Clinical nutrition ESPEN最新文献

{"title":"Six-month trajectory of phase angle after cardiovascular surgery and associated factors of the recovery during cardiac rehabilitation: A retrospective cohort study","authors":"Kenichi Shibata ,&nbsp;Masataka Kameshima ,&nbsp;Takuji Adachi ,&nbsp;Hisako Kito ,&nbsp;Chikako Tanaka ,&nbsp;Taisei Sano ,&nbsp;Mizuki Tanaka ,&nbsp;Masayuki Ida ,&nbsp;Yoriyasu Suzuki ,&nbsp;Hideki Kitamura","doi":"10.1016/j.clnesp.2024.11.017","DOIUrl":"10.1016/j.clnesp.2024.11.017","url":null,"abstract":"<div><h3>Background and aims</h3><div>Although the phase angle (PhA), a measure of frailty and sarcopenia, determined by bioelectrical impedance analysis has been reported as a prognostic factor after cardiovascular surgery, few studies have reported the trajectory of the PhA after discharge. In this study, we examined the trajectory of the PhA along with conventional physical function measures and explored the factors associated with recovery for 6 months after hospital discharge in patients who had undergone cardiovascular surgery.</div></div><div><h3>Methods</h3><div>We included 116 patients who underwent elective cardiovascular surgery and cardiac rehabilitation after discharge. The PhA, physical function measures (grip strength, knee extension isometric muscle strength [KEIS], and usual gait speed), and Geriatric Nutritional Risk Index (GNRI) were assessed preoperatively, at discharge, and 3 and 6 months. Correlations between the PhA recovery rates and physical function and nutritional indices were assessed using Spearman's correlation analysis. Multivariate linear regression analysis was performed to examine the factors associated with recoveries of PhA and physical function indices (grip strength, KEIS, gait speed) after discharge.</div></div><div><h3>Results</h3><div>Mean values of the PhA and physical function measurements and the GNRI score at discharge were lower than the preoperative values (PhA, −8.0 %; grip strength, −8.7 %; KEIS, −6.9 %; usual gait speed, −8.3 %; GNRI, −11 %). The grip strength, KEIS, and gait speed recovered to almost preoperative values 3 months after discharge. Values for the PhA and GNRI were still lower than preoperative values 3 months after discharge but had recovered to preoperative values at 6 months. The PhA was not significantly correlated with the recovery rates of the other indicators. Older age was negatively associated with PhA recovery rate, however, recovery rates decreased significantly with post-discharge physical activity.</div></div><div><h3>Conclusions</h3><div>In patients undergoing cardiovascular surgery, the PhA takes longer to recover than muscle strength or gait speed, requiring up to 6 months to recover to preoperative levels. Post-discharge interventions to increase daily physical activity may be an important method of speeding PhA recovery.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 1-8"},"PeriodicalIF":2.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680989","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 SARC-F score may indirectly reflect the extracellular water-to-total body water ratio","authors":"Akemi Hioka ,&nbsp;Naoki Akazawa ,&nbsp;Naomi Okawa ,&nbsp;Shinji Nagahiro","doi":"10.1016/j.clnesp.2024.11.015","DOIUrl":"10.1016/j.clnesp.2024.11.015","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>In the Asian Working Group for Sarcopenia 2019 guidelines, SARC-F is used to screen for sarcopenia. SARC-F is measured based on five components: strength, assistance with walking, rising from a chair, climbing stairs, and falling. However, it has been reported that SARC-F has high specificity but low sensitivity for sarcopenia screening. Considering that SARC-F is currently recommended for sarcopenia screening, indicating the utility of SARC-F not only in sarcopenia screening but also in other aspects is pivotal. This cross-sectional study aimed to clarify the relationship between the SARC-F score and the extracellular water-to-total body water ratio (ECW/TBW) in community-dwelling older people.</div></div><div><h3>Methods</h3><div>This study included 167 community-dwelling older people (aged ≥65) who were able to walk independently and used the SARC-F as a screening test for sarcopenia diagnosis. ECW/TBW and the skeletal muscle mass index (SMI) were measured using bioelectrical impedance analysis. The associations among the SARC-F score, ECW/TBW, and SMI were assessed using Spearman's correlation coefficient. Multiple linear regression analyses of the SARC-F score were conducted. Age, sex, number of medications, pain, medical history, ECW/TBW, and SMI were considered independent variables in multiple linear regression analysis.