首页 > 最新文献

Clinical nutrition最新文献

英文 中文
Increasing plant protein in the diet induces changes in the plasma metabolome that may be beneficial for metabolic health. A randomized crossover study in males 增加饮食中的植物蛋白可诱导血浆代谢组发生变化,从而有益于代谢健康。一项针对男性的随机交叉研究。
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-10-12 DOI: 10.1016/j.clnu.2024.10.009
Gaïa Lépine , François Mariotti , Marie Tremblay-Franco , Marion Courrent , Marie-Anne Verny , Jérémie David , Véronique Mathé , Patrick Jame , Anthony Anchisi , Catherine Lefranc-Millot , Caroline Perreau , Laetitia Guérin-Deremaux , Céline Chollet , Florence Castelli , Emeline Chu-Van , Jean-François Huneau , Didier Rémond , Gisèle Pickering , Hélène Fouillet , Sergio Polakof

Background & aim

Dietary shifts replacing animal protein (AP) with plant protein (PP) sources have been associated with lowering cardiometabolic risk (CMR), but underlying mechanisms are poorly characterized. This nutritional intervention aims to characterize the metabolic changes induced by diets containing different proportions of AP and PP sources in males at CMR.

Design

This study is a 4-week, crossover, randomized, controlled-feeding trial in which 19 males with CMR followed two diets providing either 36 % for the control diet (CON-D) or 64 % for the flexitarian diet (FLEX-D) of total protein intake from PP sources. Plasma nontargeted metabolomes (LC-MS method) were measured in the fasted state and after a high-fat challenge meal at the end of each intervention arm. Lipogenesis and protein synthesis fluxes, flow-mediated dilatation (FMD) and gluco-lipidic responses were assessed after the challenge meal. Data were analyzed with mixed models, and univariate and multivariate models for metabolomics data.

Results

In both arms CMR improved with time, with decreased body weight (−0.9 %), insulin resistant (−34 %, HOMA-IR, Homeostatic Model Assessment for Insulin Resistance) and low-density lipoproteins (LDL)-cholesterol (−11 %). Diet had no effect on FMD or metabolic fluxes, but a trend (0.05 < p ≤ 0.1) was observed for a stronger decrease in HOMA-IR and lower postprandial glucose after FLEX-D vs CON-D. The abundance of 21 and 37 metabolites differed between diets at fasted and fed states, respectively, including food intake biomarkers of AP (methylhistidine, eicosapentaenoic acid, hydroxyprolines) and PP sources (trigonelline, N-acetyl-ornithine). In fasted or fed states, indole acrylic acid and indole propionic acid, both products of tryptophan catabolism, were higher after FLEX-D vs CON-D, while the indispensable amino acids-related metabolites alpha-aminoadipic acid, hydroxymethylbutyric acids and propionylcarnitine were lower. In the postprandial state only, the ω-oxidation products dodecanedioic, tetradecanedioic and hexadecanedioic acids were higher after FLEX-D vs CON-D.

Conclusions

Despite little changes in risk factors after 4 wk, this study evidenced subtle metabolic adaptations in amino acids and lipid metabolism and gut microbiota activity occurring after higher PP source intake that may be beneficial to CMR.

Clinicaltrials.gov study identifier

NCT04236518.

