction and prevention in CKD patients.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"47 ","pages":"Pages 14-20"},"PeriodicalIF":6.6,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143438122","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}

{"title":"Effect of ultra-processed food consumption on the gut microbiota in the first year of life: Findings from the MINA–Brazil birth cohort study","authors":"Lucas D. Faggiani ,&nbsp;Paula de França ,&nbsp;Sofia G. Seabra ,&nbsp;Ester C. Sabino ,&nbsp;Lu Qi ,&nbsp;Marly A. Cardoso","doi":"10.1016/j.clnu.2025.01.030","DOIUrl":"10.1016/j.clnu.2025.01.030","url":null,"abstract":"<div><h3>Background and aims</h3><div>The first years of life are fundamental for the establishment of the gut microbiota, with diet being one of the main early exposures. During this period, the beneficial effect of breastfeeding on modulating the gut microbiota is well known; however, there are important gaps in the literature on the effects of ultra-processed food (UPF) consumption, particularly in longitudinal and large sample designs. Through a prospective birth cohort study, we investigated the effects of UPF consumption on the gut microbiota of children during the first year of life.</div></div><div><h3>Methods</h3><div>This study included children from the MINA–Brazil birth cohort with gut microbiota data (16S rRNA) available at the 1-year follow-up (n = 728). Data on breastfeeding practices were collected after childbirth and during follow-up visits. Complementary feeding was measured using a semi-structured questionnaire, referring to the day before the interview at the 1-year follow-up. A combined variable was generated according to breastfeeding practices and UPF consumption and was used as an independent variable in the adjusted median regression models, with alpha diversity parameters as the dependent variable. Beta diversity was analyzed using PERMANOVA according to Bray–Curtis dissimilarity and Distance-based Redundancy Analysis (db-RDA) adjusted for covariates. Relative abundance was analyzed using ANCOM-BC (corrected by FDR) and MaAsLin2 adjusted for covariates.</div></div><div><h3>Results</h3><div>Weaned children who consumed UPF showed a significant increase in alpha diversity for all parameters in the median regression models (Observed ASVs: p = 0.005; Shannon index: p = 0.036; Chao index: p = 0.026; Simpson index: p = 0.012) and in beta diversity (PERMANOVA: p = 0.006; db-RDA: p &lt; 0.001) compared to breastfed children who did not consume UPF. Breastfed children who did not consume UPF had a higher relative abundance of <em>Bifidobacterium</em> than weaned children who consumed UPF (both p &lt; 0.001 for ANCOM-BC and MaAsLin2) and a lower relative abundance of <em>Firmicutes</em> (p &lt; 0.001 for MaAsLin2), <em>Blautia</em> (both p &lt; 0.001 for ANCOM-BC and MaAsLin2), <em>Sellimonas</em> (p = 0.008 for ANCOM-BC) and <em>Finegoldia</em> (p = 0.045 for MaAsLin2) than weaned children who consumed UPF.</div></div><div><h3>Conclusion</h3><div>These findings suggest that UPF consumption may negatively impact the diversity and abundance of the gut microbiota, with a more pronounced effect in children who have already been weaned.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"46 ","pages":"Pages 181-190"},"PeriodicalIF":6.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143421510","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}

{"title":"On how to feed critically ill children in intensive care: A slowly shifting paradigm","authors":"Jan Gunst ,&nbsp;Ilse Vanhorebeek ,&nbsp;Sascha CAT. Verbruggen ,&nbsp;Karolijn Dulfer ,&nbsp;Koen FM. Joosten ,&nbsp;Greet Van den Berghe","doi":"10.1016/j.clnu.2025.02.003","DOIUrl":"10.1016/j.clnu.2025.02.003","url":null,"abstract":"<div><div>Critically ill children requiring treatment in a pediatric intensive care unit (PICU) suffer from anorexia and/or feeding intolerance. The resulting macronutrient deficit associates with poor outcome. Until recently, this association formed the basis for initiating enteral or parenteral feeding early to improve outcome. The multicenter “Early-versus-Late-Parenteral-Nutrition-in-the-Pediatric-Intensive-Care-Unit” randomized controlled trial (PEPaNIC-RCT) addressed whether this association is causal. It showed that early