Clinical nutrition ESPEN最新文献

{"title":"Excess energy intake causally increases the blood pressure and hypertension risk: A Two Sample Mendelian Randomization Analysis.","authors":"Farshad Teymoori, Mahdi Akbarzadeh, Niloufar Saber, Mitra Kazemi Jahromi, Danial Habibi, Hossein Farhadnejad, Maryam Zarkesh, Parvin Mirmiran, Mohammadreza Vafa, Maryam S Daneshpour","doi":"10.1016/j.clnesp.2025.10.001","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.10.001","url":null,"abstract":"<p><strong>Background: </strong>/Aim: The impact of excess energy intake on blood pressure(BP) and hypertension(HTN) has not been extensively studied. This study aimed to evaluate the causal link between energy intake and systolic and diastolic BP(SBP and DBP) and HTN, using a Mendelian randomization(MR) approach.</p><p><strong>Methods: </strong>We conducted an MR analysis using summary statistics from large-scale genome-wide association studies(GWAS) datasets of European ancestry. Several MR methods were applied, including inverse-variance weighted(IVW), weighted median and mode, and MR-Egger regression. Genetic variants associated with energy intake were obtained from a published GWAS of the UK Biobank(N=64,979). GWAS datasets for SBP, DBP, and HTN included 436,419; 436,424; and 361,194 individuals (1,237 cases and 359,957 controls), respectively, all from the UK Biobank. Effect estimates were reported as beta coefficients(β) with 95% confidence intervals(CIs) for continuous outcomes and odds ratios(ORs) with 95% CIs for binary outcomes.</p><p><strong>Results: </strong>The IVW analyses indicated that each SD increase in energy intake was causally associated with one SD increase in SBP(β=0.093,95%CI:0.027-0.160,P=0.006) and DBP(β=0.070,95%CI:0.014-0.126,P=0.014), based on 10 and 8 included SNPs, respectively. These significant associations were confirmed by the weighted median MR method for SBP(β=0.096,95%CI:0.032-0.169,P=0.012) and DBP(β=0.077,95%CI:0.006-0.148,P=0.044). Furthermore, a causal relationship between energy intake and HTN was observed using the IVW(OR=1.004,95%CI:1.002-1.006,P=0.012) and the MR Egger method(OR=1.012,95%CI:1.004-1.020,P=0.045), based on 9 included SNPs. No evidence of weak instrument bias, heterogeneity, or horizontal pleiotropy was detected. The significant findings were consistent across most applied MR methods.</p><p><strong>Conclusions: </strong>Our findings support a direct causal relationship between excess energy intake and both BP and HTN.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between handgrip strength and mortality in individuals undergoing hemodialysis: A retrospective cohort study.","authors":"Leticia de Paiva Souza Klippel, Cleodice Alves Martins, Karen Dos Santos Barbosa, Larissa Vitória Batista Leandro, Monica Cattafesta, Alexandre Cardoso da Cunha, Ana Cristina de Oliveira Soares, Camila Bruneli do Prado, Júlia Rabelo Santos Ferreira, Fernanda Zobole Peterle, Juliana Almeida-de-Souza, Fabiano Kenji Haraguchi, Elane Viana Hortegal Furtado, Edson Theodoro Dos Santos Neto, Luciane Bresciani Salaroli","doi":"10.1016/j.clnesp.2025.09.034","DOIUrl":"10.1016/j.clnesp.2025.09.034","url":null,"abstract":"<p><strong>Background and objectives: </strong>Handgrip strength offers a valuable method to detect changes and reduced muscle strength and frailty and can help improve prognosis by early diagnosis. Therefore, the aim of the study was to evaluate the association between reduced muscle strength and mortality in individuals undergoing hemodialysis.</p><p><strong>Methods: </strong>Retrospective cohort study with 994 individuals. Sociodemographic, clinical, and lifestyle variables were obtained from a 2019 study. Mortality data were sourced from death certificates recorded from 2019 to 2022 in the Mortality Information System. Muscle strength was classified based on the following cut-off values: <27 kg for men and <16 kg for women. Survival curves were constructed using the Kaplan-Meier method and Cox Regression was used to evaluate the effect of handgrip strength and age on the time.