Clinical trial registry

NCT04236518 on ClinicalTrials.gov.
背景和目的:以植物蛋白(PP)替代动物蛋白(AP)的膳食结构调整与降低心脏代谢风险(CMR)有关,但其潜在机制尚不十分明确。这项营养干预研究旨在确定含有不同比例 AP 和 PP 来源的膳食对处于 CMR 的男性所引起的代谢变化的特征:本研究是一项为期 4 周的交叉、随机、对照喂养试验,19 名患有 CMR 的男性遵循两种饮食,对照饮食(CON-D)的蛋白质摄入量占总蛋白质摄入量的 36%,灵活饮食(FLEX-D)的蛋白质摄入量占总蛋白质摄入量的 64%。血浆非目标代谢组(LC-MS 方法)是在空腹状态下以及在每个干预组结束时的高脂挑战餐后测定的。挑战餐后评估了脂肪生成和蛋白质合成通量、血流介导的扩张(FMD)和糖脂反应。数据采用混合模型以及代谢组学数据的单变量和多变量模型进行分析:结果:随着时间的推移,两组患者的CMR均有所改善,体重(-0.9%)、胰岛素抵抗(-34%,HOMA-IR,胰岛素抵抗静态模型评估)和低密度脂蛋白胆固醇(-11%)均有所下降。饮食对 FMD 或代谢通量没有影响,但有趋势(0.05 结论):尽管4周后风险因素变化不大,但这项研究证明,在摄入更多PP来源后,氨基酸和脂质代谢以及肠道微生物群活动会发生微妙的代谢适应性变化,这可能对CMR有益:Gov 研究标识符:NCT04236518.临床试验登记:临床试验登记:NCT04236518 on ClinicalTrials.gov。
{"title":"Increasing plant protein in the diet induces changes in the plasma metabolome that may be beneficial for metabolic health. A randomized crossover study in males","authors":"Gaïa Lépine ,&nbsp;François Mariotti ,&nbsp;Marie Tremblay-Franco ,&nbsp;Marion Courrent ,&nbsp;Marie-Anne Verny ,&nbsp;Jérémie David ,&nbsp;Véronique Mathé ,&nbsp;Patrick Jame ,&nbsp;Anthony Anchisi ,&nbsp;Catherine Lefranc-Millot ,&nbsp;Caroline Perreau ,&nbsp;Laetitia Guérin-Deremaux ,&nbsp;Céline Chollet ,&nbsp;Florence Castelli ,&nbsp;Emeline Chu-Van ,&nbsp;Jean-François Huneau ,&nbsp;Didier Rémond ,&nbsp;Gisèle Pickering ,&nbsp;Hélène Fouillet ,&nbsp;Sergio Polakof","doi":"10.1016/j.clnu.2024.10.009","DOIUrl":"10.1016/j.clnu.2024.10.009","url":null,"abstract":"<div><h3>Background &amp; aim</h3><div>Dietary shifts replacing animal protein (AP) with plant protein (PP) sources have been associated with lowering cardiometabolic risk (CMR), but underlying mechanisms are poorly characterized. This nutritional intervention aims to characterize the metabolic changes induced by diets containing different proportions of AP and PP sources in males at CMR.</div></div><div><h3>Design</h3><div>This study is a 4-week, crossover, randomized, controlled-feeding trial in which 19 males with CMR followed two diets providing either 36 % for the control diet (CON-D) or 64 % for the flexitarian diet (FLEX-D) of total protein intake from PP sources. Plasma nontargeted metabolomes (LC-MS method) were measured in the fasted state and after a high-fat challenge meal at the end of each intervention arm. Lipogenesis and protein synthesis fluxes, flow-mediated dilatation (FMD) and gluco-lipidic responses were assessed after the challenge meal. Data were analyzed with mixed models, and univariate and multivariate models for metabolomics data.</div></div><div><h3>Results</h3><div>In both arms CMR improved with time, with decreased body weight (−0.9 %), insulin resistant (−34 %, HOMA-IR, Homeostatic Model Assessment for Insulin Resistance) and low-density lipoproteins (LDL)-cholesterol (−11 %). Diet had no effect on FMD or metabolic fluxes, but a trend (0.05 &lt; <em>p</em> ≤ 0.1) was observed for a stronger decrease in HOMA-IR and lower postprandial glucose after FLEX-D <em>vs</em> CON-D. The abundance of 21 and 37 metabolites differed between diets at fasted and fed states, respectively, including food intake biomarkers of AP (methylhistidine, eicosapentaenoic acid, hydroxyprolines) and PP sources (trigonelline, N-acetyl-ornithine). In fasted or fed states, indole acrylic acid and indole propionic acid, both products of tryptophan catabolism, were higher after FLEX-D <em>vs</em> CON-D, while the indispensable amino acids-related metabolites alpha-aminoadipic acid, hydroxymethylbutyric acids and propionylcarnitine were lower. In the postprandial state only, the ω-oxidation products dodecanedioic, tetradecanedioic and hexadecanedioic acids were higher after FLEX-D <em>vs</em> CON-D.</div></div><div><h3>Conclusions</h3><div>Despite little changes in risk factors after 4 wk, this study evidenced subtle metabolic adaptations in amino acids and lipid metabolism and gut microbiota activity occurring after higher PP source intake that may be beneficial to CMR.</div></div><div><h3>Clinicaltrials.gov study identifier</h3><div>NCT04236518.</div></div><div><h3>Clinical trial registry</h3><div>NCT04236518 on ClinicalTrials.gov.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 146-157"},"PeriodicalIF":6.6,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496401","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
Metabolic kinetics and muscle and brain health markers in older adults, and the role of age and presence of chronic morbidities: A large cross-sectional cohort study 老年人的代谢动力学、肌肉和大脑健康指标,以及年龄和是否患有慢性疾病的作用:大型横断面队列研究
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-10-11 DOI: 10.1016/j.clnu.2024.10.015
Minchae C. Kang, Nicolaas E.P. Deutz, Sarah K. Kirschner, Mariëlle P.K.J. Engelen
<div><h3>Background & aims</h3><div>Older adults are at risk for muscle and cognitive function decline during advanced aging, but the underlying metabolic mechanisms and the role of aging-associated chronic morbidities remain unclear. In the present study, we examined whether protein and amino acid kinetics in older adults with and without chronic morbidities are different when 50–70 and 70–90 of age and related to markers of muscle and brain health declines.</div></div><div><h3>Methods</h3><div>In a large cross-sectional observational study, 575 older adults from 12 trials (2014–2022) were stratified based on their age (50-70y vs. 70-95y) and the presence of chronic morbidities. The main outcomes were whole-body production (WBP) and interconversions of amino acids by stable amino acid tracers, body composition, and muscle and cognitive performance. Additionally, the association between metabolic markers and muscle and brain health was assessed.</div></div><div><h3>Results</h3><div>Overall lower muscle strength, muscle and fat mass, and cognitive function (p < 0.03), but no mood disturbances, were found in 70–95y compared to 50-70y older adults. Presence of morbidities was associated with lower muscle strength and mass, and cognitive function, but higher visceral adipose tissue, and mood disturbances (p < 0.05). Aging was associated with suppressed WBP of most amino acids, <em>de novo</em> arginine production, and net protein breakdown, but higher myofibrillar protein breakdown (p < 0.007). Presence of morbidities was associated with lower WBP of glutamine, glutamate, histidine, isoleucine, phenylalanine, tyrosine, and net protein breakdown, and higher WBP of valine and taurine (p < 0.04). Age showed significant negative correlations with WBP of nearly all amino acids, <em>de novo</em> arginine production and net protein breakdown (r: [-0.407, −0.136], p < 0.01) but a positive correlation with WBP of myofibrillar protein breakdown (r = 0.133, p = 0.009). Lean mass showed positive correlations with <em>de novo</em> arginine production and net protein breakdown and WBP of all amino acids except for isoleucine (r: [0.16, 0.799], p < 0.005). MoCA showed a positive correlation with WBP of leucine and valine (r: [0.163, 0.2], p < 0.03). Worse cognitive performance was positively associated with WBP of tau-methylhistidine and taurine (r: [0.13, 0.141], p < 0.04), but negatively associated with WBP of glycine and valine, <em>de novo</em> arginine production, and net protein breakdown (r: [-0.222, −0.115], p < 0.05).</div></div><div><h3>Conclusion</h3><div>Comprehensive phenotyping of a large group of older adults revealed differences in metabolic health in response to advanced aging and chronic morbidities. Poor muscle health accompanied by advanced aging was associated with overall metabolic downregulation, except for enhanced myofibrillar (muscle) protein breakdown. Presence of chronic morbidities was further associated w
背景& 目的老年人在晚期衰老过程中面临肌肉和认知功能衰退的风险,但其潜在的代谢机制以及衰老相关慢性疾病的作用仍不清楚。在本研究中,我们考察了有慢性病和无慢性病的老年人在 50-70 岁和 70-90 岁时的蛋白质和氨基酸动力学是否不同,以及与肌肉和大脑健康衰退标志物的关系。方法在一项大型横断面观察性研究中,根据年龄(50-70 岁 vs. 70-95岁)和是否有慢性病对来自 12 项试验(2014-2022 年)的 575 名老年人进行了分层。研究的主要结果是全身氨基酸产生量(WBP)和稳定氨基酸示踪剂的氨基酸相互转化率、身体成分以及肌肉和认知能力。结果发现,与 50-70 岁的老年人相比,70-95 岁的老年人肌肉力量、肌肉和脂肪质量以及认知功能总体较低(p < 0.03),但没有情绪障碍。患有疾病的老年人肌肉力量和质量以及认知功能较低,但内脏脂肪组织和情绪障碍较高(p <0.05)。衰老与大多数氨基酸的WBP、新精氨酸生成和净蛋白质分解受到抑制有关,但与肌纤维蛋白质分解增加有关(p <0.007)。患病与谷氨酰胺、谷氨酸、组氨酸、异亮氨酸、苯丙氨酸、酪氨酸和净蛋白质分解的 WBP 值降低,以及缬氨酸和牛磺酸的 WBP 值升高有关(p <0.04)。年龄与几乎所有氨基酸、从头生成精氨酸和净蛋白质分解的 WBP 呈明显负相关(r:[-0.407,-0.136],p <;0.01),但与肌纤维蛋白质分解的 WBP 呈正相关(r = 0.133,p = 0.009)。瘦体重与从头生成精氨酸和净蛋白质分解以及除异亮氨酸外所有氨基酸的 WBP 呈正相关(r:[0.16, 0.799],p < 0.005)。MoCA 与亮氨酸和缬氨酸的 WBP 呈正相关(r:[0.163, 0.2],p < 0.03)。认知表现较差与 tau-methylhistidine 和牛磺酸的 WBP 呈正相关(r:[0.13, 0.141],p <;0.04),但与甘氨酸和缬氨酸的 WBP、从头生成精氨酸以及蛋白质净分解呈负相关(r:[-0.222, -0.115],p <;0.05)。除了肌纤维(肌肉)蛋白质分解增加外,伴随着高龄化的肌肉健康状况不佳与整体代谢下调有关。慢性疾病的存在还与肌肉健康、情绪、精氨酸和牛磺酸途径的紊乱以及内脏脂肪组织的增加有关。因此,在评估改善肌肉和大脑健康的治疗方法时,需要考虑老年人的不同表型。
{"title":"Metabolic kinetics and muscle and brain health markers in older adults, and the role of age and presence of chronic morbidities: A large cross-sectional cohort study","authors":"Minchae C. Kang,&nbsp;Nicolaas E.P. Deutz,&nbsp;Sarah K. Kirschner,&nbsp;Mariëlle P.K.J. Engelen","doi":"10.1016/j.clnu.2024.10.015","DOIUrl":"10.1016/j.clnu.2024.10.015","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background &amp; aims&lt;/h3&gt;&lt;div&gt;Older adults are at risk for muscle and cognitive function decline during advanced aging, but the underlying metabolic mechanisms and the role of aging-associated chronic morbidities remain unclear. In the present study, we examined whether protein and amino acid kinetics in older adults with and without chronic morbidities are different when 50–70 and 70–90 of age and related to markers of muscle and brain health declines.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In a large cross-sectional observational study, 575 older adults from 12 trials (2014–2022) were stratified based on their age (50-70y vs. 70-95y) and the presence of chronic morbidities. The main outcomes were whole-body production (WBP) and interconversions of amino acids by stable amino acid tracers, body composition, and muscle and cognitive performance. Additionally, the association between metabolic markers and muscle and brain health was assessed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Overall lower muscle strength, muscle and fat mass, and cognitive function (p &lt; 0.03), but no mood disturbances, were found in 70–95y compared to 50-70y older adults. Presence of morbidities was associated with lower muscle strength and mass, and cognitive function, but higher visceral adipose tissue, and mood disturbances (p &lt; 0.05). Aging was associated with suppressed WBP of most amino acids, &lt;em&gt;de novo&lt;/em&gt; arginine production, and net protein breakdown, but higher myofibrillar protein breakdown (p &lt; 0.007). Presence of morbidities was associated with lower WBP of glutamine, glutamate, histidine, isoleucine, phenylalanine, tyrosine, and net protein breakdown, and higher WBP of valine and taurine (p &lt; 0.04). Age showed significant negative correlations with WBP of nearly all amino acids, &lt;em&gt;de novo&lt;/em&gt; arginine production and net protein breakdown (r: [-0.407, −0.136], p &lt; 0.01) but a positive correlation with WBP of myofibrillar protein breakdown (r = 0.133, p = 0.009). Lean mass showed positive correlations with &lt;em&gt;de novo&lt;/em&gt; arginine production and net protein breakdown and WBP of all amino acids except for isoleucine (r: [0.16, 0.799], p &lt; 0.005). MoCA showed a positive correlation with WBP of leucine and valine (r: [0.163, 0.2], p &lt; 0.03). Worse cognitive performance was positively associated with WBP of tau-methylhistidine and taurine (r: [0.13, 0.141], p &lt; 0.04), but negatively associated with WBP of glycine and valine, &lt;em&gt;de novo&lt;/em&gt; arginine production, and net protein breakdown (r: [-0.222, −0.115], p &lt; 0.05).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Comprehensive phenotyping of a large group of older adults revealed differences in metabolic health in response to advanced aging and chronic morbidities. Poor muscle health accompanied by advanced aging was associated with overall metabolic downregulation, except for enhanced myofibrillar (muscle) protein breakdown. Presence of chronic morbidities was further associated w","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 36-47"},"PeriodicalIF":6.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446207","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
Analysis of fat oxidation capacity during cardiopulmonary exercise testing indicates long-lasting metabolic disturbance in patients with post-covid-19 syndrome 心肺运动测试期间的脂肪氧化能力分析表明,"后科维德-19 "综合征患者的代谢紊乱会长期存在
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-10-11 DOI: 10.1016/j.clnu.2024.10.010
René Garbsch , Hendrik Schäfer , Frank C. Mooren , Boris Schmitz