supplementation of insufficient/contraindicated enteral nutrition with parenteral nutrition, as compared with accepting a macronutrient deficit throughout the first week in the PICU, did not improve outcome. On the contrary, it caused more infections and prolonged organ support and PICU stay, and adversely affected neurodevelopmental outcomes 2 and 4 years later. Harm was present in all subgroups and appeared explained by the macronutrient dose, more specifically the amino-acid dose, not lipid or glucose doses. These findings corroborated results from large-scale adult RCTs. Mechanisms of harm from early enhanced nutrition comprised suppressed cellular repair pathways like autophagy and ketogenesis, suppressed illness-induced alterations in thyroid hormone metabolism, more iatrogenic hyperglycemia, increased urea cycle activity through anabolic resistance, and induction of epigenetic modifications that mediate longer-term developmental impairments.</div><div>These results came unexpected to many pediatric intensivists. Hence, the paradigm has only slowly begun to shift toward more restrictive macronutrient administration in the acute phase of critical illness. Benefits of early fasting responses have become clear, provided micronutrients are given to prevent deficiencies and refeeding syndrome. These insights open perspectives for studies investigating novel nutritional strategies to activate fasting-induced cellular repair while avoiding prolonged starvation.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"46 ","pages":"Pages 169-180"},"PeriodicalIF":6.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387421","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}

{"title":"Dual-energy x-ray absorptiometry derived body composition trajectories across adulthood: Reference values and associations with body roundness index and body mass index","authors":"Jedd Pratt ,&nbsp;Marco Narici ,&nbsp;Colin Boreham ,&nbsp;Giuseppe De Vito","doi":"10.1016/j.clnu.2025.02.001","DOIUrl":"10.1016/j.clnu.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Population-specific reference values are needed to accurately contextualise age-related changes in body composition. This study aimed to a) establish age- and sex-specific reference values and cut-points for a range of dual-energy x-ray absorptiometry (DXA) derived metrics of lean mass (LM), fat mass (FM) and bone mineral density (BMD), across adulthood in a large adult cohort; and b) determine the association between DXA-derived body composition, body roundness index (BRI), and body mass index (BMI).</div></div><div><h3>Methods</h3><div>Cross-sectional data were collected from 10,033 men and women aged from 18 to 92 years. Whole-body DXA scans were performed, and a range of metrics were calculated for LM (total LM, arm LM, leg LM, appendicular lean mass: ALM, skeletal muscle index: SMI), FM (total FM: kg and %, FMI, android to gynoid: A/G ratio) and bone (BMD). Cut-points equivalent to Z-scores of 1.0–2.5 SDs from the mean of a young reference population were established for each body composition metric.</div></div><div><h3>Results</h3><div>Detailed age- and sex-specific percentile curves were generated using the LMS method. Metrics of LM, central adiposity and BMD were higher in men, compared to women, whereas metrics of general FM accumulation were higher in women, compared to men. In both sexes, all LM metrics remained broadly stable during early and middle adulthood, after which progressively lower quantities were shown, whereas progressively higher FM metrics were shown from early adulthood through to late adulthood. In men, BMD was broadly stable across adulthood, whereas in women, markedly lower BMD was observed from the fifth decade of life. Significantly higher quantities of LM were shown across BMI categories, but not across BRI categories. The BRI was better correlated with FM%, FMI, and A/G ratio, compared to the BMI.</div></div><div><h3>Conclusion</h3><div>The reference values presented herein may support the interpretation of body composition in public health settings and the identification of people who may benefit from intervention to improve musculoskeletal and metabolic health. The BRI better reflects DXA-derived body composition and may provide screening utility beyond that of the BMI.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"46 ","pages":"Pages 137-146"},"PeriodicalIF":6.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348079","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}

