Advances in Nutrition最新文献_第10页

The Effect of Red Meat Consumption on Circulating, Urinary, and Fecal Trimethylamine-N-Oxide: A Systematic Review and Narrative Synthesis of Randomized Controlled Trials 食用红肉对循环、尿液和粪便三甲胺- n -氧化物的影响：随机对照试验的系统评价和叙事综合。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-07-01 Epub Date: 2025-05-24 DOI: 10.1016/j.advnut.2025.100453

Fatemeh Jafari, Janhavi J Damani, Kristina S Petersen

Cardiovascular concerns exist about the effect of red meat on circulating concentrations of trimethylamine N-oxide (TMAO), an emerging cardiovascular disease risk factor. The aim was to conduct a systematic review of randomized controlled trials (RCTs) to evaluate the effect of higher red meat intake, compared with lower intake, on circulating, urinary, and fecal TMAO concentrations in generally healthy adults and/or adults with stable chronic diseases. A systematic literature search was conducted using PubMed, the Cochrane Collaboration Library, and Web of Science. RCTs examining the effect of a ≥7-d dietary intervention featuring red meat on urinary, fecal, and/or circulating (plasma or serum) concentrations of TMAO in adults (≥18 y) were included. Eligible trials had a comparator group/condition that was exposed to a dietary intervention for ≥ 7 d lower in red meat and featuring white meat, fish, eggs, dairy, or plant-based protein sources. In total, 375 publications were identified. Fifteen publications reporting the results of 13 RCTs (n = 553; median duration 28 d), including 15 diet comparisons, were eligible. In 6 comparisons, higher circulating or urinary TMAO concentrations were observed after higher red meat intake (∼71–420 g/d) compared with comparator conditions lower in red meat. In 7 comparisons, no differences in serum/plasma TMAO concentrations were observed with higher red meat-containing diets (∼60–156 g/d) compared with diets lower in red meat. Two comparisons showed that consuming higher red meat diets lowered TMAO concentrations after 28 d compared with lower red meat diets containing seafood. In short-term studies (median duration of 28 d), higher red meat intake had inconsistent effects on circulating and urinary TMAO concentrations. Further high-quality research on red meat-related TMAO modulation, including effect magnitude and clinical relevance, is needed. This study was registered at Prospective Register of Systematic Reviews (PROSPERO) as CRD42023396799.

背景：人们对红肉对循环中三甲胺n -氧化物（TMAO）浓度的影响存在担忧，TMAO是一种新兴的心血管危险因素。目的：本研究旨在对随机对照试验（rct）进行系统回顾，以评估与低摄入量相比，高红肉摄入量对一般健康成年人和/或患有稳定慢性疾病的成年人血液、尿液和粪便中氧化三甲胺浓度的影响。方法：使用PubMed、Cochrane协作图书馆和Web of Science进行系统文献检索。纳入了以红肉为特征的≥7天饮食干预对成人（≥18岁）尿液、粪便和/或循环（血浆或血清）氧化三甲胺浓度影响的随机对照试验。符合条件的试验有一个对照组/条件，该组/条件暴露于饮食干预≥7天，减少红肉，以白肉、鱼、蛋、乳制品或植物性蛋白质来源为主。结果：共发现375篇文献。15篇文献报道了13项随机对照试验的结果(n=553；中位持续时间28天)，包括15个饮食比较，符合条件。在六项比较中，与红肉摄入量较低的对照条件相比，红肉摄入量较高（~ 71-420 g/天）后，观察到较高的循环或尿液TMAO浓度。在七项比较中，与低红肉饮食相比，高红肉饮食（~ 60-156 g/天）的血清/血浆TMAO浓度没有差异。两项比较表明，28天后，食用较多红肉的小鼠与食用较少含海鲜的红肉小鼠相比，氧化三甲胺浓度降低。结论：在短期研究中（中位持续时间为28天），摄入更多红肉对循环和尿中氧化三甲胺浓度的影响不一致。需要对红肉相关的氧化三甲胺调节进行进一步的高质量研究，包括效果大小和临床相关性。意义说明：本系统综述总结了与低摄入量红肉相比，高摄入量红肉对一般健康成人和/或患有稳定慢性疾病的成人血液、尿液和粪便中三甲胺n -氧化物（TMAO）浓度影响的证据。较高的红肉摄入量对氧化三甲胺浓度的影响不一致，这可能部分与临床试验方法的差异、饮食相关的氧化三甲胺调节的个体差异和/或含红肉饮食的整体健康状况有关。

