Nutrition最新文献_第5页

Nutritional risk assessment using the Nutritional Prognostic Index predicts mortality in Advanced Chronic Liver Disease patients 使用营养预后指数进行营养风险评估可预测晚期慢性肝病患者的死亡率。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Nutrition

Pub Date : 2024-10-24 DOI: 10.1016/j.nut.2024.112612

Ketsia Meneses Souza Santos Clinical Nutrition Specialist , Ramona Souza da Silva Baqueiro Boulhosa Ph.D. , Laís Spindola Garcêz Ph.D. , André Castro Lyra Ph.D. , Allain Amador Bueno Ph.D. , Rosangela Passos de Jesus Ph.D. , Lucivalda Pereira Magalhães Oliveira Ph.D.

Objectives

Early clinical prognosis and mortality reduction remains a challenge in chronic liver disease (CLD). The full potential of the Nutritional Prognostic Index (NPI) for nutritional assessment and management in CLD patients remains unexplored. The aim of this study was to establish an NPI cutoff point for the identification of nutritional risk in advanced CLD (ACLD) patients, as well as to assess the NPI's ability to predict ACLD-associated mortality.

Methods

This ethically approved prospective cohort study investigated malnutrition risk using both the NPI and the Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT) in patients hospitalized for ACLD. NPI reference values were determined using a receiver operating characteristic curve. Associations between nutritional risk identified by the RFH-NPT and the NPI were assessed using Fisher's exact test, and agreement between tools was assessed using the Kappa index. The association between NPI-defined nutritional risk and 12-mo mortality was examined using Pearson Chi-square test.

Results

The sample population consisted of 120 adults, comprising 84 (70%) male and 57 (50.9%) of alcoholic etiology and presenting as Child-Pugh A, B, or C at admission. The identified cutoff point for NPI was <41, identifying nutritional risk in 82.5% of patients. The NPI presented a statistically significant association with the RFH-NPT, with a substantial agreement coefficient of 0.34. An association between NPI <41 cutoff and mortality were observed, with 82.1% of the sample below cutoff experiencing mortality within 12 mo.

Conclusions

The NPI is a valuable nutritional marker for the identification of nutritional risk in ACLD and is a simple and effective assessment tool that can aid in early CLD prognosis assessment. Validation, however, remains necessary in other CLD populations of different etiologies.

目的：早期临床预后和降低死亡率仍是慢性肝病（CLD）的一项挑战。营养预后指数（NPI）在慢性肝病患者营养评估和管理方面的全部潜力仍有待开发。本研究的目的是为晚期慢性肝病（ACLD）患者的营养风险识别确定一个 NPI 临界点，并评估 NPI 预测 ACLD 相关死亡率的能力：这项获得伦理批准的前瞻性队列研究使用 NPI 和皇家自由医院营养优先工具 (RFH-NPT) 对 ACLD 住院患者的营养不良风险进行了调查。采用接收者操作特征曲线确定 NPI 参考值。RFH-NPT和NPI确定的营养风险之间的关联采用费舍尔精确检验进行评估，工具之间的一致性采用Kappa指数进行评估。NPI 定义的营养风险与 12 个月死亡率之间的关系采用皮尔逊卡方检验：样本人群包括 120 名成年人，其中 84 名（70%）男性，57 名（50.9%）酗酒者，入院时表现为 Child-Pugh A、B 或 C。确定的 NPI 临界点为结论：NPI 是识别 ACLD 营养风险的重要营养标志物，也是一种简单有效的评估工具，有助于早期 CLD 预后评估。但是，仍有必要在其他不同病因的慢性营养不良人群中进行验证。

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引用次数: 0

The effect of fruits and vegetables on children's mental and cognitive health: A systematic review of intervention studies and perspective for future research 水果和蔬菜对儿童心理和认知健康的影响：干预研究的系统回顾与未来研究展望

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Nutrition

Pub Date : 2024-10-24 DOI: 10.1016/j.nut.2024.112615

Nicola A. Gillies PhD , Amy L. Lovell PhD , Karen E. Waldie PhD , Clare R. Wall PhD

Objectives

To synthesize evidence from fruit and vegetable intervention studies investigating mental or cognitive health outcomes (or both) in children ≤10 y. Our aim was to understand the efficacy of such interventions in improving measures of cognitive performance or mental health and to identify successful intervention elements to inform future research.