</p><p><strong>Results: </strong>More than 65 % of individuals in the sample show depleted strength, most of which were older adults (43.25 %, p < 0.001) and men (41.32 %, p = 0.008). Older adults with depleted strength showed a significantly higher number of observed deaths than expected ones (p < 0.001). After adjustment, HGS remained a significant predictor, associated with a 49 % increased risk of death (95 % CI: 1.16-1.91, p = 0.002). Having more than 11 years of formal education demonstrated a protective effect, reducing the risk of death by 1.6 times (95 % CI: 0.41-0.88, p = 0.009). Diabetes was found to be associated with almost a twofold increase in the risk of mortality (95 % CI: 1.54-2.49, p < 0.001).</p><p><strong>Conclusions: </strong>The decrease in handgrip strength predicts mortality in individuals undergoing hemodialysis with the risk being higher among older adults, those with diabetes and individuals with fewer than 11 years of education.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"249-255"},"PeriodicalIF":2.6,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Albumin-myosteatosis gauge as a prognostic factor and its relationships with bioimpedancemetry in patients with colorectal-cancer.","authors":"Daniel de Luis, David Primo, Olatz Izaola, Israel Sánchez Lite, Juan José López Gómez","doi":"10.1016/j.clnesp.2025.09.032","DOIUrl":"10.1016/j.clnesp.2025.09.032","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to evaluate the prognostic value of albumin-myosteatosis gauge (AMG) in Caucasian patients with non-metastatic colorectal cancer and to relate AMG with classic bioimpedancemetry (BIA) parameters.</p><p><strong>Material and methods: </strong>This study involved 130 Caucasian patients diagnosed with non-metastasic colorectal cancer. CT scans were analysed at the L3 vertebral level to determine the cross-sectional area of skeletal muscle, skeletal muscle index (SMI), skeletal muscle density(SMD). Bioelectrical impedance analysis (BIA) was employed. Albumin and prealbumin were measured. The albumin-myosteatosis gauge (AMG) was calculated: serum albumin (g/dL) × skeletal muscle density (SMD) in Hounsfield Units (HU).</p><p><strong>Results: </strong>The median age was 69.7 ± 9.7 years, with a range of 57-90 years. Patients with AMG values below the median had significantly reduced serum albumin levels, L3-SMI, SMD, SMI-BIA and phase angle. The patients who died during the follow-up of these 5 years had lower levels of serum albumin, body weight, BMI, SMD, phase angle, reactance, AMG and a higher percentage of low muscle mass according to CT and hospital readmissions. The AMG values were negatively correlated with age and positively with albumin, SMD, L3-SMI, phase angle and reactance. Significant differences in 5-year survival between the AMG groups (low median AMG vs High median AMG) (HR 3.83, IC95 % = 1.10-13.42 and the SMD groups (HR 3.57, IC95 % = 1.01-12.58) were observed. AMG was identified as an independent prognostic factor for survival (HR 4.83, 95%CI = 1.21-19.17) CONCLUSION: AMG may function as an independent prognostic marker in Caucasian patients with non-metastatic CRC.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"281-288"},"PeriodicalIF":2.6,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D blood levels and vitamin D receptor polymorphisms contribute to post-acute sequelae of severe acute respiratory syndrome coronavirus 2 severity in the pediatric patients.","authors":"Pei-Chi Chen, Yu-Lung Hsu, Yen-Hsi Chen, Chih-Yu Lin, Miao-Hsi Hsieh, Hui-Ju Tsai, Wen-Shuo Kuo, Hui-Fang Kao, Shulhn-Der Wang, Yu-Shan Ho, Cheng-Ye Cai, Lawrence Shih-Hsin Wu, Jiu-Yao Wang","doi":"10.1016/j.clnesp.2025.09.033","DOIUrl":"10.1016/j.clnesp.2025.09.033","url":null,"abstract":"<p><strong>Background and aims: </strong>Vitamin D, through the vitamin D receptor (VDR), modulates immune responses and may reduce inflammation linked to prolonged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) symptoms. While vitamin D deficiency is tied to severe Coronavirus disease 2019 (COVID-19) outcomes, its role in post-acute sequelae of SARS-CoV-2 (PASC) is unclear. This study examines the relationship between PASC severity in children and their vitamin D levels or VDR genetic variants.</p><p><strong>Methods: </strong>Children with persistent and prolonged symptoms following SARS-CoV-2 infection were recruited from a hospital. A detailed questionnaire was administered, and blood samples were collected for comprehensive biomedical test. Deoxyribonucleic acid (DNA) from peripheral blood mononuclear cells (PBMCs) of the enrolled patients was extracted for genotyping of VDR genetic variants. The effects of vitamin D levels and VDR genetic variants on PASC severity were analyzed.