Background & aims

Post-COVID-19 Syndrome (PCS) is characterized by symptoms including fatigue, reduced physical performance, dyspnea, cognitive impairment, and psychological distress. The mechanisms underlying the onset and severity of PCS point to mitochondrial dysfunction as significant contributor. This study examined fat oxidation as a function of mitochondrial capacity during exercise.

Methods

Single-center prospective cohort study during inpatient rehabilitation. Cardiopulmonary exercise testing and assessment of fatigue using questionnaires were performed at admission and discharge. Detailed spirometric breath-by-breath data were used to calculate substrate oxidation rates.

Results

Patients (N = 187; 38 % women; 49.7 ± 11.4 years) were referred to rehabilitation 253.4 ± 130.6 days after infection. Lead symptoms included fatigue/exercise intolerance (79.9 %), shortness of breath (77.0 %), and cognitive dysfunction (55.1 %). Fat oxidation capacity was disturbed in PCS patients overall (AUC: 11.3 [10.7–11.9]) compared to healthy controls (p < 0.0001), with hospitalization during acute infection predicting the level of disturbance (p < 0.0001). Low exercise capacity and high fatigue scores resulted in reduced fat oxidation (both p < 0.0001). In particular, younger males were affected by significantly reduced fat oxidation capacity (sex: p = 0.002; age: p < 0.001). Metabolic disturbance was significantly improved during exercise-based rehabilitation (AUC: 14.9 [14.4–15.4]; p < 0.0001), even for the group of younger impaired males (+44.2 %; p < 0.0001). Carbohydrate oxidation was not impaired.

