Nutricion hospitalaria最新文献

Introduction: metabolic syndrome (MS) affects approximately 27 % of the global population and represents a growing public health concern. Identifying factors associated with its presence is essential for prevention, early diagnosis, and clinical management.

Objective: to evaluate the association between depressive symptomatology (DS) and three IL-18 gene variants-rs360719 (-1297 T>C), rs187238 (-137 G>C), and rs1834481 (+488 C>G)-in individuals with MS.

Methods: a descriptive, cross-sectional study was conducted between May and June 2023 involving 180 adults (90 with MS and 90 controls), diagnosed according to ALAD criteria. The PHQ-9 questionnaire was used to assess DS. Plasma IL-18 levels were measured using ELISA, and the IL-18 gene variants were genotyped by real-time PCR. The study was approved by the Ethics and Biosafety Committees (CEI-01-2023-02, CBIO-01-2023-02), and informed consent was obtained from all participants.

Results: significant differences in anthropometric, biochemical, and blood pressure parameters were found between groups, confirming a dyslipidemic and inflammatory profile in the MS group. Although no statistically significant association was observed between DS and MS, a higher proportion of moderate to severe DS was noted in the MS group. No significant differences were identified in genotype or allele distributions of the studied variants. However, nonsignificant protective trends were observed for the G allele of rs360719 and rs1834481. Plasma IL-18 levels were significantly higher in participants with MS.

Conclusions: MS was associated with characteristic clinical and inflammatory alterations. Although no significant association was found with DS, the observed trends suggest a potential proinflammatory role of IL-18 and a possible protective effect of specific gene variants.

Aim: this study aimed to assess health-related quality of life (HRQoL) and depressive symptoms in adult celiac disease (CD) patients and to evaluate the impact of sociodemographic and clinical factors on these outcomes.

Methods: in this cross-sectional study, 52 adult CD patients and 40 age- and sex-matched healthy controls were enrolled. HRQoL was assessed using the CD-QOL questionnaire and depressive symptoms were evaluated with the Beck Depression Inventory-II (BDI-II). Sociodemographic and clinical data were collected. This is first study to conducted on this topic Turkish adult CD patients.

Results: the mean CD-OQL total score was 126.8 ± 24.1, Emotion (28.1 ± 9.5) and Worries (29.6 ± 7.3) being the most impaired subscales. Age at diagnosis was significantly negatively correlated with CD-QOL total, Emotion and GI symptoms (p < 0.05), while disease duration showed positive correlation with CD-QOL total and all subscales, except Social domain (p > 0.05). There were significant differences in CD-QoL total and subscales across education levels and income groups (p = 0.03 vs p = 0.02). Approximately 26.9 % of CD patients had clinical depression, significantly higher than controls (p  =  0.002). BDI scores showed a strong negative correlation with CD-QOL total and all subscales (p < 0.01). BDI score was better in high income patients, while no difference was found among education levels. GFD adherence did not significantly affect CD-QOL or depression scores (p > 0.05).

Conclusion: CD patients face substantial psychological and socioeconomic challenges. These findings highlight the need for routine HRQoL and mental health screening in CD management to improve long-term outcomes beyond dietary control.

Introduction: pressure injuries (PIs) are chronic wounds of the skin and subcutaneous tissue with multifactorial etiology. They are preventable in 95 % of cases; however, their prevalence reaches up to 33 % among institutionalized individuals. This study comprehensively identified environmental, clinical, nutritional, and functional factors associated with the presence of pressure injuries in institutionalized older adults.

Methods: observational, cross-sectional, and analytical study conducted in 55 institutionalized older adults selected by non-probabilistic quota sampling. Nutritional status (MNA), body composition (bioimpedance), functional status (Barthel Index), frailty (FRAIL scale), and presence of PIs (NPUAP) were assessed. The analysis included descriptive statistics, bivariate tests (chi-square, Fisher's exact, Student's t-test), and multivariate logistic regression with stepwise selection, reporting odds ratios and 95 % confidence intervals.

Results: the majority were women (74.5 %), with a mean age of 86.7 years (SD, 9.8) and a mean institutionalization time of 7.3 years. The prevalence of PIs was 43.6 %. Statistically significant associations were found between PIs and nutritional status (p = 0.027), phase angle (p = 0.007), functional status (p = 0.011), and diaper use (p = 0.001). In multivariate logistic regression analysis, diaper use showed an OR of 24 (IC 95 %, 2.57-223.7, p < 0.005).

Conclusion: diaper use is an independent risk indicator for PIs in multivariate analysis. Additionally, systematic use of bioimpedance in institutionalized patients contributes to a comprehensive assessment of older adults, strengthening the management of pressure injuries and their clinical context.

Background: refeeding syndrome (RS) is a serious metabolic complication that occurs upon reintroducing nutrition to malnourished individuals. Although formally recognized for more than 70 years, significant gaps in its understanding remain.