{"title":"Circulating fatty acid profiles impact total, cardiovascular disease, and cancer mortality in a population-based prospective cohort study","authors":"Xiaohui Liu ,&nbsp;Yang Ao ,&nbsp;Yin Li ,&nbsp;Haoyin Liu ,&nbsp;Hao Ye ,&nbsp;Xiaoran Song ,&nbsp;Xunan Lin ,&nbsp;Youyou Zheng ,&nbsp;Xuzhi Wan ,&nbsp;Pan Zhuang ,&nbsp;Yu Zhang ,&nbsp;Jingjing Jiao","doi":"10.1016/j.clnu.2025.01.034","DOIUrl":"10.1016/j.clnu.2025.01.034","url":null,"abstract":"<div><h3>Background</h3><div>Evidence linking circulating fatty acids (FAs) to mortality from age-related chronic diseases was limited and inconsistent. We aimed to investigate the associations of plasma FAs with total, cardiovascular disease (CVD), and cancer mortality and explore the potential mechanism.</div></div><div><h3>Methods</h3><div>117,871 individuals were prospectively followed in the UK Biobank. Circulating FAs were measured by a high-throughput NMR-based metabolic platform. Causes and dates of death were collected from death certificates according to the code of International Statistical Classification of Diseases (ICD-10).</div></div><div><h3>Results</h3><div>Over a median follow-up of 11.9 years, 7805 (6.6 %) deaths occurred. Plasma saturated FAs (SFAs) were positively associated with total mortality risk while plasma polyunsaturated FAs (PUFAs) exhibited an inverse association. For cause-specific mortality, circulating PUFAs, linoleic acid (LA), and n-3 PUFAs were associated with 34 %, 30 %, and 37 % lower risk of CVD mortality, respectively. Moreover, plasma n-3 PUFAs were related to a 24 % lower risk of cancer mortality. However, circulating non-LA n-6 PUFAs were associated with 11 % and 22 % higher risk of total and cancer mortality, respectively. Serum levels of C-reactive protein (CRP) and apolipoprotein A (ApoA) had significant mediation effects on these associations. Additionally, the inverse association of plasma n-6 PUFAs with total mortality only existed among carriers of the GG genotype at rs16966952 and the inverse association of plasma PUFAs with CVD mortality was only observed among TT genotype carriers at rs174547.</div></div><div><h3>Conclusions</h3><div>Circulating PUFAs, particularly n-3 PUFAs and LA, were inversely related to premature death from chronic diseases and longevity. Inflammatory and lipid metabolism partially explained these associations. Genetic interactions with rs16966952 and rs174547 further modified these associations.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"46 ","pages":"Pages 191-203"},"PeriodicalIF":6.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143428260","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}

{"title":"Association between early enteral nutrition and clinical outcomes among critically ill patients with circulatory shock: A secondary analysis of a large-scale randomized controlled trial","authors":"Wenfang Jiang ,&nbsp;Weibang Pan ,&nbsp;Tianbin Cai ,&nbsp;Zhengyii Lee ,&nbsp;Guangyu Lv ,&nbsp;Yingqiao Bai ,&nbsp;Meiqiong Liu ,&nbsp;Zixiong Zhang ,&nbsp;Christian Stoppe ,&nbsp;Jayshil Patel ,&nbsp;Lu Ke ,&nbsp;Wenjian Mao ,&nbsp;Xiaoyuan Wang ,&nbsp;Chinese Critical Care Nutrition Trials Group (CCCNTG)","doi":"10.1016/j.clnu.2025.01.029","DOIUrl":"10.1016/j.clnu.2025.01.029","url":null,"abstract":"<div><h3>Background</h3><div>It remains unclear if early enteral nutrition benefits patients with circulatory shock, particularly in those with prolonged use of vasopressors. This study aimed to assess the association between early enteral nutrition and clinical outcomes in patients with circulatory shock and whether the duration of circulatory shock (transient or persistent) impacts this association.</div></div><div><h3>Methods</h3><div>Using data from a multicenter, cluster-randomized controlled trial, this secondary analysis involved patients with baseline circulatory shock as defined by a cardiovascular Sequential Organ Failure Assessment score of two or more. Patients were dichotomized into transient or persistent circulatory shock depending on the duration, while transient circulatory shock was defined by the resolution of shock within the first day of enrollment. Early enteral nutrition was defined as the initiation of enteral nutrition within 48 h after intensive care unit admission. The association between early enteral nutrition and a composite outcome (presence of any organ failure on study day 10 or 28-day mortality) was investigated by multivariable and propensity-score-weighted multivariable logistic regression analyses.