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Explorative Clustering of the Nitrogen Balance Trajectory in Critically Ill Patients: A Preliminary post hoc Analysis of a Single-Center Prospective Observational Study. 危重患者氮平衡轨迹的探索性聚类:单中心前瞻性观察性研究的初步事后分析。
IF 3.2 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-01-01 Epub Date: 2023-10-09 DOI: 10.1159/000532126
Kensuke Nakamura, Kentaro Ogura, Hidehiko Nakano, Daisuke Ikechi, Masaki Mochizuki, Yuji Takahashi, Tadahiro Goto

Background: The nitrogen balance estimates a protein net difference. However, since it has a number of limitations, it is important to consider the trajectory of the nitrogen balance in the clinical course of critically ill patients.

Objectives: We herein exploratively classified the nitrogen balance trajectory using a machine learning method.

Method: This is a post hoc analysis of a single-center prospective study for the patients admitted to our Emergency and Critical Center ICU. The nitrogen balance was evaluated with 24-h urine collection from ICU days 1-10 with 9 points. K-means clustering was performed to classify the nitrogen balance trajectory. We also evaluated factors associated with uncovered clusters.

Results: Seventy-six eligible patients were included in the present study. After clustering, the nitrogen balance trajectory was classified into 4 classes. Class 1 was trajected as a negative balance over 10 days (24 patients). Class 2 had a positive conversion on day 3 or 4 (8 patients). Class 3 had a positive conversion on day 8 or 9 (28 patients). Class 4 initially had a positive balance and then converted to a negative balance (16 patients). Sepsis complication and steroid use were associated with negative nitrogen balance trajectory. Class 2 was associated with lower length of hospital stay and femoral muscle volume loss, however, frequently had frailty and sarcopenia on admission. Active nutrition therapy intention was not correlated with positive trajectory.

Conclusions: The nitrogen balance trajectory in critically ill patients may be classified into 4 classes for clinical practice. Among patients emergently admitted to the ICU, the positive conversion of the nitrogen balance might be delayed over 10 days.

背景:氮平衡估计蛋白质净差异。然而,由于它有许多局限性,在危重患者的临床过程中考虑氮平衡的轨迹是很重要的。目的:本文采用机器学习方法对氮平衡轨迹进行了探索性分类。方法:这是对我们急诊和危重症中心ICU患者的单中心前瞻性研究的事后分析。氮平衡通过ICU第1天至第10天的24小时尿液采集进行评估,得9分。采用K-means聚类对氮平衡轨迹进行分类。我们还评估了与未覆盖集群相关的因素。结果:76名符合条件的患者被纳入本研究。聚类后,将氮平衡轨迹分为4类。在10天内(24名患者),将1类作为负平衡。2级在第3或第4天出现阳性转化(8名患者)。3级在第8天或第9天出现阳性转化(28名患者)。第4类最初为正平衡,然后转为负平衡(16名患者)。脓毒症并发症和类固醇使用与负氮平衡轨迹相关。2级与住院时间较短和股肌体积减少有关,但入院时经常出现虚弱和少肌症。积极营养治疗意向与阳性轨迹无相关性。结论:危重患者的氮平衡轨迹可分为4类,用于临床实践。在紧急入住ICU的患者中,氮平衡的正转换可能会延迟10天以上。
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引用次数: 0
European JRC Report: One More Stone for the (Scientific) Building of Nutri-Score. 欧洲JRC报告:营养评分(科学)构建的又一基石。
IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-01-01 DOI: 10.1159/000527852
Serge Hercberg, Pilar Galan, Mathilde Touvier
No.
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引用次数: 1
Expression of Concern. 表达关心。
IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-01-01 DOI: 10.1159/000529248
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引用次数: 0
Influence of Sleeve Gastrectomy on Skeletal Muscular Fat Infiltration Measured by MRI in Patients with Metabolic Syndrome: Preliminary Results. 袖带胃切除术对通过核磁共振成像测量的代谢综合征患者骨骼肌肉脂肪浸润的影响:初步结果
IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-01-01 Epub Date: 2023-01-06 DOI: 10.1159/000527941
Qiang Ma, Xiaoyue Cheng, Xinmeng Hou, Yuanyuan Yan, Chenglin Zhao, Zhenghan Yang

Introduction: Several researchers have focused on the role of skeletal muscle in metabolic problems in recent years. We aimed to evaluate influence of sleeve gastrectomy on skeletal muscular fat infiltration determined by magnetic resonance imaging in patients with metabolic syndrome (MetS).