</p><p><strong>Results: </strong>A total of 123 patients were enrolled in the study, with 90 completing the PASC severity survey and 109 providing results from biomedical tests. Vitamin D levels showed a significant negative correlation with PASC scores (p = 0.0052). There was a significant positive correlation (p < 0.05) between vitamin D levels and both lactate dehydrogenase (LDH) and aspartate amino transferase (AST), while neutrophils, lymphocytes, and eosinophils demonstrated a significant negative correlation (p < 0.05) with vitamin D levels. Patients with the GG genotype of the VDR genetic variant rs2228570 had lower PASC scores compared to those with the AA or AG genotypes. The highest PASC scores were observed in patients with 25-hydroxyvitamin D [25(OH)D] levels <20 ng/ml and the AA/AG genotype.</p><p><strong>Conclusions: </strong>Both vitamin D levels and VDR genetic variants contribute to the severity of PASC in children, with a combined additive effect on the condition's severity.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"303-308"},"PeriodicalIF":2.6,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional status and new onset of chronic kidney disease.","authors":"Atsuya Sato, Kenichi Tanaka, Hiroshi Kimura, Hirotaka Saito, Michio Shimabukuro, Koichi Asahi, Tsuyoshi Watanabe, Junichiro James Kazama","doi":"10.1016/j.clnesp.2025.09.035","DOIUrl":"10.1016/j.clnesp.2025.09.035","url":null,"abstract":"<p><strong>Background and aims: </strong>Malnutrition is associated with adverse outcomes across various populations, but its role in the development of chronic kidney disease (CKD) remains unclear. Our study evaluated relationship between nutritional status and CKD development in patients with CKD risk factors.</p><p><strong>Methods: </strong>A total of 1,046 adults with one or more CKD risk factors, an estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m², and no proteinuria were examined to investigate the association between nutritional status and new-onset CKD using longitudinal data from the Fukushima Cohort Study. Nutritional status was assessed using the Prognostic Nutritional Index (PNI), the Geriatric Nutritional Risk Index (GNRI), and Controlling Nutritional Status (CONUT) score. Cox proportional hazards modeling was used to evaluate the association between nutritional status and CKD development. The predictive performance of each nutritional index was assessed using receiver operating characteristic curves.</p><p><strong>Results: </strong>During follow-up (median, 5.2 years), 325 participants developed CKD. Compared to the highest tertile, participants in the lowest tertile of the PNI showed a significantly increased risk of developing CKD (adjusted hazard ratio, 1.65; 95 % confidence interval, 1.21-2.24). Similar associations were observed for GNRI and CONUT scores in relation to CKD risk. Although the PNI showed a slightly higher AUC than the GNRI and CONUT score, the differences were small and not statistically significant.</p><p><strong>Conclusion: </strong>In this retrospective cohort study, poor nutritional status was associated with increased risk of CKD development in a high-risk population. Nutritional assessment using indices such as the PNI, GNRI, or CONUT score may help identify individuals at elevated risk for CKD, highlighting the potential role of nutritional interventions in CKD prevention. As all three indices showed comparable associations with CKD risk, each may be useful for risk stratification in clinical practice.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"274-280"},"PeriodicalIF":2.6,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Navigating complexity: The challenge of reaching consensus on the diagnosis of malnutrition in patients with obesity via a modified delphi study\" [Clin Nutr ESPEN 68 (2025) 591-601].","authors":"Natasha Nalucha Mwala, Jeanne J F A In 't Hulst, Barbara S van der Meij, Emmelyne Vasse, Jos W Borkent, Carliene van Dronkelaar, Patty L M Lakenman, Esmee M Reijnierse, Josje D Schoufour, Peter J M Weijs, Renate M Winkels, Maarten R Soeters, Marian A E de van der Schueren","doi":"10.1016/j.clnesp.2025.07.001","DOIUrl":"10.1016/j.clnesp.2025.07.001","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"822"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Provision of additional oral nutritional supplements to postgastrectomy patients based on regular diet intake to meet