Methods

We conducted a systematic search of the Cochrane, Embase, PubMed, and CINAHL databases for articles published before August 2022 (PROSPERO registration no. CRD42022356571). A narrative synthesis was conducted according to the Synthesis Without Meta-Analysis guidelines.

Results

Of the 4686 articles identified, only 7 of the 17 full texts screened were included in the final review. No studies investigated the efficacy of interventions using “whole” fruits or vegetables. Six studies examined the effects of blueberries using drinks made from fresh (1 cup) or freeze-dried (30 g) blueberries and one study evaluated a mulberry powder–based drink. Sample sizes ranged from 14 to 54, and most studies were acute interventions with outcomes measured in a 2- to 3-h window (n = 6). Through a narrative synthesis of direction of responses, measures of executive function appeared sensitive to intervention effects in both acute and longer-term settings. Some concerns of risk of bias were evident, according to the RoB 2 tool, related to incomplete reporting of methodological aspects.

Conclusions

The studies identified through this systematic review could not directly address the planned research question, resulting in poor certainty of evidence. Future research with whole fruit and vegetable interventions could better inform population health strategies for improved mental and cognitive health outcomes in children.

我们的目的是了解这些干预措施在改善认知能力或心理健康方面的效果，并确定成功的干预因素，为未来研究提供参考。方法我们对 Cochrane、Embase、PubMed 和 CINAHL 数据库中 2022 年 8 月之前发表的文章进行了系统检索（PROSPERO 注册号：CRD42022356571）。结果在 4686 篇文章中，经筛选的 17 篇全文中只有 7 篇被纳入最终综述。没有研究调查了使用 "全 "水果或蔬菜进行干预的效果。六项研究使用新鲜蓝莓（1 杯）或冻干蓝莓（30 克）制成的饮料对蓝莓的效果进行了调查，一项研究对桑葚粉制成的饮料进行了评估。样本量从 14 个到 54 个不等，大多数研究都是急性干预，在 2 到 3 小时内测量结果（n = 6）。通过对反应方向的叙述性综合，执行功能的测量结果似乎对急性和长期干预效果都很敏感。根据RoB 2工具，一些明显的偏倚风险问题与方法学方面的报告不完整有关。结论本系统综述所确定的研究无法直接解决计划中的研究问题，因此证据的确定性较差。未来有关全果蔬干预措施的研究可以更好地为改善儿童心理和认知健康状况的人口健康战略提供信息。

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引用次数: 0

Gut microbiome and body composition with sorbitol intake during early lifespan 寿命早期摄入山梨醇的肠道微生物组和身体组成。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Nutrition

Pub Date : 2024-10-24 DOI: 10.1016/j.nut.2024.112614

Ying-Yueh Chu Ph.D. , Yu-Chen S.H. Yang Ph.D. , Shih-Yuan Hsu MSc , Hsien-Yu Fan Ph.D. , Liang-Dar Hwang Ph.D. , Jacus S. Nacis Ph.D. , Yang Ching Chen Ph.D.

Objective

The association of sorbitol intake with maintaining healthy body weight through the gut microbiome during early life was investigated.

Research Methods and Procedures

Sorbitol intake, body mass index (BMI), and fecal samples were collected in the total of 369 pregnant women with their infants (aged 4 months to 5 years) from the Taipei Mother-Infant Nutrition Cohort and 1946 children and adolescents (aged 6–18 years) from the Taiwan Puberty Longitudinal Study. The BMI-z score in sorbitol users was compared to that in sorbitol nonusers using generalized linear mixed model. The beta diversity of microbiome was investigated in both cohorts. The association between the richness of microbes and body composition was analyzed.

Results

The children and adolescents with high sorbitol intake had lower BMI-z score at 6 to 10 and 11 to 18 years of age (P < 0.01) compared with those without sorbitol intake. The beta diversity of the microbiome differed significantly between the sorbitol users and nonusers. Bifidobacterium was higher in the gut of infants and children whose mothers were sorbitol users than that of infants and children whose mothers were sorbitol nonusers during pregnancy. Several microbes were involved in the regulation of obesity, such as Staphylococcus, Faecalibacterium, and Oscillospiraceae_UCG-005 negatively associated with anthropometric measures.