Methods: Sixty five MetS patients (male/female, 20/45; mean age, 35.5 years ± 6.6 [standard deviation]; age range, 22-59 years) enrolled in our study. Prior to and 1 year after sleeve gastrectomy, patients underwent routine measurement of skeletal muscular fat concentration (denoted by proton density fat fraction, PDFF) and chemical indexes. The associations of skeletal muscular fat concentration with other variables were determined using multiple linear regression analysis.

Results: Difference between skeletal muscular PDFF at baseline (4.46 ± 2.01%) and PDFF 1-year after sleeve gastrectomy (3.00 ± 1.47%) was significant. Multivariable predictors of baseline skeletal muscular PDFF by descending order of standardized coefficient were fasting serum glucose (0.459; p = 0.001), age (0.395; p < 0.001), systolic pressure (0.319; p = 0.029), insulin (0.030; p = 0.026), white cell count (0.302; p = 0.007), diastolic pressure (-0.301; p = 0.046), and total alkaline phosphatase (-0.474; p < 0.001) all at baseline. Furthermore, multivariable predictors of change in PDFF were serum total cholesterol (3.510; p < 0.001), total alkaline phosphatase (0.535; p < 0.001), estrogen (0.457; p < 0.001), diastolic pressure (0.352; p < 0.001), systolic pressure (-0.409; p < 0.001), high-density lipoprotein cholesterol (-0.719; p < 0.001), insulin (-0.774; p < 0.001), C-reactive protein (-0.900; p < 0.001), triglyceride (-1.756; p < 0.001), and low-density lipoprotein cholesterol (-2.854; p < 0.001) all at baseline.

Conclusion: Sleeve gastrectomy could alleviate myosteatosis in MetS patients during 1-year follow-up. The extent of remission on skeletal muscular fat infiltration after sleeve gastrectomy was influenced by baseline metabolic problems related to serum glucose, serum lipid, and blood pressure level.

导言:近年来,一些研究人员关注骨骼肌在代谢问题中的作用。我们的目的是评估袖状胃切除术对代谢综合征(MetS)患者通过磁共振成像测定的骨骼肌脂肪浸润的影响:65 名 MetS 患者(男/女,20/45;平均年龄为 35.5 岁 ± 6.6 [标准差];年龄范围为 22-59 岁)参加了我们的研究。袖带胃切除术前和术后一年,患者接受了骨骼肌肉脂肪浓度(以质子密度脂肪分数表示,PDFF)和化学指标的常规测量。采用多元线性回归分析确定了骨骼肌脂肪浓度与其他变量的关系:结果:基线时的骨骼肌肉质子密度脂肪分数(4.46 ± 2.01%)与袖带状胃切除术一年后的骨骼肌肉质子密度脂肪分数(3.00 ± 1.47%)差异显著。基线骨骼肌 PDFF 的多变量预测因子按标准化系数降序排列为空腹血清葡萄糖(0.459;P = 0.001)、年龄(0.395;P < 0.001)、收缩压(0.319;p = 0.029)、胰岛素(0.030;p = 0.026)、白细胞计数(0.302;p = 0.007)、舒张压(-0.301;p = 0.046)和总碱性磷酸酶(-0.474;p < 0.001)均为基线值。此外,PDFF 变化的多变量预测因子为血清总胆固醇(3.510;p < 0.001)、总碱性磷酸酶(0.535;p < 0.001)、雌激素(0.457;p < 0.001)、舒张压(0.352;p < 0.001)、收缩压(-0.409;p < 0.001)、高密度脂蛋白胆固醇(-0.719;P<0.001)、胰岛素(-0.774;P<0.001)、C反应蛋白(-0.900;P<0.001)、甘油三酯(-1.756;P<0.001)和低密度脂蛋白胆固醇(-2.854;P<0.001)均为基线值:结论:袖带状胃切除术可在1年的随访中缓解MetS患者的肌骨软化症。袖带胃切除术后骨骼肌脂肪浸润的缓解程度受血糖、血脂和血压水平等基线代谢问题的影响。
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引用次数: 0
The Relationship between Skeletal Muscle Mass and Bone Mass at Different Sites in Older Adults. 老年人不同部位骨骼肌质量与骨量之间的关系。
IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-01-01 Epub Date: 2022-12-15 DOI: 10.1159/000528585
Lingyan Chen, Jiayu Wu, Weiying Ren, Xi Li, Man Luo, Yu Hu