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引用次数: 0

Data in Personalized Nutrition: Bridging Biomedical, Psycho-behavioral, and Food Environment Approaches for Population-wide Impact 观点：个性化营养的数据：桥接生物医学、心理行为和食品环境方法对人口的广泛影响。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-07-01 Epub Date: 2025-01-20 DOI: 10.1016/j.advnut.2025.100377

Jakob Linseisen , Britta Renner , Kurt Gedrich , Jan Wirsam , Christina Holzapfel , Stefan Lorkowski , Bernhard Watzl , Hannelore Daniel , Michael Leitzmann , Working Group “Personalized Nutrition” of the German Nutrition Society

Personalized nutrition (PN) represents an approach aimed at delivering tailored dietary recommendations, products, or services to support both prevention and treatment of nutrition-related conditions and to improve individual health using genetic, phenotypic, medical, nutritional, and other pertinent information. However, current approaches have yielded limited scientific success in improving diets or in mitigating diet-related conditions. In addition, PN currently caters to a specific subgroup of the population rather than having a widespread impact on diet and health at a population level. Addressing these challenges requires integrating traditional biomedical and dietary assessment methods with psycho-behavioral, and novel digital and diagnostic methods for comprehensive data collection, which holds considerable promise in alleviating present PN shortcomings. This comprehensive approach not only allows for deriving personalized goals (“what should be achieved”) but also customizing behavioral change processes (“how to bring about change”). We herein outline and discuss the concept of “Adaptive Personalized Nutrition Advice Systems,” which blends data from 3 assessment domains: 1) biomedical/health phenotyping; 2) stable and dynamic behavioral signatures; and 3) food environment data. Personalized goals and behavior change processes are envisaged to no longer be based solely on static data but will adapt dynamically in-time and in-situ based on individual-specific data. To successfully integrate biomedical, behavioral, and environmental data for personalized dietary guidance, advanced digital tools (e.g., sensors) and artificial intelligence-based methods will be essential. In conclusion, the integration of both established and novel static and dynamic assessment paradigms holds great potential for transitioning PN from its current focus on elite nutrition to a widely accessible tool that delivers meaningful health benefits to the general population.

个性化营养（PN）是一种旨在提供量身定制的饮食建议、产品或服务的方法，以支持预防和治疗与营养相关的疾病，并利用遗传、表型、医学、营养和其他相关信息改善个人健康。然而，目前的方法在改善饮食或减轻饮食相关疾病方面取得的科学成功有限。此外，PN目前只服务于人口中的一个特定亚群体，而不是在人口层面上对饮食和健康产生广泛影响。解决这些挑战需要将传统的生物医学和饮食评估方法与心理行为相结合，以及用于综合数据收集的新型数字和诊断方法，这在缓解当前PN缺点方面具有相当大的希望。这种全面的方法不仅允许获得个性化的目标（“应该实现什么”），而且还允许定制行为改变过程（“如何带来改变”）。我们在此概述并讨论了“适应性个性化营养建议系统”（APNASs）的概念，该系统融合了来自三个评估领域的数据：1)生物医学/健康表型；2)稳定动态的行为特征；3)食品环境数据。设想个性化目标和行为改变过程不再仅仅基于静态数据，而是基于个人特定数据实时动态地进行调整。为了成功整合生物医学、行为和环境数据以实现个性化饮食指导，先进的数字工具（如传感器）和基于人工智能（AI）的方法将是必不可少的。总之，将现有的和新的静态和动态评估范式结合起来，将PN从目前对精英营养的关注转变为一种广泛获取的工具，为普通人群提供有意义的健康益处，具有巨大的潜力。

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引用次数: 0

Effects of Nut Intake on Gut Microbiome Composition and Gut Function in Adults: A Systematic Review and Meta-analysis 坚果摄入对成人肠道微生物组成和肠道功能的影响：一项系统综述和荟萃分析。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-07-01 Epub Date: 2025-06-13 DOI: 10.1016/j.advnut.2025.100465

Matthew Snelson , Jessica R Biesiekierski , Susanna Chen , Nessmah Sultan , Barbara R Cardoso