their energy requirements reduces body weight loss.","authors":"Hitoshi Harada, Shingo Kanaji, Moe Tsuboi, Saki Nakatani, Satoko Tabuchi, Ikuko Yamamoto, Yutaka Sugita, Taro Ikeda, Yasufumi Koterazawa, Tomoaki Aoki, Yasunori Otowa, Naoki Urakawa, Hironobu Goto, Hiroshi Hasegawa, Kimihiro Yamashita, Takeru Matsuda, Michiko Takahashi, Yoshihiro Kakeji","doi":"10.1016/j.clnesp.2025.07.015","DOIUrl":"10.1016/j.clnesp.2025.07.015","url":null,"abstract":"<p><strong>Background & aims: </strong>Oral nutritional supplements (ONS) administered after gastrectomies can prevent postoperative weight loss. However, the amount of additional energy to be added to energy requirements after gastrectomy is unclear. This study aimed to clarify dietary energy intake and its association with weight loss in postgastrectomy patients.</p><p><strong>Methods: </strong>We performed a single-center, single-arm, open-label, non-randomized clinical trial. Fifty patients with gastric cancer who underwent distal or total gastrectomy were included in this study. Until 3 months postoperatively, the patients continuously consumed ONS and their intake was recorded. Additionally, the patients took photos of their regular diets. Hospital visits were made every 2 weeks to investigate calorie intake (from regular diet plus ONS), physical findings, and nutritional status. The primary endpoint was the percentage of body weight loss (%BWL) at 3 months after gastrectomy.</p><p><strong>Results: </strong>Data were available for 45 patients. %BWL was 7.5 ± 5.1 % at 3 months postoperatively. The group with ONS intake <200 kcal/day tended to show a lower %BWL; however, this was not significant. No correlation was observed between ONS and regular dietary calorie intake. The required calorie intake was 1588 ± 157 kcal/day. Calorie intake from regular diet alone and from regular diet plus ONS were 1330 ± 280 and 1487 ± 300 kcal/day, respectively. The sufficient group, whose total calorie intake met the requirements, had significantly reduced body weight loss, compared with the insufficient group.</p><p><strong>Conclusions: </strong>After gastrectomy, regular diet alone often fails to meet nutritional requirements, and ONS supplementation may reduce %BWL at 3 months postoperatively by correcting energy deficits. This study was registered with the University Hospital Medical Information Network Clinical Trial Registry (UMIN-CTR; UMIN000047451; https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000054111).</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"449-457"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144616606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum reference intervals for essential and toxic trace elements in a healthy population: A basis for nutritional monitoring and clinical intervention","authors":"Inés Rivas ,&nbsp;Marta Miranda ,&nbsp;Carlos Herrero-Latorre ,&nbsp;Rafael Monte-Secades ,&nbsp;Marta López-Alonso","doi":"10.1016/j.clnesp.2025.09.031","DOIUrl":"10.1016/j.clnesp.2025.09.031","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Trace elements play a crucial role in human metabolism, and both deficiencies and toxic exposures can have significant clinical implications. This study aimed to establish clinically relevant reference intervals for essential and toxic trace elements in serum from a healthy adult population to support nutritional assessment and public health monitoring.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted in 501 healthy adults. Serum concentrations of essential [cobalt (Co), copper (Cu), iron (Fe), iodine (I), manganese (Mn), molybdenum (Mo), selenium (Se), zinc (Zn)] and toxic [(arsenic (As), cadmium (Cd), chromium (Cr), lead (Pb), mercury (Hg), nickel (Ni)] trace elements were measured using inductively coupled plasma mass spectrometry (ICP-MS). Reference intervals (2.5th–97.5th percentiles) were calculated following CLSI guidelines, and stratified analyses were performed based on sex and age.</div></div><div><h3>Results</h3><div>Reference intervals were established for each element, revealing significant sex-related differences. Women exhibited higher serum concentrations of Co, Cu, Mo, Cd, and Hg, and lower Fe compared to men. Age-related differences were also observed for several elements, with distinct sex-specific trends particularly for Cu and Hg. While serum levels of most essential elements were within expected physiological ranges, Se concentrations were suboptimal in a considerable proportion of the population, suggesting potential nutritional inadequacy. Toxic element levels remained generally low, indicative of minimal environmental exposure.