Clinical nutrition ESPEN最新文献

{"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}

{"title":"Novel surrogate markers of insulin resistance in patients with metabolic dysfunction-associated steatosis liver disease: Associations with dietary and lifestyle inflammatory scores in the large cross-sectional study","authors":"Yusuf Yilmaz ,&nbsp;Behrad Saeedian ,&nbsp;Nastaran Babajani ,&nbsp;Sara Ashtari ,&nbsp;Fereshteh Ghorat ,&nbsp;Ehsaneh Taheri","doi":"10.1016/j.clnesp.2025.09.021","DOIUrl":"10.1016/j.clnesp.2025.09.021","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a major global health challenge, with insulin resistance (IR) and inflammation being key pathophysiological drivers. Here, this study aimed to evaluate the associations between MASLD and novel IR markers, and to examine the interrelationships between dietary (DIS) and lifestyle (LIS) inflammatory scores and IR indices.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted among participants in the baseline phase of the Sabzevar Persian Cohort Study (SPCS). We studied 970 patients with MASLD and 961 age- and sex-matched controls. Eight distinct IR markers were assessed: triglyceride-glucose index (TyG), TyG-body mass index (TyG-BMI), TyG-waist circumference (TyG-WC), TyG-waist-to-height ratio (TyG-WHtR), triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-c), lipid accumulation product (LAP), visceral adiposity index (VAI), and metabolic score for insulin resistance (METS-IR). DIS was calculated from 19 dietary components, LIS from three lifestyle parameters, and a combined dietary and lifestyle inflammation score (DLIS) from both measures.</div></div><div><h3>Results</h3><div>Patients with MASLD exhibited higher adiposity measures and comorbidity rates than controls. TyG-BMI demonstrated the strongest association with MASLD (area under the curve [AUC]: 0.994), followed by TyG-WC (AUC: 0.993) and METS-IR (AUC: 0.989). TyG-BMI demonstrated the highest specificity (96.74 %), indicating its strong ability to correctly identify individuals without the disease (true negatives), thereby minimizing false positives. In contrast, TyG-WC showed the highest sensitivity (97.31 %), reflecting its excellent capacity to correctly detect individuals with the disease (true positives), thus reducing the likelihood of false negatives. LIS correlated most strongly with TyG-BMI (<em>r</em> = 0.811, <em>p</em> &lt; 0.001), whereas DLIS correlated best with METS-IR (<em>r</em> = 0.346, <em>p</em> &lt; 0.001). Canonical correlation analysis revealed significant relationships between inflammatory scores and IR indices (<em>r</em> = 0.835, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Among novel IR markers, TyG-BMI represented the most robust surrogate marker associated with the risk of having MASLD. The strong correlation between LIS and TyG-BMI suggested the potential significant association of lifestyle-related inflammation and IR in MASLD pathophysiology that needs to be investigated in future interventional studies.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 204-217"},"PeriodicalIF":2.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145147913","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":"Authors' reply to the letter to the editor: Comment on \"Addressing nutritional risk and dehydration in vulnerable older adults in the emergency department: A single-arm feasibility study on detection, treatment, and follow-up\".","authors":"M K Nielsen, E D M Pedersen, A W Knudsen, T Munk, A M Beck","doi":"10.1016/j.clnesp.2025.09.017","DOIUrl":"10.1016/j.clnesp.2025.09.017","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091283","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":"Letter to the Editor: Comment on \"Addressing nutritional risk and dehydration in vulnerable older adults in the emergency department: A single-arm feasibility study on detection, treatment, and follow-up\".","authors":"Shashank Dokania, Parth Aphale, Himanshu Shekhar","doi":"10.1016/j.clnesp.2025.09.013","DOIUrl":"10.1016/j.clnesp.2025.09.013","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085194","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":"Beyond safety: Reassessing autonomy, infection risk, and long-term value of multi-chamber parenteral nutrition in cancer care.","authors":"Schawanya K Rattanapitoon, Nav La, Chadaporn N Gordon, Nathkapach K Rattanapitoon","doi":"10.1016/j.clnesp.2025.09.015","DOIUrl":"10.1016/j.clnesp.2025.09.015","url":null,"abstract":"<p><p>We commend Goetze et al. for evaluating multi-chamber