The reduced risk of chronic diseases such as cardiovascular disease and type 2 diabetes associated with nut consumption may occur via modulation of the gut microbiota, although this has not been comprehensively assessed. This systematic review of clinical trials aimed to assess the effects of nuts on gut microbiota composition and metabolites, as well astheir effects on gut function and symptoms in adults. The systematic review was conducted following PRISMA guidelines and registered in PROSPERO (CRD42023451282). Outcomes included microbiota diversity, specific bacterial abundances, gastrointestinal symptoms, intestinal permeability, fecal pH, fecal moisture, and short-chain fatty acid (SCFA) concentrations. We performed meta-analyses to assess the overall effect of nuts on fecal moisture, pH, intestinal permeability, and SCFA concentrations. Among the 28 intervention trials included in this review, almonds were the most commonly studied (12 trials), whereas other nuts, such as walnuts, peanuts, pistachios, and Brazil nuts, were also examined. Nineteen articles reported the effects of almond, walnut, peanut, or mixed nuts on the microbiota composition. Additionally, 6 trials used interventions involving a mixture of different nuts. A total of 19 trials assessed the community structure of the gut microbiota by evaluating α-diversity and β-diversity metrics, with most finding no significant differences following the nut intervention. Regarding taxonomic changes, the majority of studies reported no significant changes across nut interventions. However, several studies noted increases in Clostridium and Roseburia species, with mixed results for Bifidobacterium species abundance following almond or walnut intervention. Five studies assessed fecal SCFA concentrations, with positive effects of nut interventions on propionate. There were no effects of nut interventions on fecal pH and intestinal permeability, with an unfavorable effect on fecal moisture. In summary, the available evidence indicates that nuts have modest effect on gut health, but the substantial heterogeneity between studies may hinder further conclusions.

This trial was registered at PROSPERO as CRD42023451282.

食用坚果可通过调节肠道菌群来降低心血管疾病和2型糖尿病等慢性疾病的风险，但这一点尚未得到全面评估。本临床试验的系统综述旨在评估坚果对成人肠道微生物群组成和代谢物的影响。此外，它还研究了坚果对成人肠道功能和症状的影响。系统评价遵循PRISMA指南进行，并在PROSPERO注册（CRD42023451282）。结果包括微生物群多样性、特定细菌丰度、胃肠道症状、肠道通透性、粪便pH值、粪便水分和短链脂肪酸（SCFAs）浓度。我们进行了荟萃分析，以评估坚果对粪便水分、pH值、肠道通透性和SCFA浓度的总体影响。在本综述纳入的28项干预试验中，杏仁是最常被研究的（12项试验），而其他坚果，如核桃、花生、开心果和巴西坚果也被研究。19篇文章报道了杏仁、核桃、花生或混合坚果对微生物群组成的影响。此外，有6项试验使用了不同坚果的混合干预。共有19项试验通过评估α和β多样性指标来评估肠道微生物群的群落结构，大多数试验发现坚果干预后没有显著差异。在分类变化方面，大多数研究报告在坚果干预中没有显著变化。然而，几项研究表明，杏仁或核桃干预后，梭状芽孢杆菌和玫瑰菌数量增加，双歧杆菌数量增加的结果不一。五项研究评估了粪便SCFA浓度，坚果干预对丙酸的积极影响。坚果干预对粪便pH值和肠道通透性没有影响，但对粪便水分有不利影响。总之，现有证据表明坚果对肠道健康有适度的影响，但研究之间的巨大异质性可能会阻碍进一步的结论。注册号：普洛斯彼罗crd42023451282。

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引用次数: 0

Unraveling Spinal Cord Injury Nutrition: Effects of Diet on the Host and Microbiome 解开脊髓损伤营养：饮食对宿主和微生物组的影响。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-07-01 Epub Date: 2025-05-16 DOI: 10.1016/j.advnut.2025.100448

ZeHui Li , XiaoXin Wang , HuaYong Du , WuBo Liu , ChunJia Zhang , Zuliyaer Talifu , Xin Xu , Yunzhu Pan , JinMing Zhang , Han Ke , DeGang Yang , Feng Gao , Yan Yu , YingLi Jing , JianJun Li