</div></div><div><h3>Conclusions</h3><div>Essential trace element concentrations were generally adequate within the Northern Spain population, with the notable exception of Se, where a significant proportion exhibits low levels, suggesting a potential benefit from dietary supplementation or intervention. Toxic element concentrations were low corresponding to a basal level of environmental exposure; however, observed variations by age and sex highlight the importance of ongoing monitoring.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 227-239"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Examining commonalities and differences in food groups, nutrients, and diet quality among popular diets\" [Clin Nutr ESPEN 41 (2021) 377-385].","authors":"Gabrielle Turner-McGrievy, Michael D Wirth, Kathleen L Hill, Emma R Dear, James R Hébert","doi":"10.1016/j.clnesp.2025.06.032","DOIUrl":"10.1016/j.clnesp.2025.06.032","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"821"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival predictions of different arm circumference classifications in patients under intensive care.","authors":"Jorge Z Silva-Filho, Jarson P Costa-Pereira, Ivan K S Zapanta, Evi C L Brasil, Rodrigo L S Silva, Flávia M Silva","doi":"10.1016/j.clnesp.2025.07.1131","DOIUrl":"10.1016/j.clnesp.2025.07.1131","url":null,"abstract":"<p><strong>Background & aims: </strong>Mid-upper arm circumference (MUAC) is a simple anthropometric measure widely used as a marker of nutritional reserves, in the context of critical illness and other clinical conditions. Although MUAC can be classified using different approaches, few studies have investigated the prognostic value of these classifications in critically ill patients. In this study, we aimed to evaluate the ability of different MUAC classifications approaches to predict survival among patients admitted to the intensive care unit (ICU).</p><p><strong>Methods: </strong>This was a secondary analysis of a cohort study with prospective data collection. Adults of all ages admitted to a general ICU were included. MUAC was measured upon ICU admission and classified using four different approaches: two continuous and two categorical. Continuous measures included (1) absolute MUAC in centimeters (MUAC_cm) and (2) MUAC adequacy percentage (MUAC%), calculated using the 50th percentiles from Frisancho. Categorical classifications were (3) MUAC% based on Blackburn & Thornton criteria, categorized as low (<90 %), adequate (90-110 %), and excess (>110 %), and (4) using the Malnutrition Universal Screening Tool (MUST) cutoff, with low MUAC defined as <23.5 cm. Outcomes of interest were 28-day ICU mortality and in-hospital mortality.</p><p><strong>Results: </strong>A total of 426 patients were included (53.1 % male, median age: 64 years, interquartile range: 53 to 71). Metabolic disorders were the most common cause of ICU admission (49.5 %). Cox regression analysis using continuous variables showed that for each 1 cm decrease in MUAC, the risk of ICU mortality increased by 11 % (HR _adjusted 1.11, 95 % CI 1.01 to 1.20). Furthermore, for each 1 % decrease in MUAC, the risk of ICU mortality increased by 4 % (HR _adjusted 1.04, 95 % CI 1.01 to 1.06). Low MUAC according to the MUST classification was associated with a 3.73-fold increase in the hazard of 28-day ICU mortality and a 2.70-fold increase in the hazard of in-hospital mortality. No significant associations were observed using the Blackburn & Thornton classification.</p><p><strong>Conclusion: </strong>As a continuous variable, MUAC was an independent predictor of 28-day ICU mortality, but not of in-hospital mortality. In contrast, low MUAC classified according to the MUST criterion independently predicted both 28-day ICU and in-hospital mortality. No significant associations were observed using the Blackburn & Thornton classification. These findings highlight the prognostic utility of a simple anthropometric measure; however, they also suggest that different classification methods may yield distinct prognostic implications.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"428-434"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}