Asia Pacific journal of clinical nutrition最新文献

Background and objectives: Anemia is a major health problem worldwide, with complex etiologies and significantly affecting the quality of life and health outcomes. In Indonesia, anemia is a public health concern with a complex interplay between genetic, environmental, and infectious disease factors. The prevalence tends to increase in Indonesia from 2007 to 2018. This study aims to explore factors contributing to anemia in Indonesia.

Methods and study design: We used archived data from various population studies collected between 1995 and 2023. A total of 5,486 subjects from 17 study populations in Indonesia were included in the analyses.

Results: The proportions of anemic women are higher than anemic men (p<0.001), and the anemia prevalence in Indonesia is diverse in various populations. More than 50% of this study subjects were microcytic hypochromic anemia with 35% indicative of iron deficiency and 13% of thalassemia based on Mentzer Index and RDW index cut-off. Hb analysis showed that HbA2 and HbF proportions above normal were significantly higher in the anemic group (p<0.001). We also found beta thalassemia proportions were higher in the anemic group (p<0.001) indicating genetic disorders are prevalent in Indonesia.

Conclusions: The anemia prevalence in Indonesia is high, and the etiology is very complex, with nutritional and non-nutritional factors. Therefore, anemia mitigation in the Indonesian population should consider nutritional and non-nutritional factors. Policy makers should consider intervention programs beyond nutrient-specific strate-gies such as genetic background of the individuals.

Background and objectives: This study aimed to assess the predictive power of the Geriatric Nutritional Risk Index (GNRI) and the triglyceride-glucose (TyG) index for poor prognosis in non-ST segment elevation acute coronary syndrome (NSTE-ACS) patients post-percutaneous coronary intervention (PCI).

Methods and study design: A cohort of 393 NSTE-ACS patients who underwent PCI at the People's Hospital of Nanjing Jiangbei from 2016 to 2022 was analyzed. Major adverse cardiovascular events (MACEs), including death, non-fatal myocardial infarction, and target vessel revascularization, served as the primary outcome. Relationships between GNRI, TyG index, and MACEs were explored using univariate and multivariate logistic regres-sion, with results presented as odds ratios (OR) and 95% confidence intervals (CI). The predictive value was further evaluated using the area under the curve (AUC) from the receiver operating characteristic (ROC) curve.

Results: MACEs occurred in 34 patients. A TyG index ≥1.36 was associated with a significantly increased risk of MACEs (OR=5.07, 95%CI: 1.64-15.71), while a GNRI ≥108 indicated a decreased risk (OR=0.17, 95%CI: 0.04-0.68). These associations were consistent across various subgroups, including age, gender, and specific pre-existing conditions. The combined predictive value of TyG index and GNRI was higher than each alone (AUC=0.711, 95%CI: 0.642-0.779).

Conclusions: In post-PCI patients with NSTE-ACS, the TyG index and GNRI are significant predictors of MACEs, with the TyG index indicating higher risk and GNRI lower risk. Their combined use may enhance the predictive accuracy for MACEs in this patient population.

Background and objectives: To explore the nutritional challenges and its influencing factors of adults aged 40-69 living in Chinese cities.

Methods and study design: This cross-sectional study involved 300 subjects from 29 cities in China. Questionnaires were used to collect demographic information, presence of chronic disease, and the use of nutritional supplements and fortified foods. 24-hour food intake was recorded using the Eat-Right Assistant, a validated digital service.

Results: Fiber (56.7%), calcium (66.3%) and selenium (67.0%) were the nutrients with the highest insufficient intake. The foods with the highest inadequate consumption were dairy products (91%), fruits (84.3%), tubers (76.3%), soybeans and nuts (70%), and whole grains (65%). Even though 95.7% of the study population showed medium-high level of dietary diversity, di-etary imbalance was present among 99% of the subjects. Higher socioeconomic status, passive health awareness, or the use of nutritional supplements or fortified foods showed positive influence on nutrient intake and dietary quality.

Conclusions: This research provided insights into the dietary intake status and its influencing factors of 300 urban residents aged 40-69. The adult population still face a challenge of inadequate nutrient intake and imbalanced diet. In addition, this study supported the feasibility of using a digital service in research. Further studies with a larger sample size are needed to confirm current findings. This will help to clarify the unmet nutritional needs of adults in China and thus help to achieve healthy aging.

Background and objectives: Repeating food frequency questionnaires (FFQs) within the same population was reported to improve the validity of correlation coefficient (CC). However, the enhancement of validity in ranking agreement remains underreported. Herein, we assessed the validity of energy and nutrient intake es-timates using single and multiple FFQs and their ability to rank individuals.