Conclusions

Sorbitol intake was associated with lower child and adolescent BMI. Sorbitol consumption could shape the composition and richness of beneficial microbiota, contributing to the maintenance of ideal body weight and metabolic homeostasis in early life.

研究目的研究方法和步骤：从台北母婴健康中心收集了 369 名孕妇及其婴儿（4 个月至 5 岁）的山梨醇摄入量、体重指数（BMI）和粪便样本：研究方法：研究人员收集了台北市母婴营养队列的 369 名孕妇及其婴儿（4 个月至 5 岁）和台湾青春期纵向研究的 1946 名儿童和青少年（6-18 岁）的山梨醇摄入量、体重指数（BMI）和粪便样本。采用广义线性混合模型比较了山梨醇使用者与山梨醇非使用者的 BMI-z 评分。研究还调查了两个队列中微生物组的贝塔多样性。结果表明，山梨醇摄入量高的儿童和青少年体内的山梨醇含量较低，而山梨醇摄入量低的儿童和青少年体内的山梨醇含量较高：结果：与未摄入山梨醇的儿童和青少年相比，山梨醇摄入量高的儿童和青少年在 6 至 10 岁和 11 至 18 岁时的 BMI-z 评分较低（P < 0.01）。使用山梨醇和不使用山梨醇的人的微生物群β多样性差异显著。与母亲在怀孕期间不使用山梨醇的婴幼儿相比，母亲使用山梨醇的婴幼儿肠道中的双歧杆菌含量更高。有几种微生物参与了肥胖的调节，如葡萄球菌、粪便杆菌和振荡螺旋体_UCG-005与人体测量指标呈负相关：结论：山梨醇的摄入量与儿童和青少年较低的体重指数有关。结论：山梨醇的摄入量与儿童和青少年较低的体重指数有关。山梨醇的摄入量可影响有益微生物群的组成和丰富程度，有助于维持生命早期的理想体重和代谢平衡。

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引用次数: 0

Revisiting the concepts of de novo lipogenesis to understand the conversion of carbohydrates into fats: Stop overvaluing and extrapolating the renowned phrase “fat burns in the flame of carbohydrate” 重新审视新脂肪生成的概念，了解碳水化合物转化为脂肪的过程：不要再高估和推断 "脂肪在碳水化合物的火焰中燃烧 "这句名言。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Nutrition

Pub Date : 2024-10-24 DOI: 10.1016/j.nut.2024.112617

Heitor O. Santos Ph.D., R.D.N. , Nilson Penha-Silva Ph.D.

Carbohydrates can be converted into fatty acids via de novo lipogenesis (DNL). Although DNL is considered inefficient, these endogenous fatty acids contribute substantially to the esterification pathway in adipose tissue, together with fatty acids of feeding. This article revisited the concepts of DNL and aimed to discuss the clinical magnitude of carbohydrate overfeeding and fat mass accumulation. Although fat storage resulting from fat intake is more favorable for fat mass accrual than carbohydrates due to molecule structure and metabolism (e.g., oxidation and thermic effect), carbohydrates can substantially participate in lipogenesis and esterification under excess carbohydrate intake over time. Regarding only monosaccharide overfeeding, glucose and fructose favor the subcutaneous and visceral adipose tissue, respectively. While fructose and sucrose are considered villains in nonalcoholic fatty liver disease, energy surplus from carbohydrates, regardless of sources, can be considered an underlying cause of obesity. Interestingly, some degree of DNL in adipocytes may be favorable to mitigate a high deposition of fatty acids in the liver, conferring a physiological role. Although "fat burns in the flame of carbohydrate" is a praiseworthy phrase that has helped describe basic concepts in biochemistry for many decades, it appears to be overvalued and extrapolated even nowadays. DNL cannot be neglected. It is time to consider DNL an efficient biochemical process in health and disease.