Spinal cord injury (SCI) leads to severe neurological dysfunction with significant nutritional alterations. These alterations are closely associated with gut dysbiosis and neurogenic gut dysfunction after SCI, creating complex interactions that further exacerbate metabolic disturbances and impede neurological recovery. In the context of SCI, diet not only fulfills basic nutritional needs but also serves as an important therapeutic tool to modulate these interactions. This review provides a broad overview of existing research findings, analyzes the impact of existing dietary interventions on SCI, and attempts to clarify the complex relationship between diet and host and gut microbiota. We hope to provide a clear direction for future research and a scientific basis for the development of personalized dietary interventions to improve the nutritional status of patients with SCI, reduce the incidence of complications such as metabolic disorders, and promote the recovery of neurological function and overall quality of life of patients with SCI.

脊髓损伤（SCI）导致严重的神经功能障碍和显著的营养改变。这些改变与脊髓损伤后的肠道生态失调和神经源性肠道功能障碍密切相关，产生复杂的相互作用，进一步加剧代谢紊乱，阻碍神经系统恢复。在脊髓损伤的背景下，饮食不仅满足基本的营养需求，而且作为调节这些相互作用的重要治疗工具。本文综述了现有研究成果，分析了现有饮食干预对脊髓损伤的影响，并试图阐明饮食与宿主和肠道微生物群之间的复杂关系。希望为今后的研究提供明确的方向，为制定个性化的饮食干预措施提供科学依据，以改善SCI患者的营养状况，减少代谢紊乱等并发症的发生，促进SCI患者神经功能的恢复和整体生活质量。意义声明：本综述评估了脊髓损伤患者的营养变化，从宿主和肠道微生物群的角度全面阐明了饮食干预对脊髓损伤患者的影响。通过揭示它们之间复杂的相互作用，它为制定个性化的营养干预策略奠定了基础，以优化恢复并改善未来的长期健康结果。

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引用次数: 0

Impacts of Food Fortification on Micronutrient Intake and Nutritional Status of Women of Reproductive Age in Africa—A Narrative Review 食物强化对非洲育龄妇女微量营养素摄入和营养状况的影响-叙述综述。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-07-01 Epub Date: 2025-06-11 DOI: 10.1016/j.advnut.2025.100463

Justine B Coomson, Nick W Smith, Warren McNabb

More than two-thirds of women of reproductive age (WRA) in Africa are estimated to be micronutrient deficient. This is largely due to the widespread poor dietary quality and inadequate intakes of nutrient-dense foods to meet the heightened requirements for WRA. Food fortification is a cost-effective and highly recommended food-based approach for addressing these micronutrient deficiencies in low-income settings like Africa. The strategy has been implemented at different scales within the region for over 3 decades. We conducted a review to find evidence of the impact of food fortification implemented at various scales and across different population circumstances in Africa. We also sought to understand what factors may limit the impact of ongoing fortification programs on micronutrient status. We also explored findings regarding the knowledge and acceptability of fortified foods within the African population as a further barrier to the impact of food fortification on nutritional status. We found that fortification with iron and vitamin A was associated with the most variable impact from targeted and large-scale fortification programs. However, significant positive effects on nutritional status and serum biomarkers were found for food fortification with folate, iodine, and zinc among African women. Generally, fortified foods are acceptable to consumers; however, surveys assessing knowledge and preference for fortified foods found that WRA know little about food fortification and its benefits. Poor coverage of fortification, lower levels of fortificants than are recommended, and use of non-World Health Organization recommended fortificants limit the impact of food fortification on micronutrient intakes and status among WRA in Africa.