Conclusions

PCS-specific restrictions in fat oxidation may indicate persistent mitochondrial dysfunction. Clinical assessment of PCS patients should include detailed breath-by-breath analysis during exercise to identify metabolic alterations especially in the group of younger males identified in this report. Exercise-based rehabilitation results in improved exercise capacity and fat oxidation and thus likely mitochondrial function. Clinical Trials: NCT06468722.
背景& 目的Post-COVID-19 综合征(PCS)以疲劳、体能下降、呼吸困难、认知障碍和心理困扰等症状为特征。PCS 的发病机制和严重程度表明,线粒体功能障碍是导致 PCS 的重要因素。本研究考察了运动过程中脂肪氧化作为线粒体能力功能的情况。方法在住院康复期间进行单中心前瞻性队列研究。入院和出院时进行心肺运动测试,并使用问卷进行疲劳评估。结果患者(N = 187;38 % 女性;49.7 ± 11.4 岁)在感染后 253.4 ± 130.6 天转入康复中心。主要症状包括疲劳/运动不耐受(79.9%)、气短(77.0%)和认知功能障碍(55.1%)。与健康对照组相比,PCS 患者的脂肪氧化能力总体上受到干扰(AUC:11.3 [10.7-11.9])(p < 0.0001),急性感染期间的住院治疗可预测干扰程度(p < 0.0001)。低运动能力和高疲劳评分导致脂肪氧化减少(均为 p <0.0001)。尤其是年轻男性的脂肪氧化能力明显下降(性别:p = 0.002;年龄:p < 0.001)。在以运动为基础的康复过程中,代谢紊乱得到了明显改善(AUC:14.9 [14.4-15.4];p <;0.0001),即使是年轻的受损男性群体(+44.2%;p <;0.0001)也是如此。结论 PCS 特异性脂肪氧化受限可能表明线粒体功能持续障碍。对 PCS 患者的临床评估应包括在运动过程中进行详细的逐次呼吸分析,以确定新陈代谢的改变,尤其是本报告中发现的年轻男性群体。运动康复可提高运动能力和脂肪氧化能力,从而改善线粒体功能。临床试验:NCT06468722。
{"title":"Analysis of fat oxidation capacity during cardiopulmonary exercise testing indicates long-lasting metabolic disturbance in patients with post-covid-19 syndrome","authors":"René Garbsch ,&nbsp;Hendrik Schäfer ,&nbsp;Frank C. Mooren ,&nbsp;Boris Schmitz","doi":"10.1016/j.clnu.2024.10.010","DOIUrl":"10.1016/j.clnu.2024.10.010","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Post-COVID-19 Syndrome (PCS) is characterized by symptoms including fatigue, reduced physical performance, dyspnea, cognitive impairment, and psychological distress. The mechanisms underlying the onset and severity of PCS point to mitochondrial dysfunction as significant contributor. This study examined fat oxidation as a function of mitochondrial capacity during exercise.</div></div><div><h3>Methods</h3><div>Single-center prospective cohort study during inpatient rehabilitation. Cardiopulmonary exercise testing and assessment of fatigue using questionnaires were performed at admission and discharge. Detailed spirometric breath-by-breath data were used to calculate substrate oxidation rates.</div></div><div><h3>Results</h3><div>Patients (N = 187; 38 % women; 49.7 ± 11.4 years) were referred to rehabilitation 253.4 ± 130.6 days after infection. Lead symptoms included fatigue/exercise intolerance (79.9 %), shortness of breath (77.0 %), and cognitive dysfunction (55.1 %). Fat oxidation capacity was disturbed in PCS patients overall (AUC: 11.3 [10.7–11.9]) compared to healthy controls (p &lt; 0.0001), with hospitalization during acute infection predicting the level of disturbance (p &lt; 0.0001). Low exercise capacity and high fatigue scores resulted in reduced fat oxidation (both p &lt; 0.0001). In particular, younger males were affected by significantly reduced fat oxidation capacity (sex: p = 0.002; age: p &lt; 0.001). Metabolic disturbance was significantly improved during exercise-based rehabilitation (AUC: 14.9 [14.4–15.4]; p &lt; 0.0001), even for the group of younger impaired males (+44.2 %; p &lt; 0.0001). Carbohydrate oxidation was not impaired.</div></div><div><h3>Conclusions</h3><div>PCS-specific restrictions in fat oxidation may indicate persistent mitochondrial dysfunction. Clinical assessment of PCS patients should include detailed breath-by-breath analysis during exercise to identify metabolic alterations especially in the group of younger males identified in this report. Exercise-based rehabilitation results in improved exercise capacity and fat oxidation and thus likely mitochondrial function. Clinical Trials: NCT06468722.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 26-35"},"PeriodicalIF":6.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446208","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
Bioelectrical impedance analysis (BIA) phase angle in stroke patients: A systematic review 中风患者的生物电阻抗分析(BIA)相位角:系统综述。
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-10-11 DOI: 10.1016/j.clnu.2024.10.001
Chiara Francesca Gheri , Luca Scalfi , Maria Luisa Eliana Luisi , Olivia Di Vincenzo

Background and aims

Phase angle (PhA), a raw variable of bioelectrical impedance analysis (BIA), is an index of muscle structure and quality and might have a potential role in the evaluation of nutritional status.
The aim of this systematic review was to evaluate in stroke patients: baseline PhA and its changes during hospital stay; the association of PhA with clinical features of patients, comorbidities, nutritional status or sarcopenia, and clinical outcomes.

Methods

Systematic research on electronic databases (PubMed, Scopus, and Web of Science) up to June 14th, 2024 was performed according to PRISMA checklist.
Using PECOS strategy, “P” (patients) = stroke patients, “E” (exposure) = lowest PhA values, “C” (comparison) = versus greatest PhA values, “O” (outcome) = nutritional and clinical outcomes, and “S” (study design) = all study types.
Methodological quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies (NIH).

Results

Eighteen papers met the inclusion criteria, with a low risk of bias. In stroke patients, evidence suggests that PhA was associated with malnutrition, sarcopenia and sarcopenic obesity, as well as with physical function. In addition, patients with low PhA had a longer hospital stay, higher inflammatory status and higher incidence of urinary tract infections and hospital-acquired pneumonia.

Conclusions

Selected papers, although not conclusive, show that in acute and subacute stroke patients PhA was inversely associated with malnutrition and poor physical function. PhA could be a marker of health status and disease progression. PhA may be useful in a more comprehensive evaluation of nutritional status to be used for diagnosis and implementing therapy.
背景和目的:相位角(Phase angle,PhA)是生物电阻抗分析(BIA)的一个原始变量,是肌肉结构和质量的一项指标,可能在营养状况评估中发挥潜在作用。本系统性综述旨在评估中风患者的基线 PhA 及其在住院期间的变化;PhA 与患者临床特征、合并症、营养状况或肌肉疏松症以及临床结果的关系:根据 PRISMA 检查表,对截至 2024 年 6 月 14 日的电子数据库(PubMed、Scopus 和 Web of Science)进行了系统研究。采用 PECOS 策略,"P"(患者)= 脑卒中患者,"E"(暴露)= 最低 PhA 值,"C"(对比)= 与最大 PhA 值对比,"O"(结果)= 营养和临床结果,"S"(研究设计)= 所有研究类型。方法学质量采用观察性队列和横断面研究质量评估工具(NIH)进行评估:结果:18 篇论文符合纳入标准,偏倚风险较低。在中风患者中,有证据表明 PhA 与营养不良、肌肉疏松症和肌肉疏松性肥胖以及身体功能有关。此外,Phan值低的患者住院时间更长,炎症程度更高,尿路感染和医院获得性肺炎的发病率也更高:结论:部分论文虽然没有得出结论,但表明在急性和亚急性脑卒中患者中,PhA 与营养不良和身体功能差呈反比关系。PhA 可以作为健康状况和疾病进展的标志。PhA 可能有助于对营养状况进行更全面的评估,以用于诊断和实施治疗。
{"title":"Bioelectrical impedance analysis (BIA) phase angle in stroke patients: A systematic review","authors":"Chiara Francesca Gheri ,&nbsp;Luca Scalfi ,&nbsp;Maria Luisa Eliana Luisi ,&nbsp;Olivia Di Vincenzo","doi":"10.1016/j.clnu.2024.10.001","DOIUrl":"10.1016/j.clnu.2024.10.001","url":null,"abstract":"<div><h3>Background and aims</h3><div>Phase angle (PhA), a raw variable of bioelectrical impedance analysis (BIA), is an index of muscle structure and quality and might have a potential role in the evaluation of nutritional status.</div><div>The aim of this systematic review was to evaluate in stroke patients: baseline PhA and its changes during hospital stay; the association of PhA with clinical features of patients, comorbidities, nutritional status or sarcopenia, and clinical outcomes.</div></div><div><h3>Methods</h3><div>Systematic research on electronic databases (PubMed, Scopus, and Web of Science) up to June 14th, 2024 was performed according to PRISMA checklist.</div><div>Using PECOS strategy, “P” (patients) = stroke patients, “E” (exposure) = lowest PhA values, “C” (comparison) = versus greatest PhA values, “O” (outcome) = nutritional and clinical outcomes, and “S” (study design) = all study types.</div><div>Methodological quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies (NIH).</div></div><div><h3>Results</h3><div>Eighteen papers met the inclusion criteria, with a low risk of bias. In stroke patients, evidence suggests that PhA was associated with malnutrition, sarcopenia and sarcopenic obesity, as well as with physical function. In addition, patients with low PhA had a longer hospital stay, higher inflammatory status and higher incidence of urinary tract infections and hospital-acquired pneumonia.</div></div><div><h3>Conclusions</h3><div>Selected papers, although not conclusive, show that in acute and subacute stroke patients PhA was inversely associated with malnutrition and poor physical function. PhA could be a marker of health status and disease progression. PhA may be useful in a more comprehensive evaluation of nutritional status to be used for diagnosis and implementing therapy.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 63-72"},"PeriodicalIF":6.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459820","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
Association of moderate alcohol intake with the risks of cirrhosis and steatotic liver disease: Results from a large population-based cohort study 适量酒精摄入与肝硬化和脂肪肝风险的关系:一项大型人群队列研究的结果。
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-10-11 DOI: 10.1016/j.clnu.2024.10.014
Hongliang Xue , Liqing Wang , Yuankai Wu , Xinyu Liu , Jingcheng Jiang , Sun On Chan , Xu Chen , Wenhua Ling , Chao Yu