parenteral nutrition (PN) in solid tumor patients requiring home PN. Their study demonstrates improved patient autonomy and fewer PN-related adverse events, yet several limitations remain. First, the premature termination reduces statistical power, especially for infection outcomes. Second, autonomy was defined inclusively, counting family support as self-administration, which may overestimate practical independence. Third, the economic implications of higher upfront costs versus potential savings from fewer nursing visits and complications remain unclear. Finally, survival benefits were not demonstrated, underscoring the need to assess quality of life and patient-reported outcomes. Future trials should integrate cost-effectiveness and long-term endpoints to guide wider adoption.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085219","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":"Addressing malnutrition in cancer care: Where do postgraduate oncology students stand?","authors":"Lidia Santarpia ,&nbsp;Michela Zanetti ,&nbsp;Federico Bozzetti","doi":"10.1016/j.clnesp.2025.09.010","DOIUrl":"10.1016/j.clnesp.2025.09.010","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Disease-associated malnutrition and cachexia affect a high percentage (between 30 % and 80 %<strong>)</strong> of cancer patients; appropriate diagnosis and intervention can improve clinical outcomes. We investigated opinions and knowledge of oncology residents towards nutritional care in cancer patients.</div></div><div><h3>Methods</h3><div>Following mapping post-graduate schools in oncology, an invitation was sent to the directors with a link to be transferred to residents willing to participate to the survey anonymously. The survey consisted in a questionnaire including 42 questions related to nutrition in cancer patients exploring the didactic component, the clinical daily activities in the oncology department, attitude and cultural background.</div></div><div><h3>Results</h3><div>135 residents from 17 universities (54.8 % of total) completed the survey (49 responders were attending the 1st year, 26 the 2nd, 23 the 3rd, 30 the 4th and 7 the 5th or had just finished the specialty). Only 25.9 % of residents reported receiving specific lessons on clinical nutrition during their training, while malnutrition and sarcopenia were covered in 60 % and artificial nutrition in 48.9 %. Nutritional status assessment was routinely performed in 34.3 % of oncology departments, while in 63.5 % it was carried out only if the patient was already (or clearly) malnourished and in 2.2 % it was not performed at all. When performed, the assessment was conducted by oncologists in 53.7 % of cases, whereas 43.4 % relied on the nutritional team. Oral nutritional supplementation was prescribed by oncologists in 41.9 % of cases, and parenteral nutrition in 53 %.</div><div>However, significant gaps in residents' nutritional knowledge emerged: only 13.3 % of residents correctly answered more than 66 % of nutrition-related questions. A majority (84.5 %) achieved scores between 34 and 66 %, while 2.2 % scored below 33 %. Widespread misunderstanding was observed regarding key nutritional concepts such as routes of nutritional support, metabolic needs in cancer, and malnutrition criteria. Despite these deficiencies, nearly all participants (98.5 %) agreed on the importance of oncologists acquiring basic nutritional competencies.</div></div><div><h3>Conclusions</h3><div>The results of this survey indicate that malnutrition in cancer patients remains an undervalued clinical condition and the teaching of clinical nutrition in oncology residency programs remains inadequate and needs to be strengthened. These findings underscore the urgent need to integrate comprehensive nutritional education into oncology curricula and promote interdisciplinary collaboration to ensure early identification and management of malnutrition in cancer patients.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 59-68"},"PeriodicalIF":2.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079365","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":"Impact of L-carnitine supplementation on post-transplant outcomes in liver transplant candidates with sarcopenia: A randomized controlled open-label trial","authors":"Marwa Abd El-Razek Salama,&nbsp;Elham Ahmed Hassan,&nbsp;Nahed A. Makhlouf","doi":"10.1016/j.clnesp.2025.09.008","DOIUrl":"10.1016/j.clnesp.2025.09.008","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Sarcopenia, characterized by loss of skeletal muscle mass and strength, is a common complication of advanced liver disease and worsens post-transplant outcomes. While L-carnitine may improve muscle mass and function, its impact on sarcopenic liver transplant candidates remains unclear. We aimed to evaluate the impact of L-carnitine supplementation on clinical outcomes and mortality in sarcopenic patients following liver transplantation.