据估计，非洲超过三分之二的育龄妇女缺乏微量营养素。这在很大程度上是由于普遍的饮食质量差和营养密集的食物摄入量不足，无法满足WRA的更高要求。在非洲等低收入环境中，强化食品是解决这些微量营养素缺乏问题的一种具有成本效益和强烈推荐的以食物为基础的方法。30多年来，该战略在该区域内以不同规模实施。我们进行了一项审查，以寻找在非洲不同规模和不同人口情况下实施食品强化的影响的证据。我们还试图了解哪些因素可能会限制正在进行的强化计划对微量营养素状况的影响。我们还探讨了关于非洲人口中强化食品的知识和可接受性的发现，作为食品强化对营养状况影响的进一步障碍。我们发现，铁和维生素A的强化与有针对性的大规模强化计划的影响最为不同。然而，在非洲妇女中，叶酸、碘和锌的食物强化对营养状况和血清生物标志物有显著的积极影响。一般来说，消费者可以接受强化食品；然而，评估强化食品知识和偏好的调查发现，世界卫生组织对食品强化及其益处知之甚少。强化覆盖率低、强化剂水平低于建议水平以及使用非世卫组织推荐的强化剂，限制了食物强化对非洲世界粮食计划署微量营养素摄入量和状况的影响。重要意义：本综述强调了食品强化在改善WRA中必需和普遍缺乏的微量营养素摄入方面的潜力，以及目前在WRA中全球微量营养素缺乏负担最重的非洲地区限制这一潜力的因素。

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引用次数: 0

Artificial intelligence in cancer-related malnutrition and cachexia: a transformative tool in clinical nutrition 癌症相关营养不良和恶病质的人工智能：临床营养的变革性工具。

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-07-01 Epub Date: 2025-05-13 DOI: 10.1016/j.advnut.2025.100447

Salvatore Carbone

引用次数: 0

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-06-01 Epub Date: 2025-05-05 DOI: 10.1016/j.advnut.2025.100439

Elena Carrillo-Alvarez , Rosa Rifà-Ros , Blanca Salinas-Roca , Lluís Costa-Tutusaus , Mafalda Lamas , Míriam Rodriguez-Monforte

Diet-related health inequalities are a persistent public health challenge in high-income countries, disproportionately affecting socially and economically disadvantaged populations. This study aims to map the existing evidence on diet-related health inequalities in high-income countries through a scoping review of observational studies, identifying populations most affected and key dietary outcomes across social determinants of health. We conducted a systematic search of MEDLINE, Web of Science, Scopus, and Embase for observational studies published between January 2011 and March 2021. Eligible studies assessed diet-related health outcomes stratified by ≥1 Place of Residence, Race/Ethnicity, Occupation, Gender/Sex, Religion, Education, Socioeconomic Status, and Social Capital (PROGRESS)-Plus determinant. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines and registered the review with International Prospective Register of Systematic Reviews (CRD42021234567). Data were charted and analyzed thematically according to PROGRESS categories. A total of 163 studies were included. Most studies focused on education, socioeconomic status, and place of residence, whereas fewer addressed gender identity, sexual orientation, or disability. Common dietary indicators included fruit and vegetable intake, dietary patterns, and food group consumption. Evidence consistently showed that lower education and income levels were associated with poorer dietary outcomes. Notably, certain population groups (for example, ethnic minorities, rural residents, and individuals with low education or income) experienced cumulative disadvantages. The scoping review highlights persistent and intersecting diet-related health inequalities in high-income countries. It underscores the need for standardized indicators and intersectional approaches in monitoring, research, and policy making.

背景：与饮食有关的健康不平等是高收入国家持续存在的公共卫生挑战，对社会和经济上处于不利地位的人群造成了不成比例的影响。目的：通过对观察性研究的范围审查，绘制高收入国家饮食相关健康不平等的现有证据，确定受影响最大的人群和健康社会决定因素的关键饮食结果。方法：系统检索MEDLINE、Web of Science、Scopus和Embase，检索2011年1月至2021年3月间发表的观察性研究。符合条件的研究通过至少一个PROGRESS-Plus决定因素来评估饮食相关的健康结果。我们遵循PRISMA-ScR指南，并在PROSPERO注册了审查（CRD42021234567）。根据PROGRESS类别对数据进行了专题图表和分析。结果：共纳入163项研究。大多数研究集中在教育、社会经济地位和居住地，而较少涉及性别认同、性取向或残疾。常见的饮食指标包括水果和蔬菜摄入量、饮食模式和食物组消费。证据一致表明，较低的教育水平和收入水平与较差的饮食结果有关。值得注意的是，某些人口群体（如少数民族、农村居民、教育或收入低的个人）经历了累积的不利条件。结论：范围审查强调了高收入国家中持续存在的和交叉的饮食相关的健康不平等。它强调了在监测、研究和决策方面需要标准化指标和交叉方法。

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引用次数: 0

Differences in Zinc Content in Preterm Human Milk May Depend on Your Definition of “Preterm” 早产儿母乳中锌含量的差异可能取决于你对“早产”的定义