Background&aims

There is uncertainty about the associations between moderate alcohol consumption and liver-related outcomes. We aimed to explore the associations of moderate drinking with cirrhosis, steatotic liver disease (SLD), and liver cancer in a large cohort study.

Methods

A total of 215,559 non-drinkers and moderate drinkers (<20 g/day alcohol for females or < 30 g/day for males) were enrolled between 2006 and 2010 and followed up to 2022. The primary outcome is incident cirrhosis, and the secondary outcomes are the incidence of steatotic liver disease and liver cancer. Hazard ratios (HRs) and 95 % confidence intervals (CIs) were calculated for liver-related outcomes in relation to moderate drinkers, as well as the quantity and type of their alcohol intake. All analyses were stratified by sex.

Results

A total of 705 cirrhosis, 2010 SLD, and 350 liver cancer cases were documented during a median follow-up period of 12.7 years. Compared with non-drinkers, moderate drinkers had a lower risk of SLD (HR: 0.77; 95 % CI: 0.66, 0.89). Among the moderate drinkers, alcohol intake [per standard deviation (SD) increment] was associated with an increased risk of incident cirrhosis (HR: 1.11; 95 % CI: 1.02, 1.20), but the association was attenuated after restricting alcohol intake to no more than 16 g/day. Wine consumption (per SD increment of the percentage of wine consumption of total alcohol intake) had an inverse association with incident cirrhosis and SLD (HR: 0.82; 95 % CI: 0.75, 0.89 for cirrhosis; HR: 0.91; 95 % CI: 0.87, 0.96 for SLD). The inverse associations between moderate wine use and SLD were likely to be sex-dependent (P for interaction = 0.01).

Conclusions

The excessive alcohol threshold of 30 g/day for males may be set high for liver health. Further work is needed to make sex-specific recommendations on moderate drinking for liver health.
背景与目的:适量饮酒与肝脏相关结果之间的关系尚不确定。我们旨在通过一项大型队列研究探讨适量饮酒与肝硬化、脂肪肝和肝癌之间的关系:方法:共 215 559 名非饮酒者和适量饮酒者(结果:共发现 705 例肝硬化和肝癌患者):中位随访期为 12.7 年,共记录了 705 例肝硬化、2010 例 SLD 和 350 例肝癌病例。与不饮酒者相比,适度饮酒者患 SLD 的风险较低(HR:0.77;95 % CI:0.66,0.89)。在适度饮酒者中,酒精摄入量[每标准差(SD)增量]与发生肝硬化的风险增加有关(HR:1.11;95 % CI:1.02,1.20),但将酒精摄入量限制在每天不超过 16 克后,这种关联性减弱。葡萄酒摄入量(葡萄酒摄入量占酒精总摄入量百分比的每 SD 增量)与肝硬化和 SLD 的发生呈负相关(肝硬化的 HR:0.82;95 % CI:0.75,0.89;SLD 的 HR:0.91;95 % CI:0.87,0.96)。适量饮酒与 SLD 之间的负相关可能与性别有关(交互作用的 P = 0.01):结论:为了肝脏健康,男性每天 30 克的过量酒精阈值可能定得过高。结论:为了肝脏健康,男性每天过量饮酒 30 克的阈值可能定得过高,需要进一步研究,针对不同性别提出适量饮酒促进肝脏健康的建议。
{"title":"Association of moderate alcohol intake with the risks of cirrhosis and steatotic liver disease: Results from a large population-based cohort study","authors":"Hongliang Xue ,&nbsp;Liqing Wang ,&nbsp;Yuankai Wu ,&nbsp;Xinyu Liu ,&nbsp;Jingcheng Jiang ,&nbsp;Sun On Chan ,&nbsp;Xu Chen ,&nbsp;Wenhua Ling ,&nbsp;Chao Yu","doi":"10.1016/j.clnu.2024.10.014","DOIUrl":"10.1016/j.clnu.2024.10.014","url":null,"abstract":"<div><h3>Background&amp;aims</h3><div>There is uncertainty about the associations between moderate alcohol consumption and liver-related outcomes. We aimed to explore the associations of moderate drinking with cirrhosis, steatotic liver disease (SLD), and liver cancer in a large cohort study.</div></div><div><h3>Methods</h3><div>A total of 215,559 non-drinkers and moderate drinkers (&lt;20 g/day alcohol for females or &lt; 30 g/day for males) were enrolled between 2006 and 2010 and followed up to 2022. The primary outcome is incident cirrhosis, and the secondary outcomes are the incidence of steatotic liver disease and liver cancer. Hazard ratios (HRs) and 95 % confidence intervals (CIs) were calculated for liver-related outcomes in relation to moderate drinkers, as well as the quantity and type of their alcohol intake. All analyses were stratified by sex.</div></div><div><h3>Results</h3><div>A total of 705 cirrhosis, 2010 SLD, and 350 liver cancer cases were documented during a median follow-up period of 12.7 years. Compared with non-drinkers, moderate drinkers had a lower risk of SLD (HR: 0.77; 95 % CI: 0.66, 0.89). Among the moderate drinkers, alcohol intake [per standard deviation (SD) increment] was associated with an increased risk of incident cirrhosis (HR: 1.11; 95 % CI: 1.02, 1.20), but the association was attenuated after restricting alcohol intake to no more than 16 g/day. Wine consumption (per SD increment of the percentage of wine consumption of total alcohol intake) had an inverse association with incident cirrhosis and SLD (HR: 0.82; 95 % CI: 0.75, 0.89 for cirrhosis; HR: 0.91; 95 % CI: 0.87, 0.96 for SLD). The inverse associations between moderate wine use and SLD were likely to be sex-dependent (<em>P</em> for interaction = 0.01).</div></div><div><h3>Conclusions</h3><div>The excessive alcohol threshold of 30 g/day for males may be set high for liver health. Further work is needed to make sex-specific recommendations on moderate drinking for liver health.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 75-83"},"PeriodicalIF":6.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459819","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
Effects of the interaction between body mass index and dietary patterns on severe NAFLD incidence: A prospective cohort study 体重指数和饮食模式之间的相互作用对严重非酒精性脂肪肝发病率的影响:前瞻性队列研究。
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-10-11 DOI: 10.1016/j.clnu.2024.10.008
Yuxiao Wang , Jing Li , Congying Song , Jingwen Zhang , Zhidong Liu , Wenjun Zhou , Xiaoyan Huang , Guang Ji , Ying Shan , Liang Dai