Introduction: It has been well recognized that sarcopenia is closely related with osteoporosis, while the relationship between bone mass at different sites and muscle mass remains largely unexplored. This study aims to explore the relationship between bone mass at different sites and skeletal muscle mass in older adults.

Methods: A total of 228 patients over 65 years old were enrolled in this study, and then 180 valid participants with accessible dual-energy X-ray absorptiometry (DXA) scanning data and absence of malignant tumors, mobility disorders, serious liver and kidney disease, and cardiac insufficiency were selected (138 male and 42 female). These individuals were further divided into control group and low skeletal muscle mass index (SMI) group. DXA scanning was used to access skeletal muscle mass and bone mass. SMI or body mass index was defined as appendicular muscle mass or weight divided by squared height, respectively. Low SMI <7.0 kg/m2 in male or <5.4 kg/m2 in female was defined as low SMI; while the bone density score at or below 2.5 standard deviations (T-score) below normal peak bone values, was regarded as osteoporosis.

Results: The average age of enrolled patients was 82.72 years; the ratios of osteoporosis, low SMI, and low SMI with osteoporosis were 48.8%, 23.3%, and 15.0%, respectively. Compared with the control group, the prevalence of osteoporosis was higher, and the total bone mass and bone mass at various sites including limbs, spine, and pelvis, were all lower in low SMI group. Correlation analysis showed that SMI was positively related with total bone mass and bone mass at various sites. Covariance analysis showed that only total bone mass and appendicular bone mass decreased with decreasing SMI. After multiple adjustment, osteoporosis was positively related with the prevalence of low SMI, as evidenced by logistic regression analysis (odds ratio = 1.33, 95% confidential interval: 1.04-3.24, p = 0.045). Furthermore, compared with the highest quartile of appendicular bone mass, the lowest quartile was related with the increasing prevalence of low SMI (odds ratio = 7.29, 95% confidential interval: 1.21-67.45, p = 0.042).

Conclusion: Compared with the other sites, the bone mass reduction at limbs of older adults was positively associated with skeletal muscle loss. It may be more beneficial to increase bone mass at the limbs for improved sarcopenia prevention and therapy. Further investigations are needed to explore the effects of other confounders (e.g., energy, calcium and vitamin D intake, and physical activity) on the osteoporosis and sarcopenia in older adults.

