Clinical nutrition ESPEN最新文献

{"title":"Full Title: The effect-modification role of folic acid supplementation on the association between fine particulate matter exposure and risk of full-term low birth weight.","authors":"Weiye Wang, Sisi Hu, Xing Wang, Zhong Zhang","doi":"10.1016/j.clnesp.2025.09.029","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.09.029","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the association between fine particulate matter (PM_2.5) exposure during pregnancy and risk of full-term low birth weight (FT-LBW), and to explore the effect modification of folic acid (FA) supplementation on this association.</p><p><strong>Methods: </strong>This case-control study included 515 cases of FT-LBW and 1,030 controls from Jiujiang City, China, from January 2024 to June 2025. PM_2.5 exposure level during pregnancy was determined using the land use regression model, and details on FA supplementation within the 3 months before pregnancy were collected using questionnaires. Multivariate logistic regression was used to analyze the association between PM_2.5 exposure and the risk of FT-LBW, and the effect modification of FA supplementation was examined using subgroup analysis.</p><p><strong>Results: </strong>For every 10 μg/m³ increase in PM_2.5 exposure during pregnancy, the risk of FT-LBW increased by 8% (95% CI: 1.02-1.14, p=0.004). Subgroup analysis showed that in the lowest quartile of FA supplementation, for every 10 μg/m³ increase in PM_2.5 exposure, the risk of FT-LBW increased by 13% (95% CI: 1.01-1.26, p=0.031); no significant association was observed in the medium and high FA-supplementation groups.</p><p><strong>Conclusions: </strong>PM_2.5 exposure during pregnancy is positively associated with the risk of FT-LBW. FA supplementation has an effect modification on this association, and its risk is significantly increased only in the population with insufficient FA supplementation.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211854","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":"Age and sex but not disease activity or duration are associated with muscle mass in paediatric Crohn's disease.","authors":"Bayan Aljilani, Kaung Yan, Iyad Naim, Ana-Maria Darie, Mustafa Agbna, Muhammad H K Bahrin, Kostas Tsintzas, Gordon W Moran","doi":"10.1016/j.clnesp.2025.09.025","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.09.025","url":null,"abstract":"<p><strong>Background: </strong>There is evidence of low muscle mass in adults with active Crohn's disease (CD) compared to patients in remission, but this has not been explored in paediatric CD.</p><p><strong>Aim: </strong>To assess the psoas muscle cross sectional area (PCSA) measured using magnetic resonance enterography (MRE) in paediatric CD patients and compare this between those with active or inactive disease.</p><p><strong>Design: </strong>Paediatric CD patients who underwent MRE during 2016 to 2023 were included. Muscle mass was measured as PCSA at the right and left area of psoas muscle at the upper level of Lumbar 3 (L3) vertebra. Disease activity was defined by a clinical radiologist based on MRE images. Bivariable regression was used to explore unadjusted relationships, whereas a multiple linear regression model was constructed to adjust for potential confounders (disease activity, sex, age at MRE, disease duration, and current biologic use).</p><p><strong>Results: </strong>107 patients with CD (57.9% males) aged 13.0 (11.0, 15.0) [median (interquartile range)] were included. Most patients (64.5%) had active disease and the median disease duration for the whole cohort was 0.97 (0.49, 3.07) years. There was no difference in PCSA between patients with active or inactive disease [25.06 (19.51, 33.99) and 26.51 (20.62, 36.99) cm², respectively]. After adjusting for all covariates, the multivariable model identified sex and age at MRE as significant predictors of PCSA. Males had a 6.72 cm² (-11.19, -2.25cm²; p=0.004) higher PCSA compared to females. For every 1-year increase in age, PCSA increased by 2.92 cm² (2.04, 3.81; p<0.001), adjusting for other covariates. Disease activity (p= 0.22), disease duration (p= 0.49) and current biologic use (p= 0.94) did not show significant associations with PCSA.</p><p><strong>Conclusion: </strong>Age and sex but not disease activity or duration are significantly associated with muscle mass as measured by PCSA in paediatric CD.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191343","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 of Muscle Mass, Muscle Quality, and Function with Mortality in Community-Dwelling Older Adults: Focus on Segmental Phase Angle and Extracellular to Intracellular Water Ratio.","authors":"Yujiro Asano, Kenji Tsunoda, Koki Nagata, Namhoon Lim, Taishi Tsuji, Kyohei Shibuya, Tomohiro Okura","doi":"10.1016/j.clnesp.2025.09.022","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.09.022","url":null,"abstract":"<p><strong>Background & aims: </strong>We investigated the prospective association between muscle quality indicators-phase angle (PhA) and the extracellular to intracellular water (ECW/ICW) ratio-and all-cause mortality in community-dwelling older adults over a 12-year period by comparing them with traditional body composition and performing physical function tests.