Background

It remains unclear whether the associations between dietary patterns and non-alcoholic fatty liver disease (NAFLD) vary by body mass index (BMI). We aimed to explore the association between dietary patterns and severe NAFLD incidence, and further investigate the interaction of BMI with dietary patterns.

Methods

In a prospective cohort study using UK Biobank data, we included White participants with baseline food frequency questionnaire (FFQ) information. Principal component analysis (PCA) with varimax rotation was performed to identify major dietary patterns. The primary outcome was severe NAFLD, defined as hospitalization due to NAFLD or non-alcoholic steatohepatitis (NASH). We employed cause-specific Cox regression for competing risks to assess the association and calculated the relative excess risk due to interaction (RERI) to estimate the interaction of BMI.

Results

This study included 307,130 participants with a median follow-up of 12.68 years. 3104 cases of severe NAFLD were identified. PCA analysis revealed two primary dietary patterns: a prudent diet (RC1) and a meat-based diet (RC2). Multivariate analysis showed a standard deviation (SD) increase in RC1 was associated with lower severe NAFLD risk (HR 0.91 [95 % CI 0.88 to 0.94]), while a SD increase in RC2 was associated with higher risk (1.10 [1.05 to 1.14]). Significant interactions were observed between baseline BMI ≥25 kg/m2 and dietary patterns (RC1: RERI: −0.22 [95 % CI –0.43 to −0.003]; RC2: 0.29 [0.03 to 0.56]).

Conclusions

Targeted dietary modifications are vital for specific populations at risk of severe NAFLD, considering the significant interaction observed between BMI and dietary patterns.
背景:膳食模式与非酒精性脂肪肝(NAFLD)之间的关系是否因体重指数(BMI)而异尚不清楚。我们旨在探索膳食模式与严重非酒精性脂肪肝发病率之间的关系,并进一步研究体重指数与膳食模式之间的相互作用:在一项利用英国生物库数据进行的前瞻性队列研究中,我们纳入了具有基线食物频率问卷(FFQ)信息的白人参与者。采用主成分分析(PCA)和方差旋转法确定主要饮食模式。主要结果是严重非酒精性脂肪肝,即因非酒精性脂肪肝或非酒精性脂肪性肝炎(NASH)住院。我们采用了针对竞争风险的特定原因 Cox 回归来评估相关性,并计算了相互作用导致的相对超额风险 (RERI),以估计 BMI 的相互作用:本研究共纳入 307130 名参与者,中位随访时间为 12.68 年。共发现 3104 例严重非酒精性脂肪肝病例。PCA 分析显示了两种主要饮食模式:谨慎饮食(RC1)和肉类饮食(RC2)。多变量分析显示,RC1 标准差(SD)的增加与较低的严重非酒精性脂肪肝风险相关(HR 0.91 [95 % CI 0.88 至 0.94]),而 RC2 标准差的增加与较高的风险相关(1.10 [1.05 至 1.14])。基线体重指数≥25 kg/m2与饮食模式之间存在显著的相互作用(RC1:RERI:-0.22 [95 % CI -0.43 to -0.003];RC2:0.29 [0.03 to 0.56]):考虑到在体重指数和膳食模式之间观察到的显著交互作用,有针对性的膳食调整对有严重非酒精性脂肪肝风险的特定人群至关重要。
{"title":"Effects of the interaction between body mass index and dietary patterns on severe NAFLD incidence: A prospective cohort study","authors":"Yuxiao Wang ,&nbsp;Jing Li ,&nbsp;Congying Song ,&nbsp;Jingwen Zhang ,&nbsp;Zhidong Liu ,&nbsp;Wenjun Zhou ,&nbsp;Xiaoyan Huang ,&nbsp;Guang Ji ,&nbsp;Ying Shan ,&nbsp;Liang Dai","doi":"10.1016/j.clnu.2024.10.008","DOIUrl":"10.1016/j.clnu.2024.10.008","url":null,"abstract":"<div><h3>Background</h3><div>It remains unclear whether the associations between dietary patterns and non-alcoholic fatty liver disease (NAFLD) vary by body mass index (BMI). We aimed to explore the association between dietary patterns and severe NAFLD incidence, and further investigate the interaction of BMI with dietary patterns.</div></div><div><h3>Methods</h3><div>In a prospective cohort study using UK Biobank data, we included White participants with baseline food frequency questionnaire (FFQ) information. Principal component analysis (PCA) with varimax rotation was performed to identify major dietary patterns. The primary outcome was severe NAFLD, defined as hospitalization due to NAFLD or non-alcoholic steatohepatitis (NASH). We employed cause-specific Cox regression for competing risks to assess the association and calculated the relative excess risk due to interaction (RERI) to estimate the interaction of BMI.</div></div><div><h3>Results</h3><div>This study included 307,130 participants with a median follow-up of 12.68 years. 3104 cases of severe NAFLD were identified. PCA analysis revealed two primary dietary patterns: a prudent diet (RC1) and a meat-based diet (RC2). Multivariate analysis showed a standard deviation (SD) increase in RC1 was associated with lower severe NAFLD risk (HR 0.91 [95 % CI 0.88 to 0.94]), while a SD increase in RC2 was associated with higher risk (1.10 [1.05 to 1.14]). Significant interactions were observed between baseline BMI ≥25 kg/m<sup>2</sup> and dietary patterns (RC1: RERI: −0.22 [95 % CI –0.43 to −0.003]; RC2: 0.29 [0.03 to 0.56]).</div></div><div><h3>Conclusions</h3><div>Targeted dietary modifications are vital for specific populations at risk of severe NAFLD, considering the significant interaction observed between BMI and dietary patterns.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 92-100"},"PeriodicalIF":6.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496467","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
Letter to the Editor–“Risk factors for low muscle mass, malnutrition, and (probable-) sarcopenia in adults with or without a history of cancer in the UK Biobank” 致编辑的信--"英国生物库中有或无癌症病史的成年人肌肉质量低、营养不良和(可能)肌肉疏松症的风险因素"
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-10-10 DOI: 10.1016/j.clnu.2024.10.003
Lu-fang Huang, Rui-xuan Li
{"title":"Letter to the Editor–“Risk factors for low muscle mass, malnutrition, and (probable-) sarcopenia in adults with or without a history of cancer in the UK Biobank”","authors":"Lu-fang Huang,&nbsp;Rui-xuan Li","doi":"10.1016/j.clnu.2024.10.003","DOIUrl":"10.1016/j.clnu.2024.10.003","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 15-16"},"PeriodicalIF":6.6,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446291","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
Reply–Letter to the Editor: Review of “Dietary patterns, inflammatory biomarkers and cognition in older adults: An analysis of three population-based cohorts” 给编辑的回信:对 "老年人的饮食模式、炎症生物标志物和认知能力:对三个基于人群的队列的分析"
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-10-09 DOI: 10.1016/j.clnu.2024.10.013
Natalia Ortega, Leona Schütte, Patricia O. Chocano-Bedoya
{"title":"Reply–Letter to the Editor: Review of “Dietary patterns, inflammatory biomarkers and cognition in older adults: An analysis of three population-based cohorts”","authors":"Natalia Ortega,&nbsp;Leona Schütte,&nbsp;Patricia O. Chocano-Bedoya","doi":"10.1016/j.clnu.2024.10.013","DOIUrl":"10.1016/j.clnu.2024.10.013","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 3-4"},"PeriodicalIF":6.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441030","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
Apolipoprotein C-III in association with metabolic-dysfunction associated steatotic liver disease: A large, multicenter study 载脂蛋白 C-III 与代谢功能障碍相关性脂肪肝的关系:一项大型多中心研究。
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-10-08 DOI: 10.1016/j.clnu.2024.10.007
Matina Kouvari , Laura Valenzuela-Vallejo , Valentina Guatibonza-Garcia , Ornella Verrastro , Evangelos Axarloglou , Sophia C. Mylonakis , Jacob George , Georgios Papatheodoridis , Geltrude Mingrone , Christos S. Mantzoros

