Clinical nutrition ESPEN最新文献

{"title":"Prognostic importance of multiple objective nutrition screening indexes in acute ischemic stroke patients treated with intravenous tissue plasminogen activator: A retrospective observational study","authors":"Ezgi Yilmaz,&nbsp;Isa Furkan Sarier,&nbsp;Ethem Murat Arsava,&nbsp;Mehmet Akif Topcuoglu","doi":"10.1016/j.clnesp.2025.07.1133","DOIUrl":"10.1016/j.clnesp.2025.07.1133","url":null,"abstract":"<div><h3>Background</h3><div>The role of objective nutritional screening indexes in guiding treatment decisions and predicting prognosis in hyperacute stroke remains to be elucidated.</div></div><div><h3>Methods</h3><div>The modifying effects of nine biochemical parameters (albumin, globulin, blood urea nitrogen [BUN], creatinine, total lymphocyte count, AST, ALT, total cholesterol, triglycerides), three derived ratios (albumin-to-globulin, AST-to-ALT, BUN-to-creatinine), and seven objective nutritional indexes—namely CONUT (Controlling Nutritional Status score), PNI (Prognostic Nutritional Index), GNRI (Geriatric Nutritional Risk Index), INA (Instant Nutritional Assessment), AGS (Albumin-Globulin Score), TCBI (Triglyceride-Total Cholesterol-Body Weight Index), and CPNI (Cholesterol-modified Prognostic Nutritional Index)—were evaluated with respect to clinical outcomes in a cohort of 299 patients with acute ischemic stroke who received intravenous tissue plasminogen activator (IV-tPA). Discriminative efficacy was considered clinically meaningful when the lower bound of the receiver operating characteristic (ROC) area under the curve (AUC) reached or exceeded 0.6 at the 95 % confidence interval.</div></div><div><h3>Results</h3><div>Independent risk predictors for mortality were admission creatinine (OR = 2.479), globulin (OR = 2.203), CONUT score (OR = 1.362), CONUT high score group (OR = 4.332), PNI score (OR = 0.879), PNI high risk category (OR = 8.151), GNRI score (OR = 0.957) and GNRI moderate to severe category (OR = 4.559) according to regression analysis. Albumin (OR = 0.262) and albumin/globulin ratio (OR = 0.086) were found to be independent predictors of survival. However, only albumin (&gt;3.8 g/dL) (AUC = 0.666) and albumin/globulin ratio (&gt;1.33) (AUC = 0.601) provided a satisfactory discrimination capacity. ROC and PRC analyses documented that none of the other parameters reached clinically adequate discrimination capacity in terms of 3-months excellent or good outcome, symptomatic tPA-related brain hemorrhage, positive and dramatic response to tPA.</div></div><div><h3>Conclusions</h3><div>Objective Nutritional Screening Indices do not provide adequate guidance in determining prognosis in acute ischemic stroke patients receiving IV tPA.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 435-441"},"PeriodicalIF":2.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774765","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":"Relationship between body mass index and nutritional status across genetic subtypes of Prader-Willi syndrome","authors":"Romina Ceccomancini ,&nbsp;Delfina Mendiola ,&nbsp;Letícia Nunes-Campos ,&nbsp;Jorgelina Stegmann","doi":"10.1016/j.clnesp.2025.07.1132","DOIUrl":"10.1016/j.clnesp.2025.07.1132","url":null,"abstract":"<div><h3>Introduction</h3><div>The relationship between Prader-Willi Syndrome (PWS) genetic subtypes and nutritional status is generally unknown. We aimed to evaluate the relationship between body mass index (BMI) and nutritional status across genetic subtypes of PWS.</div></div><div><h3>Methods</h3><div>This retrospective cross-sectional study included male and female individuals over 8 years old with a confirmed genetic diagnosis of PWS and subtype determination. This study was conducted at a health facility led by a non-governmental organization that provides regular outpatient transdisciplinary care for rare diseases. We excluded individuals with a history of growth hormone treatment and pharmacological treatments for nutritional purposes. Participants were grouped based on the presence or absence of a genetic deletion subtype. The BMI (kg/m²) was calculated upon admission. Nutritional assessment was conducted in accordance with World Health Organization standards.</div></div><div><h3>Results</h3><div>A total of 41 individuals with PWS were included, with a mean age of 19.4 ± 6.7 years and a mean BMI of 40.2 ± 12.7 kg/m². The most frequent genotype was deletion (n = 28, 68 %). Compared to non-deletion participants, the deletion group showed a significantly higher mean BMI (42.4 ± 14.2 kg/m² vs. 35.5 ± 7.2 kg/m², p = 0.045). The nutritional status of obesity was significantly more prevalent in individuals with the deletion subtype (93 %, 26/28) compared to those with a non-deletion subtype (62 %, 9/13; p = 0.006). However, when stratified by age groups, the association between deletion and nutritional status was observed only among adults, in whom deletion was linked to a higher prevalence of obesity (94 % vs. 50 %, p = 0.006) and a higher mean BMI (47.8 ± 14.9 kg/m² vs. 35.1 ± 8.6 kg/m², p = 0.04).</div></div><div><h3>Conclusion</h3><div>In this study involving individuals with PWS, adults with the genetic deletion subtype presented higher BMI and more severe obesity compared to patients with non-deletion genotypes.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 477-481"},"PeriodicalIF":2.