</div></div><div><h3>Methods</h3><div>This randomized, controlled study included 53 HCV-related cirrhotic patients awaiting liver transplantation, divided into three groups: sarcopenia with L-carnitine (n = 18), sarcopenia without L-carnitine (n = 18), and non-sarcopenia (n = 17). Clinical, anthropometric, muscle mass, and biochemical parameters (secondary outcomes) were evaluated before and 6 months after transplantation, along with post-transplant mortality (primary outcome).</div></div><div><h3>Results</h3><div>Sarcopenic patients receiving L-carnitine showed significant post-transplant improvements in ascites, lower limb edema, anthropometric measures (TSF, MAC, handgrip), and biochemical markers (INR, albumin, bilirubin, platelets). Compared to patients without L-carnitine, the supplemented group achieved greater gains in muscle mass index (1 vs. 0 cm²/m²; <em>P</em> = 0.014), TSF (4 vs. −4 mm; <em>P</em> = 0.049), BMI (2 vs. −2 kg/m²; <em>P</em> = 0.026), and reductions in bilirubin (−15.2 vs. 20.5 mmol/L; <em>P</em> = 0.001). Mortality was significantly lower in the L-carnitine group (16.7 % vs. 55.6 %; <em>P</em> = 0.003), with survival rates comparable to non-sarcopenic patients.</div></div><div><h3>Conclusion</h3><div>L-carnitine supplementation in sarcopenic liver transplant candidates significantly improved post-transplant outcomes, muscle mass, and survival with mortality rates comparable to non-sarcopenic patients. These findings suggest a potential role of L-carnitine in optimizing pre-transplant care and enhancing post-transplant outcomes in this high-risk population.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 50-58"},"PeriodicalIF":2.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079378","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 dietary acid load and sarcopenia in patients with type 2 diabetes mellitus","authors":"Shinta Yamamoto ,&nbsp;Yoshitaka Hashimoto ,&nbsp;Fuyuko Takahashi ,&nbsp;Ryosuke Sakai ,&nbsp;Yuto Saijyo ,&nbsp;Chihiro Munekawa ,&nbsp;Hanako Nakajima ,&nbsp;Noriyuki Kitagawa ,&nbsp;Eriko Nakatani ,&nbsp;Takafumi Osaka ,&nbsp;Hiroshi Okada ,&nbsp;Naoko Nakanishi ,&nbsp;Saori Majima ,&nbsp;Emi Ushigome ,&nbsp;Masahide Hamaguchi ,&nbsp;Michiaki Fukui","doi":"10.1016/j.clnesp.2025.09.014","DOIUrl":"10.1016/j.clnesp.2025.09.014","url":null,"abstract":"<div><h3>Aim</h3><div>Sarcopenia is a common and serious complication in individuals with type 2 diabetes mellitus (T2DM). Dietary acid load has been linked to metabolic disturbances; however, its relationship with sarcopenia in T2DM remains unclear. This study aimed to investigate the associations of dietary acid load with sarcopenia in older adults with T2DM.</div></div><div><h3>Methods</h3><div>A cross-sectional analysis with aged ≥60 years was conducted. Sarcopenia was defined as both having low muscle strength, evaluated by handgrip strength, and low skeletal muscle mass index, evaluated by bioelectrical impedance analysis. Dietary acid load was evaluated by potential renal acid load (PRAL) and net endogenous acid production (NEAP). Multivariable linear and logistic regression models were used to evaluate associations with muscle mass, muscle strength, and sarcopenia.</div></div><div><h3>Results</h3><div>Among 298 older adults with T2DM (mean age 70.8 ± 6.0 years), sarcopenia was identified in 13.1 %. Multivariable regression analyses showed that both PRAL and NEAP were significantly associated with skeletal muscle mass index. Regarding muscle strength, NEAP remained significantly associated, while PRAL showed a similar but non-significant negative trend. Compared with lowest tertile, highest tertile of PRAL (odds ratio (OR) = 3.09, 95 % CI: 1.13–9.00; p for trend = 0.02) or NEAP (OR = 3.07, 95 % CI: 1.21–8.30; p for trend = 0.01) was associated with the presence of sarcopenia.</div></div><div><h3>Conclusion</h3><div>Higher dietary acid load is associated with sarcopenia among older individuals with T2DM.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"70 ","pages":"Pages 83-90"},"PeriodicalIF":2.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079441","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}