Background & aims

The available literature on the effect of apolipoprotein C-III (ApoC-III) inhibition in MASLD reveals inconsistencies. The aim of the present work was to examine levels of ApoC-III in the entire spectrum of metabolic-dysfunction associated steatotic liver disease (MASLD).

Methods

This is a multicenter study involving patients enrolled in two gastroenterology-hepatology clinics (Greece and Australia) and in a bariatric-metabolic surgery clinic (Italy), with liver biopsy before and after bariatric surgery or lifestyle modification.

Results

Comparing simple MASL to steatohepatitis (MASH) with fibrosis stage F ≥ 2 (at-risk MASH), revealed a marginally significant trend for decreased ApoC-III levels in the latter group (p = 0.07). Multi-adjusted analysis revealed an inverse association between ApoC-III and at-risk MASH (Odds Ratioper 1 mg/dL increase in ApoC-III = 0.91, 95 % Confidence Interval (0.83, 0.99)). ApoC-III interacted with triglycerides in predicting at-risk MASH (p-for-interaction = 0.002). Participants with ApoC-III > median (∼3.75 mg/dL) and normal triglycerides (triglyceridese≤150 mg/dL) had the lowest likelihood to present at-risk MASH (31.8 %) in contrast with participants with ApoC-III < median and hypertriglyceridemia among whom at-risk MASH was recorded in 57.1 %. In multi-adjusted analysis participants with normal triglycerides and high ApoC-III had 64 % lower odds of at-risk MASH compared with their counterparts with ApoC-III < median (OR = 0.36, 95%CI (0.14, 0.86)). Among participants with hypertriglyceridemia, those with ApoC-III < median had less prevalent at-risk MASH compared with those with ApoC-III ≥ median (OR = 0.54, 95%CI (0.32, 0.98)); however in all cases significance was lost when liver enzymes were taken into account.

Conclusions

In advanced disease stages, ApoC-III levels seem to be decreased and advanced organ damage may be a potential explanation. Mendelian randomization studies are needed to confirm or refute this hypothesis.
背景与目的:关于载脂蛋白C-III(ApoC-III)抑制剂在MASLD中的作用,现有文献并不一致。本研究旨在检测代谢功能障碍相关性脂肪性肝病(MASLD)整个病程中载脂蛋白 C-III 的水平:这是一项多中心研究,涉及两个胃肠病肝病诊所(希腊和澳大利亚)和一个减肥代谢外科诊所(意大利)的患者,他们在减肥手术或生活方式调整前后接受了肝活检:将单纯 MASL 与纤维化分期 F≥2 的脂肪性肝炎(MASH)(高危 MASH)进行比较,发现后一组的载脂蛋白 C-III 水平略有下降趋势(p = 0.07)。多重调整分析显示,载脂蛋白C-III与高危MASH之间呈反向关系(载脂蛋白C-III增加1毫克/分升的比值比=0.91,95%置信区间(0.83,0.99))。载脂蛋白C-III与甘油三酯在预测高危MASH方面存在交互作用(交互作用 p = 0.002)。载脂蛋白C-III>中位数(∼3.75 mg/dL)且甘油三酯正常(甘油三酯ese≤150 mg/dL)的参与者出现高危MASH的可能性最低(31.8%),与载脂蛋白C-III的参与者形成鲜明对比:在疾病晚期,载脂蛋白C-III水平似乎有所下降,晚期器官损伤可能是一个潜在的原因。需要进行孟德尔随机研究来证实或反驳这一假设。
{"title":"Apolipoprotein C-III in association with metabolic-dysfunction associated steatotic liver disease: A large, multicenter study","authors":"Matina Kouvari ,&nbsp;Laura Valenzuela-Vallejo ,&nbsp;Valentina Guatibonza-Garcia ,&nbsp;Ornella Verrastro ,&nbsp;Evangelos Axarloglou ,&nbsp;Sophia C. Mylonakis ,&nbsp;Jacob George ,&nbsp;Georgios Papatheodoridis ,&nbsp;Geltrude Mingrone ,&nbsp;Christos S. Mantzoros","doi":"10.1016/j.clnu.2024.10.007","DOIUrl":"10.1016/j.clnu.2024.10.007","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>The available literature on the effect of apolipoprotein C-III (ApoC-III) inhibition in MASLD reveals inconsistencies. The aim of the present work was to examine levels of ApoC-III in the entire spectrum of metabolic-dysfunction associated steatotic liver disease (MASLD).</div></div><div><h3>Methods</h3><div>This is a multicenter study involving patients enrolled in two gastroenterology-hepatology clinics (Greece and Australia) and in a bariatric-metabolic surgery clinic (Italy), with liver biopsy before and after bariatric surgery or lifestyle modification.</div></div><div><h3>Results</h3><div>Comparing simple MASL to steatohepatitis (MASH) with fibrosis stage F ≥ 2 (at-risk MASH), revealed a marginally significant trend for decreased ApoC-III levels in the latter group (<em>p</em> = <em>0.07</em>). Multi-adjusted analysis revealed an inverse association between ApoC-III and at-risk MASH (Odds Ratio<sub>per 1 mg/dL increase in ApoC-III</sub> = 0.91, 95 % Confidence Interval (0.83, 0.99)). ApoC-III interacted with triglycerides in predicting at-risk MASH (<em>p-for-interaction</em> = <em>0.002</em>). Participants with ApoC-III &gt; median (∼3.75 mg/dL) and normal triglycerides (triglyceridese≤150 mg/dL) had the lowest likelihood to present at-risk MASH (31.8 %) in contrast with participants with ApoC-III &lt; median and hypertriglyceridemia among whom at-risk MASH was recorded in 57.1 %. In multi-adjusted analysis participants with normal triglycerides and high ApoC-III had 64 % lower odds of at-risk MASH compared with their counterparts with ApoC-III &lt; median (OR = 0.36, 95%CI (0.14, 0.86)). Among participants with hypertriglyceridemia, those with ApoC-III &lt; median had less prevalent at-risk MASH compared with those with ApoC-III ≥ median (OR = 0.54, 95%CI (0.32, 0.98)); however in all cases significance was lost when liver enzymes were taken into account.</div></div><div><h3>Conclusions</h3><div>In advanced disease stages, ApoC-III levels seem to be decreased and advanced organ damage may be a potential explanation. Mendelian randomization studies are needed to confirm or refute this hypothesis.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 101-108"},"PeriodicalIF":6.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496465","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
Enteropancreatic hormone changes in caloric-restricted diet interventions associate with post-intervention weight maintenance 限制热量饮食干预中的肠胰激素变化与干预后的体重维持有关
IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Pub Date : 2024-10-05 DOI: 10.1016/j.clnu.2024.10.004
Huibin Lin , Qiaoling Wang , Aibo Gao , Yingkai Sun , Chongrong Shen , Yufei Chen , Zhifeng Wang , Xiaoqiang Xu , Mengshan Ni , Yanru Chen , Juan Zhang , Yaogan Luo , Xu Lin , Yufang Bi , Guang Ning , Weiqing Wang , Jie Hong , Weiqiong Gu , Jiqiu Wang , Ruixin Liu