</div></div><div><h3>Results</h3><div>The analyses revealed a significant positive correlation between the SARC-F score and ECW/TBW (ρ = 0.473, p &lt; 0.001). SMI was significantly and negatively correlated with the SARC-F score (ρ = −0.233, p = 0.002). In the multiple linear regression analysis, ECW/TBW (β = 0.311, p &lt; 0.001) and prevalence of pain (β = 0.169, p = 0.023) were significantly and independently associated with the SARC-F score (R² = 0.260). SMI was not significantly associated with the SARC-F score (β = 0.002, p = 0.986).</div></div><div><h3>Conclusion</h3><div>This study revealed a positive correlation between SARC-F score and ECW/TBW in community-dwelling older people, and this relationship persisted even after adjusting for confounding factors. However, there was no correlation between the SARC-F score and SMI. Our study indicated that the SARC-F score may be considered an indirect indicator of ECW/TBW. The score might also be useful for discriminating high and low ECW/TBW. These findings highlight a new use for SARC-F.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 59-63"},"PeriodicalIF":2.9,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667449","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 \"Maternal non-compliance with recommended folic acid supplement use alters global DNA methylation in cord blood of newborns: A cohort study\".","authors":"Letícia Van-Lume Lima, Ana Elisa Toscano, Joaci Pereira Dos Santos Júnior, Eulália Rebeca da Silva-Araújo, José Geneilson Silva, Raul Manhães-de-Castro","doi":"10.1016/j.clnesp.2024.10.169","DOIUrl":"10.1016/j.clnesp.2024.10.169","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"236-237"},"PeriodicalIF":2.9,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647128","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":"No sex differences in systemic metabolic responses to acute sprint interval training performed after an oral 75-g glucose load in adults with excess adiposity","authors":"Robinson Ramírez-Vélez ,&nbsp;Hugo Alejandro Carrillo-Arango ,&nbsp;Miguel Alejandro Atencio-Osorio ,&nbsp;Carlos Alejandro López-Álban ,&nbsp;Juan Carlos Calderon-González ,&nbsp;David Morales-Álamo ,&nbsp;Mikel Izquierdo ,&nbsp;María Correa-Rodríguez","doi":"10.1016/j.clnesp.2024.11.005","DOIUrl":"10.1016/j.clnesp.2024.11.005","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Research exploring sex-based variations in responses to acute sprint interval training (SIT) remains limited. This study aimed to examine the impact of biological sex on the systemic metabolic response to SIT. We hypothesized that acute metabolic responses to SIT would differ between males and females.</div></div><div><h3>Methods</h3><div>Sedentary adults (15 males; 14 females) with excess adiposity (defined as body fat &gt;30 %) were matched for age (32.8 ± 7.5 vs. 29.5 ± 6.5 years) and body fat mass (33.0 ± 2.9 vs. 33.2 ± 2.8 %). Following a 75-g glucose load, participants were randomly allocated to either a control (resting) or SIT trial (8 × 30 s of “all-out” cycling at a resistance of 0.075 % W kg⁻¹ of muscle mass, interspersed with 1 min of recovery). Parameters assessed included respiratory quotient (RQ), resting energy expenditure (REE), substrate utilization rates (fat and carbohydrate), total energy output, and blood lactate and glucose levels. These were collected during fasting and at 60, 120, and 240 min post-glucose load, with the area under the curve (AUC) calculated for both trials.</div></div><div><h3>Results</h3><div>An interaction was observed in time (<em>P</em> = 0.012) and trial (<em>P</em> &lt; 0.001) for RQ; however, there was no significant interaction between sex × trial (<em>P</em> = 0.818). Males exhibited higher mean REE values than females in both conditions. Nevertheless, AUC analysis showed no significant interaction between sex and trial (<em>P</em> = 0.562). A significant trial × time relationship was found for fat and carbohydrate percentage contributions (P &lt; 0.001). Post-SIT, AUCs for fat contribution (g min⁻¹ and mg kg⁻¹ min⁻¹) to energy expenditure increased in both sexes compared with resting (<em>P</em> &lt; 0.05), with differences noted among trials over time (P &lt; 0.001). Blood lactate levels also increased similarly post-SIT in both sexes (<em>P</em> &lt; 0.05), without a significant sex × trial interaction (AUC, <em>P</em> = 0.798).