</p><p><strong>Methods: </strong>This longitudinal study included a total of 868 older adults aged ≥65 years who underwent examinations from 2011 to 2019, and mortality data were monitored through to 2023 using the city's municipal database. Body composition was measured using multi-frequency bioelectrical impedance analysis to assess whole-body and leg PhA, ECW/ICW resistance ratio (muscle quality), appendicular lean muscle mass index (ALMI), leg SMI, and fat mass percentage (fat%) (body quantity). Physical function was evaluated using hand grip strength, a 5-m habitual walk (5-m walk), and a 5-repetition sit-to-stand test (chair stand). We performed Cox regression analysis to examine the prospective association of bioelectrical impedance analysis (BIA) and physical function variables with all-cause mortality and applied restricted cubic splines to reveal the dose-response relationship between them.</p><p><strong>Results: </strong>The adjusted Cox model showed significant associations between lower leg PhA (hazard ratio [HR] 0.79, 95% confidence interval [CI] 0.64-0.97), leg ECW/ICW resistance ratio (HR: 0.79, 95% CI: 0.64-0.98), slower 5-m walk (HR: 0.83, 95% CI: 0.60-0.95), and fewer chair stands (HR: 0.87, 95% CI: 0.76-0.999) and mortality (z-scores obtained for all dependent variables and good values set to positive). A dose-response relationship indicated a higher risk for individuals with values below the median in restricted cubic splines. No associations were found between ALMI, fat%, hand grip strength, and mortality.</p><p><strong>Conclusion: </strong>Muscle quality, particularly leg PhA and ECW/ICW ratio, are key predictors of mortality in community-dwelling older adults.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191376","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 of diabetes with sarcopenia in patients on hemodialysis: a nationwide cross-sectional study in Portugal.","authors":"Marvery P Duarte, Pedro Martins, Diogo V Leal, Otávio T Nóbrega, Heitor S Ribeiro, João L Viana","doi":"10.1016/j.clnesp.2025.09.023","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.09.023","url":null,"abstract":"<p><strong>Background & aims: </strong>Diabetes mellitus is a leading cause of chronic kidney disease and has been linked to an increased risk of sarcopenia. However, evidence on the bidirectional relationships between these conditions remains inconclusive among patients on hemodialysis. This study aimed to investigate the association between diabetes and sarcopenia in this population.</p><p><strong>Methods: </strong>This cross-sectional analysis used data from a nationwide cohort study conducted across 20 dialysis clinics in Portugal. Sarcopenia was diagnosed based on the revised European Working Group on Sarcopenia in Older People (EWGSOP2) criteria, and diabetes was defined using the American Diabetes Association guidelines.</p><p><strong>Results: </strong>A total of 715 patients were included (median age: 63 years; 37% female). The prevalence of sarcopenia and diabetes was 16% and 27%, respectively. Sarcopenia was more than twice as common in patients with diabetes (27% vs. 12%, P < 0.001), who also exhibited poorer functionality (all P < 0.001). Adjusted multinomial logistic regression revealed an independent association between diabetes and confirmed sarcopenia (adjusted odds ratio [aOR] 2.41; 95% confidence interval [95% CI], 1.41-4.11). Subgroup analysis showed that this association was specifically observed in males (aOR: 2.64; 95% CI, 1.37-5.09).</p><p><strong>Conclusions: </strong>In this nationwide cross-sectional and study, diabetes mellitus was independently associated with sarcopenia and its related traits in patients on hemodialysis. Notably, this association was specifically in males, suggesting a potential sex-related difference. These findings highlight the importance of early diabetes detection and the implementation of multidisciplinary strategies to mitigate adverse effects on physical function and muscle mass at a high-risk population.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191295","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":"Implementation and challenges of prehabilitation in gastrointestinal oncology: a national cross-sectional survey in France.","authors":"Eva Ester Molina Beltran, Nora Dollet Nedellec, Marc Hilmi, Matthieu Delaye, Bruno Raynard, Sandrine Hiret, Damien Vansteene, Florence Carrouel, Claude Dussart, Cindy Neuzillet","doi":"10.1016/j.clnesp.2025.09.018","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.09.018","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the implementation, structure, and challenges of multimodal prehabilitation programs in gastrointestinal (GI) oncology across France, in a context where evidence supports its benefits but national standardization is lacking.