引言人们普遍认为,肌肉疏松症与骨质疏松症密切相关,而不同部位的骨量与肌肉质量之间的关系却仍未得到深入探讨。本研究旨在探讨老年人不同部位骨量与骨骼肌质量之间的关系:本研究共招募了 228 名 65 岁以上的患者,然后选择了 180 名可获得双能 X 射线吸收测量(DXA)扫描数据且无恶性肿瘤、行动不便、严重肝肾疾病和心功能不全的有效参与者(男性 138 人,女性 42 人)。这些人又被分为对照组和低骨骼肌质量指数(SMI)组。采用 DXA 扫描检测骨骼肌质量和骨量。骨骼肌质量指数或体重指数的定义分别为附着肌质量或体重除以身高的平方。低 SMI 结果:入组患者的平均年龄为 82.72 岁,骨质疏松症、低 SMI 和低 SMI 与骨质疏松症的比例分别为 48.8%、23.3% 和 15.0%。与对照组相比,低 SMI 组的骨质疏松症患病率较高,总骨量和各部位(包括四肢、脊柱和骨盆)的骨量均较低。相关分析表明,SMI 与总骨量和各部位骨量呈正相关。协方差分析表明,随着 SMI 的降低,只有总骨量和附属骨量有所下降。经多重调整后,Logistic 回归分析表明,骨质疏松症与低 SMI 的发生率呈正相关(几率比 = 1.33,95% 置信区间:1.04-3.24,P = 0.045)。此外,与阑尾骨量的最高四分位数相比,最低四分位数与低 SMI 患病率的增加有关(几率比 = 7.29,95% 置信区间:1.21-67.45,p = 0.042):与其他部位相比,老年人四肢骨量减少与骨骼肌损失呈正相关。增加四肢骨量可能更有利于预防和治疗肌肉疏松症。我们还需要进一步研究其他混杂因素(如能量、钙和维生素 D 摄入量以及体力活动)对老年人骨质疏松症和肌肉疏松症的影响。
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引用次数: 0
Total Energy Expenditure in Healthy Ambulatory Older Adults Aged ≥80 Years: A Doubly Labelled Water Study. 年龄≥80 岁的健康非卧床老年人的总能量消耗:双标记水研究
IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-01-01 Epub Date: 2023-01-02 DOI: 10.1159/000528872
Kay Nguo, Helen Truby, Judi Porter

Introduction: The life expectancy of older adults continues to increase; however, knowledge regarding their total energy requirements is lacking. This study aimed to compare the total energy expenditure (TEE) of older adults ≥80 years measured using doubly labelled water (DLW), with estimated TEE. The hypothesis was that the Mifflin, Ikeda, and Livingston equations will more closely estimate energy requirements than the commonly used Schofield equation.

Methods: Resting metabolic rate (RMR) and TEE were measured using the reference methods of indirect calorimetry and DLW, respectively. Bland-Altman plots compared measured RMR and TEE with predicted RMR using equations (Mifflin, Ikeda, Livingston, Schofield) and predicted TEE (predicted RMR × physical activity level).

Results: Twenty-one older adults (age range 80.7-90.1 years, BMI 26.1 ± 5.5 kg/m2) were included. The Schofield equation demonstrated the greatest bias from measured RMR, overestimating approximately up to double the mean difference (865 ± 662 kJ/day) compared with the three other equations. The Schofield equation exhibited the greatest bias (overestimation of 641 ± 1,066 kJ/day) compared with measured TEE. The other three equations underestimated TEE, with the least bias from Ikeda (37 ± 1,103 kJ/day), followed by Livingston (251 ± 1,108 kJ/day), and Mifflin (354 ± 1,140 kJ/day). Data are mean ± SD.

Conclusions: In older adults ≥80 years, the Ikeda, Mifflin, and Livingston equations provide closer estimates of TEE than the widely used Schofield equation. The development of nutrition guidelines therefore should consider the utilization of equations which more accurately reflect age-specific requirements.