Objective: to conduct a narrative review on the current state of knowledge regarding RS, its recent advances, existing gaps, and future perspectives.

Methods: an integrative review was conducted using articles published between 2000 and 2024 from international databases, following a systematic methodology of literature search, selection, and analysis.

Results: the main pathophysiological mechanisms of RS, its multisystemic clinical manifestations, current diagnostic criteria, and risk-based therapeutic strategies were identified. Despite advances in biomarkers and personalized nutrition, challenges remain in early diagnosis, prevention, and treatment, especially in vulnerable populations.

Conclusions: RS continues to pose a complex clinical challenge that requires standardized protocols, identification of reliable biomarkers, and increased clinical research, particularly in underrepresented regions such as Latin America. Prevention, based on a multidisciplinary approach, is important to reducing its impact.

Background: vitamin D deficiency is highly prevalent in individuals with overweight or obesity, due to volumetric dilution and impaired metabolic activation. Genetic polymorphisms in VDR, CYP2R1, and GC genes may further influence serum 25-hydroxyvitamin D [25(OH)D] levels and responsiveness to supplementation.

Objective: this study evaluated the longitudinal response to a 6-month, genotype-informed vitamin D₃ and nutritional intervention, and its impact on 25(OH)D, parathyroid hormone (PTH), insulin resistance (HOMA-IR), and inflammatory markers (hs-CRP), in a cohort stratified by BMI and vitamin D-related SNPs.

Methods: a total of 116 adults (aged 18-50 years) were genotyped for VDR rs731236, CYP2R1 rs10741657, and GC rs2282679. Participants received personalized vitamin D₃ dosing (1000-6000 IU/day) and nutritional plans adjusted for genotype and BMI. Clinical parameters were measured at baseline (T0), 3 months (T1), and 6 months (T2). Genetic risk scores (GRS) were calculated, and ROC analysis assessed predictors of vitamin D sufficiency (25(OH)D ≥ 30 ng/mL).

Results: serum 25(OH)D increased significantly from T0 to T2 (mean: 20.84 ± 4.55 to 37.64 ± 6.48 ng/mL, p < 0.001), alongside reductions in BMI, PTH, HOMA-IR, and hs-CRP (all p < 0.001). GC rs2282679 CC and CYP2R1 GG genotypes were associated with persistently lower 25(OH)D levels. Baseline 25(OH)D was the strongest predictor (AUC = 0.83). No significant BMI × genotype interaction was found.

Conclusion: genotype-informed vitamin D₃ supplementation with lifestyle intervention improves endocrine and metabolic markers. Personalization based on key polymorphisms supports precision nutrition strategies in at-risk populations.

Objective: the aim of this study was to investigate the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and echocardiographic indices in children and adolescents with obesity combined with metabolic syndrome (MetS).

Methods: we performed a retrospective study of patients hospitalized between January 2018 and December 2022. A total of 180 patients with obesity combined with MetS were enrolled and underwent anthropometric measurements and serum 25(OH)D level detection. Spearman correlation, multiple linear regression, and binary logistic regression analyses were employed to assess the association between serum 25(OH)D levels and echocardiographic indices of cardiac structure and function in this population.

Results: Serum 25(OH)D concentrations showed significant inverse correlations with end-diastolic interventricular septal thickness (IVSd; r = -0.285, p < 0.001), left ventricular posterior wall thickness in diastole (LVPWd; r = -0.168, p = 0.024), left ventricular mass (LVM; r = -0.217, p=0.004), and relative wall thickness (RWT; r = -0.247, p = 0.001). No significant correlations were found with left-ventricular end-diastolic diameter (LVEDd), left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), or left ventricular mass index (LVMI). After multivariate adjustment (age, sex, BMI, season, blood pressure, lipids, uric acid, glucose), 25(OH)D remained independently and inversely associated with IVSd (β = -0.242, 95% CI: -0.382, -0.101; p = 0.001) and RWT (β = -0.241, 95% CI: -0.392, -0.091; p = 0.002), but not with LVPWd or LVM. Logistic regression identified vitamin D deficiency as an independent predictor of concentric hypertrophy, even after full adjustment.

Conclusions: our findings underscore the importance of maintaining sufficient vitamin D levels in pediatric populations with obesity and MetS as a potential strategy to mitigate adverse cardiac remodeling. Vitamin D deficiency may represent a modifiable risk factor for cardiac complications in this high-risk population.

Background: an increase in ultra-processed food consumption and obesity prevalence has become a major global concern. This study aims to determine the association between ultra-processed food consumption and the increased risk of adult obesity in Zanzibar, Tanzania.