Methods and study design: 213 men and women aged ≥20 years were recruited from the residents participating in the Tohoku Medical Mega-bank Project (TMM) cohort studies; three FFQs were conducted in November each year from 2019 to 2021, with 12-day weighted food records (WFRs) as the reference method. Spearman's rank CCs were calculated between single or multiple FFQs estimates and those obtained through the 12-day WFR. Additionally, the ranking agreement was compared based on cross-classification.

Results: CCs between intake estimated using a single FFQ and 12-day WFR were moderate for several nutrients, with median CCs of 0.52 for men and 0.48 for women. CCs for multiple FFQs were slightly higher than that of single FFQ, with median CCs of 0.59 for men and 0.56 for women. Regardless of the number of FFQs, the proportion of subjects classified into the opposite extreme category was ≤5% for most nutrients.

Conclusions: A single FFQ used for adults in the TMM cohort studies showed moderate validity. Estimates from multiple FFQs improved the accuracy slightly; nevertheless, this indicates that relying on a single FFQ is unlikely to result in a serious misclassifica-tion compared to using intake data from multiple FFQs over a relatively short period.

Background and objectives: To investigate the correlation between weight-adjusted-waist index (WWI), a novel obesity index, and serum ferritin (SF) level in patients with type 2 diabetes mellitus (T2DM), and the association between WWI and the prevalence of hyperferritinemia.

Methods and study design: A total of 943 patients with T2DM were divided into three groups based on WWI tertile levels. Disparities in SF levels and the prevalence of hyperferritinemia were compared among these groups. The correlations among WWI, SF levels, and hyperferritinemia were analyzed in patients with T2DM.

Results: As WWI tertile levels increased, SF levels tended to increase (p for trend <0.01). A statistically significant positive correlation was observed between the WWI and SF levels (R = 0.263, p < 0.001). After adjusting for confounders by multiple linear regression, a significant positive correlation was maintained between the WWI and SF levels [β = 0.194, 95% CI (49.914, 112.120)], p < 0.01]. Binary logistic regression analysis revealed a positive association between the WWI and the likelihood of hyperferritinemia, with a notably stronger correlation observed in females compared to males [OR = 3.248, 95% CI (2.027, 5.204), p < 0.01 vs. OR = 2.091, 95% CI (1.432, 3.054), p < 0.01].

Conclusions: Along with increasing WWI, SF levels gradually increased in patients with T2DM. The WWI exhibited a positive correlation with SF levels and hyperferritinemia, more significantly in female patients.

Background and objectives: Acquired acrodermatitis enteropathica (AE), a rare dermatological condition, often stems from nutritional zinc deficiency linked to prolonged total parenteral nutrition (TPN). This study aims to explore the pathogenesis, clinical characteristics, and treatment approaches for AE, emphasizing the importance of early recognition and intervention.

Methods and study design: A 51-year-old female patient with acquired AE presented with widespread erythema, pustules, and itching. A comprehensive diagnostic approach, including various tests and skin biopsy pathology, confirmed the diagnosis. Treatment involved zinc gluconate supplementation, topical applications, and symptomatic TPN support.

Results: Significant im-provement was observed one week post-treatment, with reduced erythema, pustules, and skin lesions, along with improved hair loss. Erosive and ulcerative surfaces healed substantially, indicating positive treatment outcomes.

Conclusions: The successful management of adult-onset AE in this case underscores the significance of recognizing clinical features and implementing effective treatment strategies. These findings provide valuable insights for diagnosing and managing AE.

Background and objectives: Evidence regarding the relationship between dietary and plasma lutein + zeaxanthin (L + Z) levels and the risk of depression is scarce. This study aimed to investigate the associations of dietary consumption of L + Z and plasma L + Z level with risk of depression in adult of United States by using data from National Health and Nutrition Examination Survey (NHANES).

Methods and study design: A total of 7,829 and 7,324 individuals aged ≥ 20 years were included from the NHANES to analyze the relationship between dietary L + Z and depression, as well as plasma L+ Z levels with the risk of depression, separately. Multivariable logistic regression analyses were used. Subsequently, the dose-response relationships were conducted using restricted cubic splines.

Results: In the multivariable model, the highest quartile of dietary L + Z intake was associated with a significantly lower risk of depression compared to the lowest quartile (OR = 0.68, 95%CI: 0.52, 0.89, p < 0.01). Similarly, the highest quartile of plasma L + Z levels was linked to a reduced risk of depression compared to the lowest quartile (OR = 0.58, 95%CI: 0.44, 0.76, p < 0.001).