简介老年人的预期寿命在不断延长,但对他们的总能量需求却缺乏了解。本研究旨在比较使用双标记水(DLW)测量的≥80 岁老年人的总能量消耗(TEE)与估计的总能量消耗。假设米夫林、池田和利文斯顿方程比常用的肖菲尔德方程更接近估计能量需求:方法:分别使用间接热量计和 DLW 的参考方法测量静息代谢率(RMR)和 TEE。将测得的 RMR 和 TEE 与使用方程(Mifflin、Ikeda、Livingston、Schofield)预测的 RMR 和预测的 TEE(预测的 RMR × 体力活动水平)进行比较,绘制 Bland-Altman 图:共纳入 21 名老年人(年龄范围为 80.7-90.1 岁,体重指数为 26.1 ± 5.5 kg/m2)。Schofield 公式与测量的 RMR 之间的偏差最大,与其他三个公式相比,高估了大约两倍的平均差异(865 ± 662 千焦/天)。与测量的 TEE 相比,Schofield 方程的偏差最大(高估了 641 ± 1,066 千焦/天)。其他三个方程低估了 TEE,其中池田方程的偏差最小(37 ± 1,103 千焦/天),其次是利文斯顿方程(251 ± 1,108 千焦/天)和米夫林方程(354 ± 1,140 千焦/天)。数据为平均值 ± SD:对于年龄≥80 岁的老年人,池田方程、米夫林方程和利文斯顿方程比广泛使用的肖菲尔德方程能提供更接近的 TEE 估计值。因此,在制定营养指南时应考虑使用能更准确反映特定年龄需求的方程。
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引用次数: 0
Erratum. 勘误表。
IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-01-01 Epub Date: 2023-08-22 DOI: 10.1159/000533253
{"title":"Erratum.","authors":"","doi":"10.1159/000533253","DOIUrl":"10.1159/000533253","url":null,"abstract":"","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"410"},"PeriodicalIF":3.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10050859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
The Cancer Cachexia Index Can Be Used to Prognostically Predict Patients with Gastric Cancer Undergoing Gastrectomy. 癌症恶病质指数可用于预测接受胃切除术的癌症患者。
IF 3.2 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-01-01 Epub Date: 2023-09-26 DOI: 10.1159/000534244
Katsunobu Sakurai, Naoshi Kubo, Tsuyoshi Hasegawa, Junya Nishimura, Yasuhito Iseki, Takafumi Nishii, Toru Inoue, Masakazu Yashiro, Yukio Nishiguchi, Kiyoshi Maeda

Introduction: Cancer cachexia occurs in cancer patients more frequently as the cancer progresses, with a negative impact on treatment outcomes. In this study, we sought to clarify the clinical impact of a cancer cachexia index (CXI) in patients with gastric cancer (GC) undergoing gastrectomy.

Methods: Between January 2013 and December 2018, we reviewed data from 556 patients treated for GC at our hospital. CXI was calculated using skeletal muscle index (SMI), serum albumin, and neutrophil-lymphocyte ratios (NLR). Patients were divided into high (n = 414) or low CXI (n = 142) groups. We investigated the clinical impact of CXI in patients with GC undergoing gastrectomy.

Results: Multivariate analyses of 5-year overall survival (OS) and cancer-specific survival (CSS) rates indicated that a low CXI was independently associated with unfavorable outcomes for patients with GC. In multivariate analyses, SMI was independent predictor of OS but not CSS. NLR was not an independent predictor of either OS or CSS. Complication incidences (≥ Clavien Dindo 3) were non-significantly higher in the low (vs. high) CXI group.

Conclusion: CXI was a more valuable prognostic biomarker when compared with SMI or NLR in GC patients undergoing gastrectomy. We suggest that patients with low CXI values should be given more comprehensive treatment, including exercise and nutritional therapy to improve clinical outcomes.