碳水化合物可通过新生脂肪生成（DNL）转化为脂肪酸。尽管DNL被认为是低效的，但这些内源性脂肪酸与进食脂肪酸一起对脂肪组织中的酯化途径做出了重大贡献。本文重温了 DNL 的概念，旨在讨论碳水化合物过量摄入和脂肪堆积的临床严重程度。虽然由于分子结构和新陈代谢（如氧化和热效应）的原因，脂肪摄入导致的脂肪储存比碳水化合物更有利于脂肪量的积累，但在碳水化合物长期过量摄入的情况下，碳水化合物也会大量参与脂肪生成和酯化。仅就单糖过量摄入而言，葡萄糖和果糖分别有利于皮下和内脏脂肪组织。虽然果糖和蔗糖被认为是非酒精性脂肪肝的罪魁祸首，但碳水化合物的能量过剩，无论其来源如何，都可以被认为是肥胖的根本原因。有趣的是，脂肪细胞中一定程度的 DNL 可能有利于减轻肝脏中脂肪酸的大量沉积，从而发挥生理作用。虽然 "脂肪在碳水化合物的火焰中燃烧 "是一个值得称赞的短语，几十年来一直有助于描述生物化学的基本概念，但时至今日，它似乎被高估和推断了。DNL 不可忽视。现在是时候将 DNL 视为健康和疾病中的一个有效生化过程了。

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引用次数: 0

Comparison of Two Techniques to Assess Muscle Mass Loss During ICU Stay: Muscle Ultrasound vs Bioelectrical Impedance Analysis 比较两种评估重症监护病房住院期间肌肉质量损失的技术：肌肉超声与生物电阻抗分析。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Nutrition

Pub Date : 2024-10-24 DOI: 10.1016/j.nut.2024.112607

Gintarė Šostakaitė , Martyna Jauniškytė , Dominykas Budrys , Kastytis Budrevičius , Erika Šalčiūtė-Šimėnė , Marija Svetikienė , Tomas Jovaiša , Tadas Žvirblis , Andrius Klimašauskas , Jūratė Šipylaitė

Background and aims

Muscle wasting is a prevalent issue among long-term critically ill patients and is associated with adverse clinical outcomes. Evaluating muscle mass in the ICU presents challenges due to the lack of a consistent methodology and the significant impact of fluid balance range in ICU patients. This prospective study aimed to compare the utility of bioelectrical impedance analysis (BIA) and ultrasound (US) for monitoring muscle wasting in critically ill patients over an initial seven-day period of critical illness.

Methods

Conducted in a tertiary teaching hospital's mixed ICU, the study included adult patients with ICU stays exceeding seven days. Measurements were taken on Day 1 (within 24 hours of ICU admission), Day 5, and Day 7.

Results

Out of 101 enrolled patients, 74 were male, with a mean age of 55.3 (SD 14.8) years. The mean APACHE II score was 18.2 (SD 7.2), and the Day 1 SOFA score was 7.9 (SD 3.2). The ICU survival rate was 65%, and the mean ICU length of stay was 19.2 (SD 19.2) days. Statistically significant muscle mass loss was detected by US measurement, demonstrating the relative change in general muscle thickness: -2.5% (SD 11.8) by Day 5 and -6.5% (SD 12.4) by Day 7 (P < 0.001). BIA demonstrated no significant change in phase angle, as the relative change by Day 5 was -3.3% (SD 19.9) and by Day 7 it was -1.9% (SD 21.9), with no significant difference (P = 0.374).

Conclusions

Ultrasound was a more suitable method for assessing and monitoring muscle wasting during ICU stays, while bioelectrical impedance analysis failed to demonstrate a comparable degree of muscle loss at Days 5 and 7. This study highlights the importance of selecting an appropriate assessment method based on the specific clinical context, emphasizing the reliability of US in evaluating muscle wasting among critically ill patients.