</div></div><div><h3>Conclusions</h3><div>These data demonstrate that exercise differed between the sexes and did not support the premise that acute metabolic responses to SIT would vary between males and females.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 25-35"},"PeriodicalIF":2.9,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647134","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":"Challenges and opportunities of Reformulated foods for improved nutritive values in African countries","authors":"Rebecca Oziohu Omosimua,&nbsp;Baskar Venkidasamy,&nbsp;Muthu Thiruvengadam","doi":"10.1016/j.clnesp.2024.11.012","DOIUrl":"10.1016/j.clnesp.2024.11.012","url":null,"abstract":"","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"64 ","pages":"Pages 525-526"},"PeriodicalIF":2.9,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647105","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 relationship between caloric intake and clinical outcomes in critically ill patients: A retrospective study","authors":"You-Ru Lin ,&nbsp;Po-Chuan Chen ,&nbsp;Wei-Ting Li ,&nbsp;Min-Hsin Huang ,&nbsp;Shu-Fen Huang ,&nbsp;Chih-Jung Wang ,&nbsp;Yu-Wen Chien ,&nbsp;Ai-Wen Kao ,&nbsp;Yan-Shen Shan","doi":"10.1016/j.clnesp.2024.11.008","DOIUrl":"10.1016/j.clnesp.2024.11.008","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Despite ongoing research, the optimal nutritional support strategy in the first week of intensive care unit (ICU) stay remains unclear, given the complex interplay of the dynamic metabolic change and evolving nutritional requirements. In this study, we assessed the impact of calorie deficiency during this period on the nutritional care of critically ill patients.</div></div><div><h3>Methods</h3><div>In this retrospective study, we examined ICU admissions from January 2018 to September 2021, focusing on patients whose ICU stay exceeded 7 days. Data were collected from days 2–7 of ICU admission. The “average caloric intake (%)\" was calculated as the actual calorie intake divided by the calculated calorie requirement over 6 days. Cox proportional hazard models were employed for analyzing the 28-day mortality, supplemented by sensitivity and subgroup analyses.</div></div><div><h3>Results</h3><div>The analysis of 3544 patients revealed that those receiving less than 60 % of their target calories in the first ICU week experienced higher 28-day mortality (hazard ratio (HR): 1.41, 95 % confidence interval (CI): 1.19–1.67, p &lt; 0.0001). Daily caloric intake below 30 % of the goal from day 5 onward was associated with a gradual increase in mortality risk. Conversely, a significant reduction in 28-day mortality was noted in patients with a daily intake of &gt;80 % starting from day 6.</div></div><div><h3>Conclusion</h3><div>Our study underscores the correlation between caloric deficit (&lt;60 %) in the initial ICU week and heightened mortality risk. It suggests the potential benefits of aggressive nutritional intervention toward the end of the week. These insights offer valuable guidance for clinicians in critical care settings.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 9-15"},"PeriodicalIF":2.9,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Course of measured energy expenditure over the first 10 days of critical illness: A nested prospective study in an adult surgical ICU.","authors":"Lizl Veldsman, Guy A Richards, Carl Lombard, Renée Blaauw","doi":"10.1016/j.clnesp.2024.11.009","DOIUrl":"10.1016/j.clnesp.2024.11.009","url":null,"abstract":"<p><strong>Background & aims: </strong>Various factors may cause significant daily variations in energy expenditure in and between critically patients. This nested, prospective study (ClinicalTrials.gov Identifier: NCT04099108) in a predominantly trauma surgical ICU, aimed to determine the course of measured energy expenditure over the first 10 days of critical illness, and to identify factors contributing to energy expenditure.</p><p><strong>Methods: </strong>Indirect calorimetry was performed on alternate days from ICU Day 3 ± 1 until Day 10 ± 1. The mean daily measured energy expenditure, respiratory quotient and total energy delivery as a percentage of measured energy expenditure were modelled using linear mixed regression with two fractional polynomial terms to accommodate non-linear responses over time.