目的:随着癌症的发展,癌症恶病质在癌症患者中发生的频率越来越高,对治疗结果产生负面影响。在这项研究中,我们试图阐明癌症恶病质指数CXI对接受胃切除术的癌症(GC)患者的临床影响。方法:2013年1月至2018年12月,我们回顾了在我院接受GC治疗的556名患者的数据。使用骨骼肌指数(SMI)、血清白蛋白和中性粒细胞淋巴细胞比率(NLR)计算CXI。将患者分为高CXI组(n=414)和低CXI组。我们研究了CXI对胃癌胃切除术患者的临床影响。结果:5年总生存率(OS)和癌症特异性生存率(CSS)的多因素分析表明,低CXI与GC患者的不良结局独立相关。在多变量分析中,SMI是OS的独立预测因子,但不是CSS。NLR不是OS或CSS的独立预测因子。低(与高)CXI组的并发症发生率[≥Clavien-Dindo(CD)3]无显著性差异。结论:与SMI或NLR相比,CXI是胃癌胃切除术患者更有价值的预后生物标志物。我们建议,CXI值较低的患者应接受更全面的治疗,包括运动和营养治疗,以改善临床结果。
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引用次数: 0
Testing for Protein Leverage in Patients with Gastric Bypass: A Pilot Study. 胃旁路术患者蛋白质杠杆作用的检测:一项初步研究。
IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-01-01 Epub Date: 2023-08-03 DOI: 10.1159/000532125
Nantli Rodriguez-Murguiaa, Juan M Malacara, Daniel Kusnir, Alberto Siniego, Dora Melendez-Rios, David Raubenheimer, Steven Simpson, Claudia Martinez-Cordero

Introduction: Protein leverage (PL) is the phenomenon whereby a dominant appetite for protein drives overconsumption of energy with a decline in the ratio of protein to fat and carbohydrate in the diet. PL has been independently verified in several randomized control trials, and its predictions are supported by diet surveillance data. Our aim in the present study was to test whether surgical intervention through gastric bypass will ameliorate the PL effect.

Methods: Ten patients with gastric bypass (2-5 years postsurgical time) were given ad libitum access to study food comprising 10%, 15%, or 25% protein and no access to other foods for 3 days while controlling food palatability and variety. Food intake was measured, and energy and nutrient intakes were calculated. Body weight, blood chemistry, lipid profile, hormones (insulin, leptin, and ghrelin), and creatinine were determined before and after each experimental period.

Results: The gastric bypass patients in our study did not show evidence for protein intake regulation as predicted under PL but ate to constant total energy intake on the 10%, 15%, and 25% protein diets with protein intake varying significantly. Patients lost weight in the three study periods, but significant weight loss was observed only on the 15% protein diet.

Conclusion: Our results suggest that gastric bypass might disengage the PL mechanism, thus ameliorating an appetite-specific mechanism that drives energy overconsumption in modern food environments.

引言:蛋白质杠杆作用(PL)是一种对蛋白质的主要欲望导致能量过度消耗,导致饮食中蛋白质与脂肪和碳水化合物的比例下降的现象。PL已经在几个随机对照试验中得到了独立验证,其预测得到了饮食监测数据的支持。我们在本研究中的目的是测试通过胃旁路手术干预是否会改善PL效果。方法:10名胃旁路术患者(术后2-5年)在控制食物适口性和多样性的同时,随意食用含有10%、15%或25%蛋白质的研究食物,3天内不食用其他食物。测量食物摄入量,计算能量和营养素摄入量。在每个实验期前后测定体重、血液化学、脂质概况、激素(胰岛素、瘦素和胃促生长素)和肌酸酐。结果:我们研究中的胃旁路患者没有显示出PL下预测的蛋白质摄入调节的证据,但在10%、15%和25%的蛋白质饮食中,蛋白质摄入变化显著,总能量摄入保持不变。患者在三个研究期间体重减轻,但仅在15%蛋白质饮食中观察到显著的体重减轻。结论:我们的研究结果表明,胃旁路可能脱离PL机制,从而改善现代食物环境中驱动能量过度消耗的食欲特异性机制。
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引用次数: 0
Erratum. 勘误表。
IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2023-01-01 Epub Date: 2023-08-22 DOI: 10.1159/000533241
{"title":"Erratum.","authors":"","doi":"10.1159/000533241","DOIUrl":"10.1159/000533241","url":null,"abstract":"","PeriodicalId":8269,"journal":{"name":"Annals of Nutrition and Metabolism","volume":" ","pages":"403"},"PeriodicalIF":3.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10041903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
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Annals of Nutrition and Metabolism
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