Background & aims

To explore enteropancreatic hormone changes during isocaloric-restricted dietary interventions and their impact on post-intervention weight maintenance.

Methods

253 individuals with overweight/obesity and prediabetes were randomly assigned to 25% isocaloric-restricted diets: Control diet, Traditional Jiangnan diet or Mediterranean diet. Serum hormones and clinical indices were evaluated at 0, 3 and 6 months. Body weight values were collected again 6 months after completing interventions.

Results

We observed decreased fasting and post-glucose load levels of glucagon, amylin, peptide YY, and glucagon-like peptide-1 (GLP-1) while increased ghrelin at three months after 25% calorie restriction (CR) of three dietary interventions, and most of these changes were sustained through the six month-treatment period. Interestingly, changes in appetite-inhibitory hormones glucagon, amylin and GLP-1 showed positive associations with body weight change while appetite-promoting hormone ghrelin showed an inverse association during intervention. Furthermore, subjects with more reduction in amylin and GLP-1, or more increase in ghrelin during intervention showed a greater increase in body weight after completing intervention.

Conclusions

CR intervention results in consistent hormone signatures regardless of dietary patterns. More changes in amylin, GLP-1 or ghrelin levels during CR are associated with poor weight maintenance after intervention, supporting that CR-induced hormone changes as biomarkers for predicting weight maintenance after intervention.

Trial registration

Clinicaltrials.gov NCT03856762.
方法 253 名超重/肥胖和糖尿病前期患者被随机分配到 25% 的等热量限制饮食中:对照饮食、传统江南饮食或地中海饮食。分别在 0、3 和 6 个月时对血清激素和临床指标进行评估。结果 我们观察到,在三种饮食干预方法限制 25% 热量(CR)三个月后,空腹和葡萄糖负荷后的胰高血糖素、淀粉样蛋白、肽 YY 和胰高血糖素样肽-1(GLP-1)水平降低,而胃泌素水平升高,而且这些变化大多在六个月的治疗期间得以维持。有趣的是,在干预期间,抑制食欲的激素胰高血糖素、淀粉样蛋白和 GLP-1 的变化与体重变化呈正相关,而促进食欲的激素胃泌素则呈反相关。此外,干预期间淀粉样蛋白和 GLP-1 减少较多或胃泌素增加较多的受试者在完成干预后体重增加较多。CR干预期间淀粉样蛋白、GLP-1或胃泌素水平的变化越大,干预后的体重维持情况越差,这支持将CR诱导的激素变化作为预测干预后体重维持情况的生物标志物。
{"title":"Enteropancreatic hormone changes in caloric-restricted diet interventions associate with post-intervention weight maintenance","authors":"Huibin Lin ,&nbsp;Qiaoling Wang ,&nbsp;Aibo Gao ,&nbsp;Yingkai Sun ,&nbsp;Chongrong Shen ,&nbsp;Yufei Chen ,&nbsp;Zhifeng Wang ,&nbsp;Xiaoqiang Xu ,&nbsp;Mengshan Ni ,&nbsp;Yanru Chen ,&nbsp;Juan Zhang ,&nbsp;Yaogan Luo ,&nbsp;Xu Lin ,&nbsp;Yufang Bi ,&nbsp;Guang Ning ,&nbsp;Weiqing Wang ,&nbsp;Jie Hong ,&nbsp;Weiqiong Gu ,&nbsp;Jiqiu Wang ,&nbsp;Ruixin Liu","doi":"10.1016/j.clnu.2024.10.004","DOIUrl":"10.1016/j.clnu.2024.10.004","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>To explore enteropancreatic hormone changes during isocaloric-restricted dietary interventions and their impact on post-intervention weight maintenance.</div></div><div><h3>Methods</h3><div>253 individuals with overweight/obesity and prediabetes were randomly assigned to 25% isocaloric-restricted diets: Control diet, Traditional Jiangnan diet or Mediterranean diet. Serum hormones and clinical indices were evaluated at 0, 3 and 6 months. Body weight values were collected again 6 months after completing interventions.</div></div><div><h3>Results</h3><div>We observed decreased fasting and post-glucose load levels of glucagon, amylin, peptide YY, and glucagon-like peptide-1 (GLP-1) while increased ghrelin at three months after 25% calorie restriction (CR) of three dietary interventions, and most of these changes were sustained through the six month-treatment period. Interestingly, changes in appetite-inhibitory hormones glucagon, amylin and GLP-1 showed positive associations with body weight change while appetite-promoting hormone ghrelin showed an inverse association during intervention. Furthermore, subjects with more reduction in amylin and GLP-1, or more increase in ghrelin during intervention showed a greater increase in body weight after completing intervention.</div></div><div><h3>Conclusions</h3><div>CR intervention results in consistent hormone signatures regardless of dietary patterns. More changes in amylin, GLP-1 or ghrelin levels during CR are associated with poor weight maintenance after intervention, supporting that CR-induced hormone changes as biomarkers for predicting weight maintenance after intervention.</div></div><div><h3>Trial registration</h3><div>Clinicaltrials.gov NCT03856762.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":""},"PeriodicalIF":6.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441029","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
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1