</p><p><strong>Methods: </strong>A national cross-sectional survey was conducted from April to July 2024. The 54-item questionnaire, developed by a multidisciplinary group, assessed team demographics, patient selection, intervention modalities, pathway coordination, and barriers to implementation. Descriptive statistics were used for data analysis.</p><p><strong>Results: </strong>Among 92 respondent teams, 19 (20.7%) reported having a structured prehabilitation pathway. Most included nutritional (94.7%) and physical activity (74%) interventions, while only 5.3% provided systematic psychological support. Program eligibility was generally based on nutritional risk, surgical magnitude, and patient frailty, but varied widely. Prehabilitation was most often coordinated by surgeons (40%) and dietitians (78.9%), and typically delivered in day-hospital settings. Key challenges included insufficient human resources (60%), coordination issues (49%), and funding limitations (35%). Despite these barriers, perceived utility and satisfaction with prehabilitation programs were high (median scores of 8/10 and 8.6/10, respectively).</p><p><strong>Conclusion: </strong>Prehabilitation in GI oncology is emerging but remains inconsistently applied across France. To scale these interventions equitably and effectively, national guidelines, enhanced coordination and institutional support are essential. Integration with existing perioperative pathways like ERAS and increased psychological support are also needed to improve patient outcomes. Only one center in our sample offered systematic psychological support.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184692","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":"Phase Angle as a prognostic factor of survival in patients with metastatic prostate cancer.","authors":"Tanya Cauz-Valero, Ema Elvira Herrera-López, Anna Scavuzzo, Ivan Calvo-Vázquez, Andrey Ramírez-González, Alonso Hurtado-Vázquez, Nancy Reynoso-Noverón, Dana Aline Pérez-Camargo, Miguel Ángel Jímenez-Ríos","doi":"10.1016/j.clnesp.2025.09.028","DOIUrl":"https://doi.org/10.1016/j.clnesp.2025.09.028","url":null,"abstract":"<p><strong>Background & aims: </strong>Phase angle (PA), derived from bioelectrical impedance analysis (BIA), is a non-invasive marker of cellular integrity and nutritional status. While its prognostic value has been demonstrated in various malignancies, evidence in metastatic prostate cancer (mPCa) is scarce. This study aimed to evaluate the association between PA and overall survival (OS) in patients with mPCa receiving androgen deprivation therapy (ADT).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including 103 patients with confirmed mPCa undergoing ADT. PA was measured using multi-frequency BIA and patients were categorized into two groups: PA ≤ 4.0° and PA > 4.0°. Clinical, anthropometric, and body composition data were collected. OS was estimated using Kaplan-Meier analysis, and Cox proportional hazards models were used to assess the association between PA and mortality.</p><p><strong>Results: </strong>Patients with PA ≤ 4.0° (n = 24; 23.3%) had significantly lower fat-free mass and higher fat mass percentage compared to those with PA > 4.0° (n = 79; 76.7%). A significantly higher proportion of patients with PA ≤ 4.0° experienced disease progression (79.2% vs. 45.6%, p = 0.004). Kaplan-Meier analysis showed reduced survival in the low PA group (Log-rank p = 0.0043). In multivariate Cox regression, PA ≤ 4.0° was independently associated with higher mortality risk (HR: 4.603; 95% CI: 1.653-12.817; p = 0.003).</p><p><strong>Conclusions: </strong>Low phase angle is independently associated with reduced survival in men with mPCa undergoing ADT. PA may serve as a reliable, low-cost biomarker for risk stratification and nutritional assessment in this population.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174064","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":"Distinct determinants of systolic and diastolic blood pressure in obese children: A multivariate cluster analysis.","authors":"Sevde Kahraman, Yusuf Celik, Serra Gonce, Cagla Kara, Ayse Altuntop, Hatice Iktimur, Fatma Celik","doi":"10.1016/j.clnesp.2025.09.024","DOIUrl":"10.1016/j.clnesp.2025.09.024","url":null,"abstract":"<p><strong>Background & aims: </strong>This study evaluated the nutritional status and blood pressure of obese children aged 6-15 using multivariate cluster analysis to reveal distinct risk patterns for systolic and diastolic hypertension.</p><p><strong>Methods: </strong>A total of 240 obese children were assessed using anthropometric measurements, 24-h dietary recalls, Mediterranean dietary adherence scale (KIDMED) scores, and blood pressure values. Multivariate cluster analysis, which evaluates all variables collectively, was used to detect interrelated subgroups.