</p><p><strong>Results: </strong>Fifty ICU patients (mean age 36.9 ± 11.8 years, Acute Physiology and Chronic Health Evaluation (APACHE II) 13.5 ± 6.6, Sequential Organ Failure Assessment (SOFA) 4.5 ± 3.2) were included. Mean body mass index (BMI) was 24.8 ± 4.0 kg/m² and mean ventilation duration 7.7 ± 2.7 days. Mean daily measured energy expenditure showed a significant non-linear response (p = 0.006) increasing over the first 4 days peaking on day 5 and then plateauing. Mean daily respiratory quotient increased over the first 7 days, thereafter plateauing with a slight downward trend from day 8 despite a progressive increase in total energy delivery as a percentage of measured energy expenditure. Mean daily measured energy expenditure was significantly lower in the early than in the late acute phases (p = 0.024), whereas the late- and post-acute phases were similar. Age, sex and BMI significantly influenced measured energy expenditure.</p><p><strong>Conclusion: </strong>Measured energy expenditure showed a significant non-linear response over the first 10 days in ICU, increasing over the first 4 days peaking on day 5 then plateauing. The observed variability highlights the complexity of managing critically ill patients and the importance of personalised nutrition therapy. Additionally, the observed trend with a peak in measured energy expenditure around day five could inform timing and strategies for nutritional intervention in this patient cohort.</p>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":" ","pages":"227-235"},"PeriodicalIF":2.9,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647114","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":"Estimated protein intake and prognosis in hospitalised heart failure: A focus on patients with and without chronic kidney disease","authors":"Taishi Dotare ,&nbsp;Maeda Daichi ,&nbsp;Yuya Matsue ,&nbsp;Yudai Fujimoto ,&nbsp;Tsutomu Sunayama ,&nbsp;Takashi Iso ,&nbsp;Taisuke Nakade ,&nbsp;Shoichiro Yatsu ,&nbsp;Sayaki Ishiwata ,&nbsp;Yutaka Nakamura ,&nbsp;Yuka Akama ,&nbsp;Shoko Suda ,&nbsp;Takao Kato ,&nbsp;Masaru Hiki ,&nbsp;Takatoshi Kasai ,&nbsp;Tohru Minamino","doi":"10.1016/j.clnesp.2024.11.006","DOIUrl":"10.1016/j.clnesp.2024.11.006","url":null,"abstract":"<div><h3>Background and aims</h3><div>In patients with heart failure (HF), differences in the association between estimated protein intake (PI) and prognosis in those with and without chronic kidney disease (CKD) remain to be clarified. This study aimed to investigate whether the prognostic effects of the estimated PI differ between patients with HF with and without CKD.</div></div><div><h3>Methods</h3><div>We included patients who required hospitalisation owing to worsening HF between 2015 and 2019 and assessed the estimated PI based on the adjusted Maroni formula using the body mass index and urinary urea nitrogen level. Patients were stratified into the higher and lower estimated PI groups according to the median value of the estimated PI at the time of admission. The primary outcome was all-cause mortality.</div></div><div><h3>Results</h3><div>Among the 694 enrolled patients, 286 had CKD. A lower estimated PI was independently associated with a worse nutritional status. During a median follow-up period of 17.2 months, 175 all-cause deaths occurred, including 99 and 76 in the lower and higher estimated PI groups, respectively. In the Kaplan–Meier curves, the lower estimated PI group was associated with higher overall mortality. However, lower estimated PI was significantly associated with all-cause mortality in patients without CKD, but not in those with CKD, after adjustment for covariates. A significant interaction in terms of prognostic effect was observed between the presence or absence of CKD and estimated PI.</div></div><div><h3>Conclusions</h3><div>Among patients with HF, prognostic effect of the estimated PI may differ between patients with and without CKD.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 43-49"},"PeriodicalIF":2.9,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647125","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":"Does caffeine supplementation affect sleep in athletes? A systematic review of nine randomized controlled trials","authors":"Mahmut Bodur ,&nbsp;James Barkell ,&nbsp;Xinzhu Li ,&nbsp;Zohreh Sajadi Hezaveh","doi":"10.1016/j.clnesp.2024.11.007","DOIUrl":"10.1016/j.clnesp.2024.11.007","url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review aimed to assess the effects of caffeine supplements on sleep parameters among professional athletes.