Methods: a cross-sectional analysis of anthropometric and dietary data from 531 adults aged ≥ 18 years was conducted. Food intake was assessed through 24-hour records on three non-consecutive days. The NOVA classification system was used for ultra-processed food identification, i.e., industrially manufactured derived from foods with added sugar, salt, color, and flavors such as sweet, confectionery, soft and carbonated drinks, fast foods, packaged snacks, etc. Weight (kg) and height (m2) were used to determine the body mass index, and the waist-to-hip ratio was calculated; general and abdominal obesity were then diagnosed. Regression models were performed to evaluate the association between ultra-processed food and obesity while adjusting for socio-demographic and physical exercise. A two-tailed statistical test with a p-value of < 0.05 was identified as statistically significant.

Results: the prevalence of obesity and central obesity was 16.9 % and 46.9 %, respectively. Average energy consumed was 2256.71 kcal/day, of which 18.5 % derived from UPF. As UPF consumption increases from the lowest to the highest quintile, mean BMI (from 23.73 kg/m² to 25.85 kg/m²) and WHR (from 0.864 to 0.902) show a gradual rise with regression coefficient of (β = 2.12 [1.23 to 3.22]) for obesity and (β = 0.038 [0.023 to 0.053]) for abdominal obesity.

Conclusion: UPF consumption is associated with an increased risk of obesity, highliting the need of holistic public health solution in Zanzibar, Tanzania.

Background: a byproduct of the body's metabolism of proteins, urea nitrogen is one of the main markers of renal function. However, there is some uncertainty regarding the association between blood urea nitrogen (BUN) and bone mineral density (BMD). The purpose of this study is to determine whether blood urea nitrogen levels and bone mineral density in people aged 20 to 59 are correlated.

Methods: using information from the 2011-2018 National Health and Nutrition Examination Survey (NHANES), The multivariate logistic regression model was employed to determine the relationship between blood urea nitrogen and total bone mineral density. Additionally, we made advantage of a generalized additive model and fitted smooth curves.

Results: 9807 adults in total were taken into account in the present study. Following various variable adjustments, we discovered a positive correlation between BUN and total BMD. The BUN and total BMD of diabetes patients showed a U-shaped curve in reverse, and the turning point was 5.71 mmol/L.

Conclusions: among individuals in the 20-59 age range, our study found a positive correlation between BUN and total BMD. Among participants with diabetes, this association follows a U-shaped curve in reverse, and the turning point was 5.71 mmol/L.

Background and objective: in this cross-sectional study, we investigated the relationships between respiratory muscle strength, handgrip strength (HGS) and conventional body composition indices such as skeletal muscle mass (SMM), skeletal muscle mass index (SMI) and body mass index (BMI).

Material and methods: forty-eight (52 % males) instrumental musicians who had no history of medical or musculoskeletal disease were enrolled. Maximal inspiratory pressure (PImax), and maximal expiratory pressure (PEmax) were evaluated using a spirometer to demonstrate respiratory muscle strength. Upper muscle strength was evaluated by HGS. Skeletal muscle mass was measured by bioelectrical impedance analysis and expressed as a SMM and SMI. The relationships between respiratory muscle strength, HGS and conventional body composition indices were investigated using Pearson's correlation coefficients and multiple linear regression analysis adjusted by age, weekly instrumental practice, number of years of practice, smoking history, and leisure-time physical activity levels.

Results: in males, PImax and PEmax showed positive correlations with HGS (r = 0.426) and (r = 0.589), respectively (p < 0.05). PImax also correlated with SMM (r = 0.740, p < 0.05) and BMI (r = 0.580, p < 0.01). However, the female group had no significant correlations with these conventional muscle mass indices. PImax were related to HGS (β = 0.504, p = 0.024), BMI (β = 0.676, p = 0.007) and SMM (β = 0.831, p < 0,001) among males' group in multivariable analysis. PEmax was the only independent factor related to HGS (β = 0,676, p < 0,001).

Conclusion: in conclusion, this study reveals the independent relationship between HGS and conventional body composition indices with respiratory muscle strength in instrumental musicians.

Aim: to evaluate the relationship between the prevalence of diabetes mellitus 2 (PDM2) and the human development index (HDI) and its components from 2011 to 2021.

Methods: an ecological study was conducted using data from PDM2 (2011, 2013, 2015, 2017, 2017, 2019, 2021) and HDI and its components. Spearman's linear correlations between DM2 and HDI and its components were analyzed and linear regressions were performed to estimate the relationship between the two.

Results: there is a statistically significant relationship between PDM2 and HDI (p < 0.05). HDI represented 3.44 % of the variability explained in PDM2. Likewise, a significant relationship (p < 0.05) was identified with the components of life expectancy (R2 = 0.0275), expected years of schooling (R2 = 0.0098) and mean years of schooling (R2 = 0.0335).

Conclusions: the influence of HDI and its components on PDM2 is positive.