背景和目的：肌肉萎缩是长期重症患者中普遍存在的问题，并与不良临床结果有关。由于缺乏一致的方法以及 ICU 患者体液平衡范围的显著影响，ICU 患者肌肉质量的评估面临挑战。这项前瞻性研究旨在比较生物电阻抗分析法（BIA）和超声波法（US）在监测重症患者最初七天的肌肉萎缩方面的效用：研究在一家三级教学医院的混合重症监护室进行，包括在重症监护室住院超过七天的成年患者。在第 1 天（入院 24 小时内）、第 5 天和第 7 天进行测量：在 101 名入选患者中，74 人为男性，平均年龄为 55.3 岁（标准差为 14.8 岁）。平均 APACHE II 评分为 18.2（标清 7.2），第 1 天 SOFA 评分为 7.9（标清 3.2）。重症监护室存活率为 65%，重症监护室平均住院时间为 19.2 天（标准差 19.2 天）。通过 US 测量发现了统计意义上的明显肌肉质量损失，显示了一般肌肉厚度的相对变化：第 5 天为 -2.5%（标清 11.8），第 7 天为 -6.5%（标清 12.4）（P < 0.001）。BIA显示相位角无明显变化，第5天的相对变化为-3.3%（标准差19.9），第7天为-1.9%（标准差21.9），无明显差异（P = 0.374）：结论：超声波是评估和监测重症监护病房住院期间肌肉萎缩的一种更合适的方法，而生物电阻抗分析在第 5 天和第 7 天未能显示出可比的肌肉萎缩程度。这项研究强调了根据具体临床情况选择合适评估方法的重要性，并强调了超声波在评估重症患者肌肉萎缩方面的可靠性。

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引用次数: 0

Peripheral fatty acids and outcome of assisted reproduction 外周脂肪酸与辅助生殖的结果

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Nutrition

Pub Date : 2024-10-24 DOI: 10.1016/j.nut.2024.112616

Valentina De Cosmi , Sonia Cipriani , Marie-Louise Syren , Stefano Turolo , Fabio Parazzini , Marco Reschini , Martina Abodi , Walter Vegetti , Francesca Chiaffarino , Camilla Bertoni , Edgardo Somigliana , Carlo Agostoni

Objectives

The present study investigated the relationship between fatty acid levels in whole blood in women undergoing in vitro fertilization and four successive assisted reproductive technology (ART) outcomes.

Methods

A cross-sectional study was performed on data from a prospective cohort study conducted between 2014 and 2016.

Results

Participants were 238 women undergoing in vitro fertilization and participating in a study on the role of lifestyle habits and diet in ART outcomes. Blood polyunsaturated fatty acids were measured by gas chromatography. Overall, higher blood levels of monounsaturated fatty acids and oleic acid and higher ω-6/ω-3 ratio and arachidonic/docosahexaenoic acid ratio were associated with more favorable ART outcomes. By contrast, higher concentrations of long chain polyunsaturated fatty acids tended to be negatively associated with the considered outcomes.

Conclusions

Further prospective studies are needed to determine the ranges of fatty acid concentrations that are optimal for women with subfertility.

本研究调查了接受体外受精的女性全血中脂肪酸水平与四种连续辅助生殖技术（ART）结果之间的关系。结果238名接受体外受精的女性参与了一项关于生活习惯和饮食对ART结果影响的研究。通过气相色谱法测量了血液中的多不饱和脂肪酸。总体而言，血液中单不饱和脂肪酸和油酸含量越高，ω-6/ω-3 比率和花生四烯酸/二十二碳六烯酸比率越高，抗逆转录病毒疗法的效果越好。相比之下，较高浓度的长链多不饱和脂肪酸往往与所考虑的结果呈负相关。结论需要进一步开展前瞻性研究，以确定不孕症妇女的最佳脂肪酸浓度范围。

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引用次数: 0

Assessment of the adherence to perioperative nutritional care protocols in Brazilian hospitals: The PreopWeek study 评估巴西医院对围手术期营养护理方案的遵守情况：术前一周研究

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Nutrition

Pub Date : 2024-10-23 DOI: 10.1016/j.nut.2024.112611

Maria Cristina Gonzalez M.D., Ph.D. , Thiago J.M. Gonçalves M.D., Ph.D. , Valéria A. Rosenfeld M.D. , Silvana P. Orlandi R.D., Ph.D. , Pedro E. Portari-Filho M.D., Ph.D. , Antonio Carlos L. Campos M.D., Ph.D.