</p><p><strong>Results: </strong>The study included 240 obese children (mean age 11.3 ± 2.2 years; 51.7 % female). Mean systolic and diastolic blood pressure values were 114.1 ± 13.1 and 69.8 ± 12.0 mmHg, respectively. Among children aged 13-15 years, 17.9 % had elevated systolic and 23.9 % had elevated diastolic blood pressure. The mean KIDMED score was 7.1 ± 3.0, with 46.3 % showing optimal adherence to the Mediterranean diet. Average daily intake was 2132 ± 502 kcal, 206.5 ± 74.5 g carbohydrates, 85.4 ± 14.3 g protein, and 110.3 ± 23.4 g fat. Cluster analysis revealed that systolic blood pressure clustered with BMI, waist and neck circumferences, while diastolic blood pressure was associated with protein intake and sleep duration.</p><p><strong>Conclusion: </strong>Multivariate cluster analysis enabled a whole-system view, identifying tailored clinical targets. By differentiating the factors affecting systolic and diastolic pressure, this approach offers a new perspective for personalized interventions in obese children.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"182-187"},"PeriodicalIF":2.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174039","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":"The impact of malnutrition and associated nutritional deficiencies on mortality in older adults","authors":"Elifnur Aydın ,&nbsp;Müberra Tanrıverdi ,&nbsp;Ozge Pasin ,&nbsp;Cihan Heybeli ,&nbsp;Damla Aslan Kirazoglu ,&nbsp;Laurent Boyer ,&nbsp;Masoud Rahmati ,&nbsp;Pinar Soysal","doi":"10.1016/j.clnesp.2025.09.026","DOIUrl":"10.1016/j.clnesp.2025.09.026","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>This study aimed to evaluate the effects of various nutritional indicators, including undernutrition, malnutrition risk, malnutrition, weight loss, comorbidities, appetite loss, dysphagia, and deficiencies of vitamin B12, folate, and vitamin D, on mortality in older patients.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analyzed data from 1911 older outpatients (mean age: 81.0 ± 13.0 years, 70.8 % female). For each patient, age, sex, education level, and comorbid diseases were recorded. Patients with two or more comorbid diseases were classified as having multimorbidity. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), dysphagia was measured using Eating Assessment Tool-10 (EAT-10), and appetite loss was evaluated with Council on Nutrition Appetite Questionnaire (CNAQ). Patients or caregivers reported weight loss over the past three months. Vitamin B12, vitamin D, and folate deficiencies were defined as &lt;200 pg/ml, &lt;30 ng/ml, and &lt;3 ng/ml, respectively.</div></div><div><h3>Results</h3><div>After a median follow-up of 71.61 months, 413 patients (21.4 %) had died. After adjusting for age, sex, and multimorbidity, multivariate hazard ratio analysis showed a significant correlation with mortality (p &lt; 0.001) for malnutrition (HR: 4.40), undernutrition (HR: 2.86), weight loss ≥3 kg (HR: 2.45), malnutrition risk (HR: 2.13), dysphagia (HR: 1.71), loss of appetite (HR: 1.62), and vitamin D deficiency (HR: 1.62). Multicollinearity and multivariate hazard ratio after adjusted for all confounders, only malnutrition retained statistical significance (HR: 2.10).</div></div><div><h3>Conclusions</h3><div>Malnutrition, risk of malnutrition and undernutrition, ≥3 kg weight loss (using a question derived from the MNA), dysphagia, loss of appetite, and vitamin D deficiency highlight the critical role of nutritional status, these should be considered in the clinic. No significant association was found with weight loss (&lt;3 kg), vitamin B12, and folate deficiency.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 174-181"},"PeriodicalIF":2.6,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174042","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":"Computed tomography radiomic analysis of paraspinal muscles in the prognosis of advanced head and neck cancers","authors":"Rémi Thomas-Monier ,&nbsp;Alexane Lere ,&nbsp;Bruno Pereira ,&nbsp;Julian Biau ,&nbsp;Maureen Bernadach ,&nbsp;Lucie Cassagnes ,&nbsp;Nicolas Saroul ,&nbsp;Benoît Magnin","doi":"10.1016/j.clnesp.2025.09.020","DOIUrl":"10.1016/j.clnesp.2025.09.020","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Sarcopenia is a well-recognized risk factor for adverse outcomes in neoplastic diseases, and body composition assessment using computed tomography is a standard method for its evaluation. Radiomics, an automated and quantitative image-analysis approach that has demonstrated prognostic value in various clinical contexts, has not yet been applied to the assessment of axial musculature for outcome prediction in head and neck cancers. The primary aim of this study was to investigate whether radiomic analysis of the paravertebral muscles on computed tomography imaging could improve survival prediction in patients with locally advanced head and neck cancer.