</div></div><div><h3>Methods</h3><div>A systematic search of randomized controlled trials (PROSPERO: CRD42024505377) was performed from 1980 to December 2023 through Web of Science (ISI), Cinahl, Embase, CENTRAL, PubMed/MEDLINE, Scopus, and Scienceopen. The effect of caffeine supplement on all sleep parameters (e.g. duration, quality, insomnia), assessed through objective and subjective methods, was investigated among the athletic community.</div></div><div><h3>Results</h3><div>Of 1469 records, nine trials were eligible for the current review. The studies showed varying results concerning sleep quality, quantity, efficiency, number of awakenings, sleep onset latency, and other sleep-related variables. These differences in findings may be attributable to factors such as the timing of caffeine consumption in relation to sleep time and the time of exercise, habitual caffeine use, and the dose of caffeine prescribed. Given the nature of caffeine, insomnia following ingestion is likely to occur.</div></div><div><h3>Conclusions</h3><div>This review explores the mechanisms by which caffeine influences sleep in athletes. While caffeine supplementation may enhance athletic performance, it could have a detrimental effect on sleep and therefore recovery. It is important that supplementation considers individual responses to caffeine so that it does not adversely affect sleep in this population.</div></div><div><h3>Prospero registration number</h3><div>CRD42024505377.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 76-85"},"PeriodicalIF":2.9,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modulation of inflammatory markers in type 2 diabetes mellitus through gut microbiome-targeted interventions: An umbrella review on meta-analyses","authors":"Arman Habibi ,&nbsp;Negin Letafatkar ,&nbsp;Nazila Sattari ,&nbsp;Sara Nobakht ,&nbsp;Zahra Rafat ,&nbsp;Saman Soltani Moghadam ,&nbsp;Arian Mirdamadi ,&nbsp;Mona Javid ,&nbsp;Parsa Jamilian ,&nbsp;Soheil Hassanipour ,&nbsp;Mohammad-Hossein Keivanlou ,&nbsp;Ehsan Amini-Salehi","doi":"10.1016/j.clnesp.2024.11.011","DOIUrl":"10.1016/j.clnesp.2024.11.011","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Type 2 diabetes mellitus (T2DM) poses a significant global health challenge due to various lifestyle factors contributing to its prevalence and associated complications. Chronic low-grade inflammation, characterized by elevated levels of inflammatory markers such as C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α), plays a pivotal role in the pathogenesis of T2DM. Modulation of the gut microbiota through microbiome-targeted therapy (MTT), including probiotics, prebiotics, and synbiotics, has emerged as a potential strategy to mitigate inflammation and improve metabolic outcomes in T2DM.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted following PRISMA guidelines to evaluate the impact of MTT on inflammatory markers in patients with T2DM. Searches were performed in PubMed, Scopus, and Web of Science databases up to June 2024, with inclusion criteria limited to English-language meta-analyses of randomized controlled trials (RCTs) assessing the effects of probiotics, prebiotics, or synbiotics on inflammatory markers in T2DM patients.</div></div><div><h3>Results</h3><div>Ten meta-analyses met the inclusion criteria, comprising studies investigating the effects of various MTT interventions on CRP, IL-6, and TNF-α levels in T2DM patients. Meta-analysis results indicated significant reductions in CRP (SMD: −0.070; 95 % CI: −0.119 to −0.020) and TNF-α (SMD: −0.370; 95 % CI: −0.554 to −0.186) levels following MTT, while IL-6 reductions (SMD: −0.070; 95 % CI: −0.269 to 0.129) did not reach statistical significance. However, heterogeneity in study quality, intervention protocols, and participant demographics posed challenges in interpretation.</div></div><div><h3>Conclusions</h3><div>While improvements in inflammatory markers with MTT have been observed, significant limitations—such as heterogeneity in study quality and variation in intervention protocols—highlight the need for further research to confirm its efficacy and clarify underlying mechanisms. Future studies should aim to address these limitations by exploring variations in dosage, supplement formulations, and bacterial strains, which are crucial for improving the reliability and broader applicability of MTT in the management of T2DM.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"65 ","pages":"Pages 93-104"},"PeriodicalIF":2.9,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647131","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}