Objectives

The study (PreopWeek) aimed to assess the perioperative nutritional care for major surgical patients in Brazilian hospitals, focusing on adherence to emerging multimodal protocols like Enhanced Recovery After Surgery and Acceleration of Total Postoperative Recovery.

Methods

An observational cross-sectional study was conducted in Brazilian hospitals enrolled voluntarily from June 19 to June 23, 2023 (convenience sample). Data were collected through patient interviews and medical records review.

Results

Data from 219 patients up to the fifth postoperative day or postoperative discharge across 24 hospitals were analyzed. Only three hospitals (12.5%) had established institutional perioperative protocols. Most of the patients were female (60.3%) and over 60 y old (81.7%) and underwent gastrointestinal (34.7%) or orthopedic (33.3%) surgeries. General and nutritional preoperative counseling was provided to a respective 82.2% and 62.6% of the patients. Only 25.7% of the patients had preoperative fasting for up to 3 h, and 28.8% received carbohydrate-rich supplements. Immunonutrition was not received by 43.8% at any point. Although most started postoperative refeeding within 24 h (81.7%), 39.4% started with a liquid diet and 70.6% reported postoperative immobilization in the first 24 h. Notable differences were observed between hospitals with and without protocols. Hospitals with institutional protocols reported significantly more preoperative exercises and nutritional counseling and higher adherence rates for all the perioperative protocols.

Conclusions

Our study demonstrates a lack of adherence to the multimodal protocols, even in hospitals with institutional protocols. Future educational programs are necessary to improve this result.

研究目的该研究（PreopWeek）旨在评估巴西医院对重大手术患者的围手术期营养护理，重点关注新出现的多模式方案（如加强术后恢复和加速术后全面恢复）的遵守情况：一项观察性横断面研究于 2023 年 6 月 19 日至 6 月 23 日在自愿注册的巴西医院进行（方便抽样）。数据通过患者访谈和病历审查收集：分析了来自 24 家医院的 219 名患者截至术后第五天或术后出院的数据。只有三家医院（12.5%）制定了机构围手术期规范。大多数患者为女性（60.3%）和 60 岁以上（81.7%），接受胃肠道手术（34.7%）或骨科手术（33.3%）。分别有 82.2% 和 62.6% 的患者在术前接受了一般咨询和营养咨询。只有 25.7% 的患者在术前禁食长达 3 小时，28.8% 的患者接受了富含碳水化合物的补充剂。43.8%的患者在任何时候都没有接受免疫营养。虽然大多数患者在术后 24 小时内开始进食（81.7%），但有 39.4% 的患者在术后 24 小时内开始进食流质饮食，70.6% 的患者在术后 24 小时内固定不动。制定了制度规范的医院报告的术前运动和营养咨询明显更多，所有围手术期规范的遵守率也更高：结论：我们的研究表明，即使在有机构协议的医院，也缺乏对多模式协议的遵守。未来有必要开展教育计划来改善这一结果。

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引用次数: 0

Plant-derived compounds as potential neuroprotective agents in Parkinson's disease 作为帕金森病潜在神经保护剂的植物提取物。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Nutrition

Pub Date : 2024-10-23 DOI: 10.1016/j.nut.2024.112610

Chengu Niu M.D. , Yu Zou M.Sc. , Miaoxian Dong M.B.B.S. , Yingcai Niu Ph.D.

Objectives

Current Parkinson's disease (PD) medications treat symptoms; none can slow down or arrest the disease progression. Disease-modifying therapies for PD remain an urgent unmet clinical need. This review was designed to summarize recent findings regarding to the efficacy of phytochemicals in the treatment of PD and their underlying mechanisms.

Methods

A literature search was performed using PubMed databases from inception until January 2024.

Results

We first review the role of oxidative stress in PD and phytochemical-based antioxidant therapy. We then summarize recent work on neuroinflammation in the pathogenesis of PD, as well as preclinical data supporting anti-inflammatory efficacy in treating or preventing the disease. We last evaluate evidence for brain mitochondrial dysfunction in PD, together with the phytochemicals that protect mitochondrial function in preclinical model of PD. Furthermore, we discussed possible reasons for failures of preclinical-to-clinical translation for neuroprotective therapeutics.