Conclusions: This study suggests that an appropriate increase in dietary L + Z intake and higher plasma L + Z levels are associated with a lower risk of depression. These results should be confirmed by randomized controlled trial (RCTs) to explore the effects of supplementing L + Z on depression.

Background and objectives: Sarcopenia is the progressive loss of muscle mass and strength that can adversely affect an individual's health and quality of life. The objective of this study was to evaluate the effectiveness of a combined nutritional and exercise intervention among older adults who were at risk of sarcopenia.

Methods and study design: 46 older adults were included in a 30±3 days intervention that combined oral nutritional supplements with resistance exercise. Parameters were measured at baseline (day 0) and after intervention (day 30±3), including routine parameters of sarcopenia, blood tests, and body measurements. The ITT analysis method was used, and the data were analysed using paired t-tests/paired Wilcoxon test, and ANOVA.

Results: Among the 46 participants, there were no significant changes in hip circumference (HC), muscle mass of both lower limbs, appendicular skeletal muscle mass index (ASMI), and hemoglobin (Hb) after intervention. However, both hand grip strength (GS) significantly increased, as did muscle mass of both upper limbs and the total muscle strength. Blood tests showed a slight increase in albumin (ALB) levels and a significant increase in 25-OH-D levels, while the waist (WC) and calf circumferences (CC) also increased significantly after intervention. Somatic motor performance improved significantly in the 6-meter walk and 5 sit-ups tests.

Conclusions: The combined nutritional and exercise intervention was feasible and effective in improving muscle mass and strength, especially in the upper limbs, as well as somatic motor performance among older adults at risk of sarcopenia. It could be beneficial among three stages of sarcopenia.

Background and objectives: Postprandial hyperglycemia is a risk factor not only for diabetes mellitus, but also arteriosclerosis. Therefore, controlling the rapid postprandial increase in blood glucose levels is necessary. This study aimed to develop a mulberry leaf and water chestnut husk tea and investigate its effect on postprandial blood glucose levels.

Methods and study design: We measured the polyphenols and 1-deoxynojirimycin contents as well as antioxidant activity of mulberry leaf and water chestnut husk tea in an in vitro experiment. The effect of the tea on postprandial blood glucose levels in 30 participants with borderline diabetes was investigated in a randomized, double-blind, placebo-controlled crossover comparison study.

Results: The 1-deoxynojirimycin and total polyphenol contents in the tea (test food, 3g) were 10.2±0.8 and 61.3±1.4 mg, respectively. The test food showed higher antioxidant activity than the placebo food. Compared with those in the placebo group, blood glucose levels in the test group significantly decreased 30 and 60 min after eating rice. Additionally, insulin was significantly lower at all time points (30, 60, 90, and 120 min after rice consumption).

Conclusions: The mulberry leaves and water chestnut mix tea may be an effective beverage to reduce insulin secretion and prevent rapid increases in blood glucose levels in patients with borderline diabetes.

Background and objectives: This study investigated the iodine status of pregnant women at an average altitude of approximately 2000 meters in Qujing, China. The relationship between iodine and thyroid function in different trimesters as well as adverse pregnancy and fetal outcomes were also investigated.

Methods and study design: A total of 1,025 pregnant women who were admitted to Qujing Affiliated Hospital of Kunming Medical University from January 2019 to August 2021 were included. Urinary iodine concentration (UIC) was detected by colorimetric method, and serum thyroid function was detected by chemiluminescence. Among them, 537 pregnant women were followed up to analyze the association of iodine with adverse pregnancy and fetal outcomes.

Results: The median UIC was 127 μg/L. Serum triiodothyronine, thyroxine, free triiodothyronine, and free thyroxine were negatively associated with urinary iodine concentration in the first and second trimesters of pregnancy. The proportion of pregnant women testing positive for thyroid peroxidase antibody (TPO-Ab) and the prevalence of thyroid autoimmunity (TAI) increased significantly in more-than-adequate iodine and excess iodine groups. Logistic regression analysis showed maternal iodine was not associated with adverse pregnancy and fetal outcomes.

Conclusions: Mild iodine deficiency is common among pregnant women in plateau areas of China. The relationship between iodine and thyroid function is significant in the first and second trimesters of pregnancy, especially in those with moderate to severe iodine deficiency. Abnormal iodine level in pregnant women was not significantly associated with adverse pregnancy and fetal outcomes in areas with predominantly mild iodine deficiency.