</div></div><div><h3>Results</h3><div>Seven hundred and eighty-five patients were included in the analysis, and early enteral nutrition was administered to 385 patients (49.0 %) in the whole study cohort. In patients with transient circulatory shock (n = 527), 221 patients (41.9 %) received early enteral nutrition, and in those with persistent circulatory shock (n = 258), 164 patients (63.6 %) did so. For the overall cohort, there was no difference in the incidence of primary composite outcome between early enteral nutrition and ‘no early enteral nutrition ' groups (adjusted odd ratio 0.84, 95 % confidence interval 0.60–1.18) after adjustment for potential confounders. In patients with transient circulatory shock, receipt of early enteral nutrition, compared to no early enteral nutrition, was significantly associated with reduced incidence of the composite outcome (adjusted odd ratio 0.63, 95 % confidence interval 0.41–0.95, p = 0.027). On the contrary, there is no association between early enteral nutrition and the incidence of the composite outcome in patients with persistent circulatory shock (adjusted odd ratio 1.28, 95 % confidence interval 0.64–2.58, p = 0.485). The results of propensity-weighted multivariable analysis conform to the primary analysis.</div></div><div><h3>Conclusion</h3><div>Early enteral nutrition was associated with improved clinical outcomes among patients with circulatory shock that resolved within the first day.</div></div><div><h3>Research registration unique identifying number (UIN) of the original NEED trial</h3><div>ISRCTN Registry, Registry number: ISRCTN12233792.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"46 ","pages":"Pages 147-154"},"PeriodicalIF":6.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143348078","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}

{"title":"G protein-coupled receptors: A golden key to the treasure-trove of neurodegenerative diseases","authors":"Huanhuan Li ,&nbsp;Zhen Qiao ,&nbsp;Xue Xiao ,&nbsp;Xiu Cao ,&nbsp;Zhaodong Li ,&nbsp;Mengru Liu ,&nbsp;Qian Jiao ,&nbsp;Xi Chen ,&nbsp;Xixun Du ,&nbsp;Hong Jiang","doi":"10.1016/j.clnu.2025.01.032","DOIUrl":"10.1016/j.clnu.2025.01.032","url":null,"abstract":"<div><div>G protein-coupled receptors (GPCRs) are a class of transmembrane proteins that distribute in various organs extensively. They can regulate physiological functions such as perception, neurotransmission and endocrinology through the synergies of signaling pathways. At present, Food and Drug Administration (FDA) have approved more than 500 drugs targeting GPCRs to treat a variety of conditions, including neurological diseases, gastrointestinal diseases and tumors. Conformational diversity and dynamic changes make GPCRs a star target for the treatment of neurodegenerative diseases. Moreover, GPCRs can also open biased signaling pathways for G protein and β-arrestin, which has unique functional selectivity and the possibility of overcoming side effects. Some studies believe that biased drugs will be the mainstream direction of drug innovation in the future. To disclose the essential role and research process of GPCRs in neurodegenerative diseases, we firstly reviewed several pivotal GPCRs and their mediated signaling pathways in Alzheimer's disease (AD), Parkinson's disease (PD) and Amyotrophic lateral sclerosis (ALS). Then we focused on the biased signaling pathway of GPCRs in these diseases. Finally, we updated the GPCR drugs under research for the treatment of neurodegenerative diseases in the clinical trials or approval. This review could provide valuable targets for precision therapy to cope with the dysfunction of neurodegenerative diseases in the future.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"46 ","pages":"Pages 155-168"},"PeriodicalIF":6.6,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143378296","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}