</div></div><div><h3>Methods</h3><div>We retrospectively included 71 patients with locally advanced head and neck cancer who received induction chemotherapy at our institution. Radiomic features were extracted following manual segmentation of the paravertebral muscles at the L1 level on computed tomography scan. Only features that were unaffected by the timing of contrast injection and demonstrated high intra-observer reproducibility were retained for analysis. Associations between these radiomic features and survival were assessed using univariate and multivariate Cox proportional hazards regression. Relationships with treatment toxicity and therapeutic response were evaluated using either Student's t-test or the Mann–Whitney test, as appropriate, and multivariate logistic regression.</div></div><div><h3>Results</h3><div>A total of 21 radiomic parameters were retained for analysis. In the multivariate analysis, none of these parameters were significantly associated with survival. However, the ability to maintain oral feeding at diagnosis and one histogram-based radiomic feature - the sum of Hounsfield unit values after discretization - emerged as the most promising predictors. After binarization of this histogram feature, both variables were significantly associated with survival, stratifying the cohort into four groups with distinct survival outcomes (p &lt; 0.001). None of the radiomic parameters demonstrated a significant association with treatment-related toxicity in the multivariate analysis. Nevertheless, the CT subcutaneous fat index and the second-order radiomic feature GLRLM SRE exhibited a trend toward being risk factors for toxicity.</div></div><div><h3>Conclusions</h3><div>No parameter, including radiomic features, was able to statistically and independently demonstrate prognostic value for locally advanced head and neck cancers. However, a radiomic feature, the sum of Hounsfield unit value after discretization, when used in conjunction with Computed Tomography body composition parameters and clinico biological nutritional parameters could help predict survival.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 146-156"},"PeriodicalIF":2.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147887","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 creatinine and cystatin C-based index is a prognostic factor in patients with nonmetastatic breast cancer after surgery","authors":"Ruoyu Wang ,&nbsp;Zhe Wang ,&nbsp;Yiou Wang ,&nbsp;Jianing Jiang ,&nbsp;Jinming Zhu ,&nbsp;Simiao Tian","doi":"10.1016/j.clnesp.2025.09.019","DOIUrl":"10.1016/j.clnesp.2025.09.019","url":null,"abstract":"<div><h3>Background</h3><div>Sarcopenia is an important prognostic factor of breast cancer (BC). The serum creatinine/cystatin C ratio (CCR) and the serum creatinine × cystatin C-based glomerular filtration rate (SCr × eGFR_cys) index are novel screening tools for sarcopenia; but to date, has not been studied in Chinese patients with BC. We aimed to explore and investigate their prognostic values for overall survival (OS) and recurrence-free survival (RFS) in patients with BC undergoing surgery.</div></div><div><h3>Methods</h3><div>This cohort study Chinese women who were diagnosed with primary nonmetastatic BC (T1-4N0-3M0) and underwent surgery at our Hospital between January 2011 and December 2017. Preoperative laboratory data, clinicopathological feature and postoperative adjuvant treatment details were collected from medical records. Patients were divided into SCr × eGFR_cys index or CCR quartiles. Kaplan–Meier survival was performed to estimate rate difference of outcomes of interest for each quartile of these two indices, and cox regression analyses were used examine their associations, respectively. The cutoff value of the SCr × eGFR_cys index was determined using receiver operating characteristic curves.</div></div><div><h3>Results</h3><div>Among 697 nonmetastatic BC women included in total, 6.6 % (46/697) of death and 60 (8.61 %) recurrence occurred after a median follow-up of 76 months (interquartile range, 67–88 months). Kaplan–Meier analysis showed significant differences in OS rates for SCr × eGFR_cys index quartiles (log-rank <em>P</em> = 0.031), but not for CCR quartiles (log-rank <em>P</em> = 0.27). The higher SCr × eGFR_cys index quartiles was an independent prognostic factor for OS in multivariate analysis, with a decreased mortality risk (hazard ratio [HR], 0.29; 95 % confidence interval, 0.09–0.92 when the 4th SI quartile vs. the lowest) after adjusting for preoperative clinicopathological features, but the significant association was not found with CCR quartiles. Furthermore, subgroup analysis revealed that the prognostic ability of SCr × eGFR_cys index was only held in patients with low prognostic nutritional index, early TNM stage, normal-weight, and those without chemoradiotherapy.</div></div><div><h3>Conclusions</h3><div>Higher SCr × eGFR_cys index is associated with a favourable long-term prognosis of BC, and SCr × eGFR_cys index may be considered as pragmatic biomarker for clinicians when managing patients with BC in daily clinical practice.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 119-128"},"PeriodicalIF":2.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147906","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}