Conclusions

There is now extensive evidence from preclinical studies that neuroprotective phytochemicals as promising candidate drugs for PD are needed to translate from the laboratory to the clinic.

目标：目前的帕金森病（PD）药物只能治疗症状，无法减缓或阻止疾病进展。帕金森病的疾病调节疗法仍是一项尚未得到满足的迫切临床需求。本综述旨在总结有关植物化学物质治疗帕金森病的疗效及其内在机制的最新发现：方法：使用 PubMed 数据库对从开始到 2024 年 1 月的文献进行了检索：我们首先回顾了氧化应激在帕金森病中的作用以及基于植物化学物质的抗氧化疗法。然后，我们总结了神经炎症在帕金森病发病机制中的最新研究成果，以及支持抗炎治疗或预防该疾病疗效的临床前数据。最后，我们评估了帕金森病脑线粒体功能障碍的证据，以及在帕金森病临床前模型中保护线粒体功能的植物化学物质。此外，我们还讨论了神经保护疗法从临床前到临床转化失败的可能原因：目前临床前研究的大量证据表明，神经保护性植物化学物质作为治疗帕金森病的有前途的候选药物，需要从实验室转化到临床。

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引用次数: 0

Association between improved dysphagia and increased trunk muscle mass in older patients with stroke undergoing convalescent rehabilitation 接受康复疗养的老年中风患者吞咽困难改善与躯干肌肉质量增加之间的关系。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Nutrition

Pub Date : 2024-10-23 DOI: 10.1016/j.nut.2024.112609

Ryo Shiraishi R.P.T., Ph.D. , Setsuko Kato R.N. , Nami Shiraishi R.D. , Takahiro Ogawa M.D., Ph.D.

Objective

The association between dysphagia and activities of daily living in patients with stroke has been reported, but the effect of improved dysphagia on the increase in trunk muscle mass is not clear. The aim of this study was to investigate the relationship between improved dysphagia and increased trunk muscle mass in older patients with stroke.

Research Methods & Procedures

This retrospective, case-control study enrolled patients with stroke aged ≥65 years. Dysphagia was evaluated using the Kuchi-Kara Taberu (KT) Index. Patients were classified into two groups according to KT Index at discharge: improved dysphagia group (≥57 scores) and non-improved dysphagia group (<57 scores). The primary outcome of the study was Trunk Muscle Mass Index (TMI) gain from admission to discharge. Multiple regression analysis was performed to investigate the association between trunk muscle mass gain and improved dysphagia.

Results

There were 153 participants with a mean age of 79.8 ± 7.7 years, and 89 (58%) were classified in the improved dysphagia group. The TMI gain was greater in the improved dysphagia group compared to that in the nonimproved group. Multiple regression analysis showed that improved dysphagia (β: 0.776, 95% confidence interval: 0.643 to 0.909, P < 0.001) was independently associated with TMI gain.

Conclusion

Improved dysphagia was independently associated with trunk muscle mass gain, suggesting that improved dysphagia is important for trunk muscle mass gain in patients with stroke.

目的：吞咽困难与脑卒中患者日常生活活动之间的关系已有报道，但吞咽困难改善对躯干肌肉质量增加的影响尚不明确。本研究旨在探讨老年中风患者吞咽困难改善与躯干肌肉质量增加之间的关系：这项回顾性病例对照研究招募了年龄≥65 岁的中风患者。采用 Kuchi-Kara Taberu（KT）指数对吞咽困难进行评估。根据出院时的 KT 指数将患者分为两组：吞咽困难改善组（≥57 分）和吞咽困难未改善组（结果：共有 153 名参与者，平均年龄为 79.8 ± 7.7 岁，其中 89 人（58%）被归入吞咽困难改善组。与未改善吞咽困难组相比，改善吞咽困难组的 TMI 增益更大。多元回归分析表明，吞咽困难改善（β：0.776，95% 置信区间：0.643 至 0.909，P <0.001）与 TMI 增益独立相关：结论：吞咽困难的改善与躯干肌肉质量的增加独立相关，这表明吞咽困难的改善对脑卒中患者躯干肌肉质量的增加非常重要。