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-06-01 Epub Date: 2025-05-22 DOI: 10.1016/j.advnut.2025.100435

Brian Stansfield, Amy Gates

引用次数: 0

Unlocking the Secrets of Human Milk: Isolation and Characterization of Extracellular Vesicles 揭开母乳的秘密：细胞外囊泡的分离和表征

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-06-01 Epub Date: 2025-04-25 DOI: 10.1016/j.advnut.2025.100430

Klaudia Tiszbein, Izabela Koss-Mikołajczyk, Dorota Martysiak-Żurowska

Extracellular vesicles from human milk (HMEVs) are crucial for neonatal development, immune modulation, and protection against pathogens. However, the lack of standardized isolation and characterization protocols poses significant challenges. This review aims to evaluate and compare various methods for the isolation and characterization of HMEVs, highlighting their effectiveness and potential applications. Preliminary purification steps, including the removal of cells, fat globules, and casein micelles, enhance the purity of isolated HMEVs. We categorized isolation methods into density-based, size-based, and affinity-based techniques. Density-based methods include differential and density gradient ultracentrifugation. Size-based methods encompass polymer precipitation, membrane filtration, electrophoretic filtration, size exclusion chromatography, and microfluidics. Affinity-based methods involve immunoisolation using antibodies specific to HMEV surface proteins. Characterization techniques discussed include flow cytometry, dynamic light scattering, nanoparticle tracking analysis, tunable resistive pulse sensing, electron microscopy, atomic force microscopy, confocal microscopy, western blotting, ELISA, and lateral flow immunoassay systems. Differential ultracentrifugation, considered the “gold standard,” provides high purity but is time-consuming. Density gradient ultracentrifugation offers precise separation. Size-based methods like polyethylene glycol precipitation and membrane filtration are simple and fast. Electrophoretic filtration and microfluidics provide precise control of sample flow. Affinity-based methods are highly specific but costly. Advanced characterization techniques provide comprehensive insights into HMEV properties and functions. Standardizing isolation protocols and employing advanced characterization techniques are essential for advancing HMEV research. Future studies should focus on understanding the molecular mechanisms of HMEVs, exploring the impact of maternal health, and developing targeted delivery technologies. These efforts will enhance the therapeutic potential of HMEVs in neonatal care and contribute to personalized nutritional interventions.

人乳细胞外囊泡（hmev）对新生儿发育、免疫调节和抵抗病原体至关重要。然而，缺乏标准化的分离和表征方案带来了重大挑战。本文旨在评价和比较各种分离和鉴定hmev的方法，突出其有效性和潜在的应用前景。初步纯化步骤，包括去除细胞、脂肪球和酪蛋白胶束，提高分离hmev的纯度。我们将分离方法分为基于密度、基于大小和基于亲和力的技术。基于密度的方法包括微分和密度梯度超离心。基于尺寸的方法包括聚合物沉淀、膜过滤、电泳过滤、尺寸排除色谱和微流体。基于亲和力的方法包括使用HMEV表面蛋白特异性抗体进行免疫分离。讨论的表征技术包括流式细胞术、动态光散射、纳米颗粒跟踪分析、可调电阻脉冲传感、电子显微镜、原子力显微镜、共聚焦显微镜、western blotting、ELISA和侧流免疫分析系统。差动超离心，被认为是“金标准”，提供高纯度，但耗时。密度梯度超离心提供精确的分离。基于尺寸的方法，如聚乙二醇沉淀和膜过滤，简单而快速。电泳过滤和微流体提供样品流的精确控制。基于亲和力的方法非常具体，但成本很高。先进的表征技术提供了对HMEV特性和功能的全面见解。标准化隔离方案和采用先进的表征技术对推进HMEV研究至关重要。未来的研究应侧重于了解hmev的分子机制，探索其对孕产妇健康的影响，以及开发靶向分娩技术。这些努力将增强hmev在新生儿护理中的治疗潜力，并有助于个性化营养干预。

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引用次数: 0

Homocysteine and Multiple Health Outcomes: An Outcome-Wide Umbrella Review of Meta-analyses and Mendelian Randomization Studies 同型半胱氨酸和多种健康结果：荟萃分析和孟德尔随机化研究的综合综述

