Nutritional impact of leucine-enriched supplements: Evaluating protein type through artificial intelligence (AI)-augmented muscle ultrasonography in hypercaloric, hyperproteic support

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-08-06 DOI:10.1016/j.clnesp.2025.07.1134

Juan José López-Gómez , Jaime González-Gutiérrez , Olatz Izaola-Jauregui , Ángela Cebriá , Lucía Estévez-Asensio , David Primo-Martín , Pablo Fernández-Velasco , Paloma Pérez-López , Rebeca Jimenez-Sahagún , Daniel Rico-Bargues , Eduardo Jorge Godoy , Daniel A. De Luis-Román

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引用次数: 0

Abstract

Introduction

Malnutrition adversely affects physical function and body composition in patients with chronic diseases. Leucine supplementation has shown benefits in improving body composition and clinical outcomes. This study aimed to evaluate the effects of a leucine-enriched oral nutritional supplement (ONS) on the nutritional status of patients at risk of malnutrition.

Methods

This prospective observational study followed two cohorts of malnourished patients receiving personalized nutritional interventions over 3 months. One group received a leucine-enriched oral supplement (20 % protein, 100 % whey, 3 g leucine), while other received a standard supplement (hypercaloric and normo-hyperproteic) with mixed protein sources. Nutritional status was assessed at baseline and after 3 months using anthropometry, bioelectrical impedance analysis, AI assisted muscle ultrasound, and handgrip strength.

Results

A total of 142 patients were included (76 Leucine-ONS, 66 Standard-ONS), mostly women (65.5 %), mean age 62.00 (18.66) years. Malnutrition was present in 90.1 % and 34.5 % had sarcopenia. Cancer was the most common condition (30.3 %). The Leucine-ONS group showed greater improvements in phase angle (+2.08 % vs. −1.57 %; p = 0.02) and rectus femoris thickness (+1.72 % vs. −5.89 %; p = 0.03). Multivariate analysis confirmed associations between Leucine-ONS and improved phase angle (OR = 2.41; 95%CI: 1.18–4.92; p = 0.02) and reduced intramuscular fat (OR = 2.24; 95%CI: 1.13–4.46; p = 0.02).

Conclusions

Leucine-enriched-ONS significantly improved phase angle and muscle thickness compared to standard ONS, supporting its role in enhancing body composition in malnourished patients. These results must be interpreted in the context of the observational design of the study, the heterogeneity of comparison groups and the short duration of intervention. Further randomized controlled trials are needed to confirm these results and assess long-term clinical and functional outcomes.

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富含亮氨酸补充剂的营养影响：通过人工智能增强肌肉超声在高热量、高蛋白支持下评估蛋白质类型。

慢性疾病患者营养不良对身体功能和身体成分有不良影响。补充亮氨酸已显示出改善身体成分和临床结果的好处。本研究旨在评估富含亮氨酸的口服营养补充剂（ONS）对营养不良风险患者营养状况的影响。方法：这项前瞻性观察性研究随访了两组接受个性化营养干预超过3个月的营养不良患者。一组服用富含亮氨酸的口服补充剂（20%蛋白质，100%乳清，3g亮氨酸），而另一组服用混合蛋白质来源的标准补充剂（高热量和正常高蛋白）。在基线和3个月后，通过人体测量、生物电阻抗分析、人工智能辅助肌肉超声和握力评估营养状况。结果：共纳入142例患者（76例亮氨酸- ons， 66例标准- ons），大多数为女性（65.5%），平均年龄62.00（18.66）岁。90.1%存在营养不良，34.5%存在肌肉减少症。癌症是最常见的疾病（30.3%）。亮氨酸- ons组相位角改善更大(+2.08% vs -1.57%；P =0.02)和股直肌厚度(+1.72% vs -5.89%；p = 0.03)。多因素分析证实亮氨酸- ons与改善相角相关(OR=2.41；95%置信区间:1.18—-4.92;p=0.02)，肌内脂肪减少(OR=2.24；95%置信区间:1.13—-4.46;p = 0.02)。结论：与标准ONS相比，富含亮氨酸的ONS可显著改善相角和肌肉厚度，支持其在营养不良患者中增强身体成分的作用。这些结果必须在研究的观察设计、对照组的异质性和干预时间短的背景下解释。需要进一步的随机对照试验来证实这些结果并评估长期临床和功能结果。

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

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.