Metabolic profiles and malnutrition in hospitalized adults: A metabolomic cohort study

IF 3.2 3区医学 Q2 NUTRITION & DIETETICS

Journal of Parenteral and Enteral Nutrition Pub Date : 2025-02-17 DOI:10.1002/jpen.2728

Marte A. Trollebø Msc, Randi J. Tangvik PhD, Eli Skeie PhD, Ottar Nygård MD, PhD, Tomas M. L. Eagan MD, PhD, Adrian McCann PhD, Jutta Dierkes PhD

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引用次数: 0

Abstract

Background

Malnutrition or risk of malnutrition is present in about one-third of patients admitted to Western hospitals and is identified by either screening for malnutrition or further nutrition assessment. To date, there are no commonly accepted biomarkers of malnutrition, which could expedite screening efforts, ease diagnosis, and hasten treatment. We aimed to investigate whether metabolomics could identify markers associated with malnutrition in hospitalized patients and performed a retrospective metabolomic cohort study in this patients' group.

Methods

The study population included adult patients hospitalized in a medical unit. Malnutrition was identified by the second step of the Global Leadership Initiative on Malnutrition criteria independently of the outcome of the screening step (nutritional risk screening 2002). Amino acids were determined by targeted metabolomics using gas chromatography–tandem mass spectrometry and liquid chromatography–tandem mass spectrometry. Logistic regression analyses with Benjamini-Hochberg procedure to reduce false discovery rate were used to identify biomarkers associated with malnutrition.

Results

In total, 218 patients were included in the final analysis, with 62 patients having a diagnosis of malnutrition. In crude analyses, 11 metabolites were associated with malnutrition, but further adjustment attenuated the associations. After multiple adjustment, neopterin and cystatin C were positively associated with malnutrition, whereas His, Cys, and kynurenine to tryptophan ratio were negatively associated.

Conclusion

The observed associations require confirmation in a replication cohort before they can be recommended as biomarkers of malnutrition.

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住院成人的代谢特征和营养不良：一项代谢组学队列研究。

背景：西方医院约三分之一的住院患者存在营养不良或营养不良风险，可通过营养不良筛查或进一步的营养评估来确定。迄今为止，还没有普遍接受的营养不良生物标志物，可以加快筛查工作，简化诊断和加速治疗。我们的目的是研究代谢组学是否可以识别与住院患者营养不良相关的标志物，并在该患者组中进行了回顾性代谢组学队列研究。方法：研究人群包括在某医疗单位住院的成年患者。营养不良是由营养不良全球领导倡议标准的第二步确定的，独立于筛查步骤的结果（2002年营养风险筛查）。采用气相色谱-串联质谱法和液相色谱-串联质谱法对氨基酸进行靶向代谢组学测定。采用benjamin - hochberg程序进行Logistic回归分析，以减少错误发现率，以确定与营养不良相关的生物标志物。结果：共纳入218例患者，其中62例诊断为营养不良。在初步分析中，11种代谢物与营养不良有关，但进一步的调整减弱了这种关联。经多次调整后，neopterin和胱抑素C与营养不良呈正相关，而His、Cys和犬尿氨酸/色氨酸比例呈负相关。结论：观察到的相关性需要在复制队列中得到证实，然后才能推荐作为营养不良的生物标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Parenteral and Enteral Nutrition 医学-营养学

CiteScore

7.80

自引率

8.80%

发文量

161

审稿时长

6-12 weeks

期刊介绍： The Journal of Parenteral and Enteral Nutrition (JPEN) is the premier scientific journal of nutrition and metabolic support. It publishes original peer-reviewed studies that define the cutting edge of basic and clinical research in the field. It explores the science of optimizing the care of patients receiving enteral or IV therapies. Also included: reviews, techniques, brief reports, case reports, and abstracts.