IF 8 1区医学 Q1 NUTRITION & DIETETICS

Advances in Nutrition

Pub Date : 2025-06-01 Epub Date: 2025-04-25 DOI: 10.1016/j.advnut.2025.100434

Futao Zhou , Yue He , Xinhua Xie , Ning Guo , Wanjiao Chen , Yushi Zhao

Elevated levels of homocysteine (Hcy) are associated with various health outcomes. We aimed to systematically assess the credibility and certainty of evidence of associations of Hcy and Hcy-lowering therapies with various health outcomes. We retrieved observational meta-analyses examining the associations between Hcy and health outcomes, interventional meta-analyses investigating health outcomes related to Hcy-lowering treatments, and Mendelian randomization (MR) studies exploring the causal associations of Hcy with health outcomes to perform an umbrella review. A total of 135 observational meta-analyses, 106 MR studies, and 26 interventional meta-analyses were included. Among observational studies, 10 associations of diseases/outcomes were classified as highly suggestive; only 1 outcome (digestive tract cancer) was supported by convincing evidence (class I; odd ratio = 1.27, 95% confidence interval = 1.16, 1.40; P = 6.79 × 10^-7; I² = 0, 95% prediction interval excluding null, >1000 cases; P > 0.1 for tests of both small-study effects and excess significance bias). In MR studies, 5 outcomes associated with Hcy presented robust evidence (P < 0.01, power >80%). Among 25 outcomes explored by both observational meta-analyses and MR studies, 7 had consistent results, indicating that elevated Hcy is causally associated with an increased risk of these outcomes. The 3 types of studies collectively suggested that the association of stroke with Hcy was supported by observational studies, causally by MR studies, and further validated by intervention meta-analyses showing that Hcy-lowering with folic acid significantly reduced risk of stroke. For dementia and colorectal cancer, Hcy was significantly associated in meta-analyses of observational studies and folic acid decreased disease risks in interventional meta-analyses. The current umbrella review indicates that convincing evidence for a definitive role of Hcy exposure solely exists in the context of digestive tract cancer excluding bias; however, Hcy may not be causal for this disease. All the 3 types of studies collectively support that Hcy is a key causal risk factor, and Hcy-lowering (specifically with folic acid) may serve as an effective intervention for stroke.

This trial was registered at PROSPERO as CRD42024541335.

高水平的同型半胱氨酸（Hcy）与各种健康结果相关。我们的目的是系统地评估Hcy和降低Hcy治疗与各种健康结果相关证据的可信度和确定性。我们检索了检验Hcy与健康结果之间关系的观察性荟萃分析、调查与降低Hcy治疗相关的健康结果的干入性荟萃分析，以及探索Hcy与健康结果因果关系的孟德尔随机化（MR）研究，以进行总揽性回顾。共纳入135项观察性荟萃分析、106项磁共振研究和26项介入性荟萃分析。在观察性研究中，10种疾病/结果的关联被归类为高度提示性；只有1个结局（消化道癌）有令人信服的证据支持(I类；奇比= 1.27,95%置信区间= 1.16,1.40；P = 6.79 × 10-7；I2 = 0, 95%预测区间排除null， >；1000例；P比;对于小型研究效应和过度显著性偏差的检验均为0.1)。在磁共振研究中，与Hcy相关的5个结果提供了强有力的证据(P <；0.01，功率>；80%)。在观察性荟萃分析和MR研究探讨的25个结果中，有7个结果一致，表明Hcy升高与这些结果的风险增加有因果关系。这三种类型的研究共同表明，观察性研究支持Hcy与卒中的关联，MR研究与Hcy有因果关系，并通过干预荟萃分析进一步证实，叶酸降低Hcy可显著降低卒中风险。在观察性研究的荟萃分析中，对于痴呆和结直肠癌，Hcy显著相关；在介入性荟萃分析中，叶酸降低疾病风险。目前的综述表明，排除偏倚，Hcy暴露的明确作用仅存在于消化道癌症的背景下；然而，Hcy可能不是导致这种疾病的原因。所有这三种类型的研究共同支持Hcy是一个关键的因果危险因素，降低Hcy（特别是叶酸）可能作为卒中的有效干预措施。该试验在普洛斯彼罗注册为CRD42024541335。

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引用次数: 0