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引用次数: 0

Preventing Progression of Renal Disease: A New Method for Monitoring Body Fat Percentage in Predialysis Chronic Kidney Disease Patients 预防肾病恶化：监测透析前慢性肾病患者体脂百分比的新方法。

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Nutrition

Pub Date : 2024-10-19 DOI: 10.1016/j.nut.2024.112605

María del Rocío Jiménez-Mérida R.N., M.Sc., Ph.D. , José Manuel Alcaide-Leyva R.N., M.Sc., Ph.D. , Miguel Lopez-Lucena R.N. , Silvia Portero de la Cruz R.N., M.Sc., Ph.D. , Rafael Molina-Luque R.N., M.Sc., Ph.D. , Pablo Martínez-Angulo R.N., M.Sc., Ph.D.

Background and Aims

Chronic kidney disease (CKD) is a progressive condition affecting metabolic pathways and physiological mechanisms. In Spain, CKD prevalence has risen, increasing patients requiring renal replacement therapy (RRT). Managing nutritional status in advanced CKD (ACKD) patients is crucial as it influences disease progression and quality of life. This study aims to describe the nutritional status of predialysis patients at University Hospital Reina Sofia, Cordoba, Spain, and develop a quick and easy model for estimating body fat percentage without bioimpedance.

Methods and Results

This cross-sectional study, conducted from February to May 2023, involved 106 patients from the ACKD consultation at the University Hospital Reina Sofia. Inclusion criteria were stage 3 or 4 CKD patients who consented to participate. Data included demographic and anthropometric variables, with body composition assessed using a Tanita BC-545N bioimpedance analyzer.

The sample included 32 females (30.5%) and 73 males (69.5%), with an average BMI of 30.31 (SD 5.48). Significant findings were higher body fat percentage in women (37.82%) than men (27.86%; P < 0.001) and notable differences in waist circumference and waist-to-hip ratio between sexes. Multiple linear regression showed waist circumference, height, and sex as significant predictors of body fat percentage, with an intraclass correlation coefficient of 0.71 (95% CI = 0.59–0.79).

Conclusion

Accurately assessing body composition in CKD patients is crucial as traditional measures like BMI may not capture health risks effectively. The developed model offers a practical alternative to bioimpedance for estimating body fat percentage, potentially improving CKD management and patient outcomes. Further validation in diverse populations and integration with lifestyle interventions is needed.

背景和目的：慢性肾脏病（CKD）是一种影响代谢途径和生理机制的渐进性疾病。在西班牙，慢性肾脏病的发病率有所上升，需要接受肾脏替代治疗（RRT）的患者也随之增加。晚期慢性肾脏病（ACKD）患者的营养状况影响着疾病的进展和生活质量，因此对其营养状况的管理至关重要。本研究旨在描述西班牙科尔多瓦索菲亚王后大学医院透析前患者的营养状况，并开发一种无需生物阻抗即可估算体脂百分比的快速简便模型：这项横断面研究于 2023 年 2 月至 5 月进行，涉及索菲亚雷娜大学医院 ACKD 诊所的 106 名患者。纳入标准为同意参与的 3 期或 4 期 CKD 患者。数据包括人口统计学和人体测量变量，并使用Tanita BC-545N生物阻抗分析仪评估身体成分。样本包括 32 名女性（30.5%）和 73 名男性（69.5%），平均体重指数为 30.31（标清 5.48）。显著的发现是女性的体脂率（37.82%）高于男性（27.86%；P < 0.001），而且男女之间的腰围和腰臀比也有明显差异。多元线性回归结果显示，腰围、身高和性别是体脂率的重要预测因素，类内相关系数为 0.71 (95% CI = 0.59-0.79)：结论：准确评估 CKD 患者的身体成分至关重要，因为 BMI 等传统测量方法可能无法有效捕捉健康风险。所开发的模型为估算体脂百分比提供了生物阻抗的实用替代方法，有可能改善 CKD 管理和患者预后。还需要在不同人群中进一步验证，并与生活方式干预相结合。

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引用次数: 0