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774766","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 sarcopenic obesity on the prevalence and prognosis of non-metastatic colorectal cancer: A systematic review and meta-analysis","authors":"Wanping Wang ,&nbsp;Fang Fang ,&nbsp;Tianxiu Wang ,&nbsp;Xinyi Chen ,&nbsp;Lu Zhao ,&nbsp;Chunmei Wang ,&nbsp;Yujia Tang ,&nbsp;Qin Li ,&nbsp;Dong Tang ,&nbsp;Jingqiu Zhang","doi":"10.1016/j.clnesp.2025.07.1127","DOIUrl":"10.1016/j.clnesp.2025.07.1127","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>The prevalence of sarcopenic obesity (SO) and its impact on prognosis in patients with non-metastatic colorectal cancer (nmCRC) remain controversial. This meta-analysis evaluated SO prevalence and its associations with survival and postoperative outcomes in nmCRC patients.</div></div><div><h3>Methods</h3><div>PubMed, EMBASE, CINAHL, OVID, Web of Science, and the Cochrane Library were searched up to January 2025. Observational studies reporting SO prevalence or its prognostic impact in nmCRC were included. Data were pooled using random/fixed-effects models in R.4.5.1.</div></div><div><h3>Results</h3><div>A total of 18 studies involving 11283 nmCRC patients were included. The pooled SO prevalence in patients with nmCRC was 13% (95%CI: 7%–22%). SO significantly decreased overall survival (HR = 1.52; 95%CI: 1.26–1.82; P = 0.000), disease-free survival (HR = 1.72; 95%CI: 1.27–2.32;P = 0.000). It increased risks of total complications (OR = 2.23; 95%CI: 1.05–4.73; P = 0.037), anastomotic leakage (OR = 2.56; 95%CI: 1.30–5.05; P = 0.007), and mortality (OR = 1.87; 95%CI: 1.34–2.62; P = 0.000). No statistically significant association was observed for cancer-specific survival (HR = 1.50; 95%CI: 0.86–2.63; P = 0.154), recurrence-free survival (HR = 1.60; 95%CI: 0.64–4.04; P = 0.318), or length of stay (OR = 3.74; 95%CI: 0.74–18.98; P = 0.111).</div></div><div><h3>Conclusion</h3><div>SO is linked to poorer survival and higher postoperative complications. Routine body composition assessments may aid early SO identification and intervention. Standardized diagnostic criteria and prospective studies are needed to refine prognostic evaluations.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 492-502"},"PeriodicalIF":2.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768494","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":"Long-term antithrombotic therapy practices in adult patients with short bowel syndrome following acute mesenteric ischemia: An international case-based survey","authors":"B. Deleenheer ,&nbsp;C. Cuerda ,&nbsp;P. Jeppesen ,&nbsp;F. Joly ,&nbsp;S. Lal ,&nbsp;G. Lamprecht ,&nbsp;M. Mundi ,&nbsp;K. Szczepanek ,&nbsp;T. Vanassche ,&nbsp;L. Van der Linden ,&nbsp;A. Van Gossum ,&nbsp;G. Wanten ,&nbsp;L. Pironi","doi":"10.1016/j.clnesp.2025.07.1126","DOIUrl":"10.1016/j.clnesp.2025.07.1126","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Long-term antithrombotic therapy is recommended for short bowel syndrome (SBS) after acute mesenteric ischemia (AMI). However, targeted recommendations on drug selection, dosing, duration and monitoring, are lacking. Current recommendations rely on data from other arterial diseases, often overlooking SBS-related drug absorption issues. To understand current practices, this survey aimed to assess the long-term antithrombotic therapy practices in AMI.</div></div><div><h3>Methods</h3><div>An e-survey was disseminated to HAN-CIF (Home Artificial Nutrition – Chronic Intestinal Failure) database centers of ESPEN (European Society on Clinical nutrition and Metabolism) and coagulation specialists. It included ten cases with varying postsurgical intestinal anatomy, revascularisation and aetiology. Questions focused on drug class choice, administration route, dosing, duration and monitoring of antithrombotic therapy.</div></div><div><h3>Results</h3><div>For patients with AMI of unknown aetiology, but with hypercholesterolaemia and smoking status, intestinal failure (IF) teams preferred anticoagulants (55.8–65.1 %) over antiplatelet therapy (27.9–37.2 %), while coagulation specialists favoured antiplatelet therapy (57.1 %). IF teams selected antiplatelet therapy more often in patients with type 3 anatomy (largest absorptive capacity). They favoured parenteral agents for patients with end-jejunostomy or duodenocolic anastomosis (51.2 % and 55.8 % respectively; lowest absorptive capacity), oral agents for those without IF (69.8 %; highest absorptive capacity), and both for patients with a jejunocolic anastomosis (48.8 % oral, 44.2 % parenteral; moderate absorptive capacity). Coagulation specialists consistently preferred oral therapy.</div><div>Lifelong antiplatelet therapy was preferred by IF teams (71.4–100.0 %), while anticoagulants were prescribed either temporarily (16.7–59.1 %) or lifelong (40.9–83.3 %). Standard doses were used for all drug classes, irrespective of anatomy, revascularisation or comorbidities. Monitoring varied: IF teams monitored subcutaneous low molecular weight heparins and non-vitamin K oral anticoagulants (DOACs), whereas coagulation specialists only monitored DOACs.</div><div>Both specialists commonly performed a 24-h Holter, transthoracic and transoesophageal echocardiograms for arterial mesenteric ischaemia (MI) and requested thrombophilia parameters more for venous MI, with antiphospholipid antibodies checked for both MI subtypes.</div></div><div><h3>Conclusion</h3><div>We observed significant variation in long-term antithrombotic management in post-AMI SBS patients, with differing approaches between IF and coagulation specialists. A multidisciplinary position statement is necessary to standardise care.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 421-427"},"PeriodicalIF":2.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768493","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 role of whey protein supplementation after one-anastomosis gastric bypass: Results of a double-blind randomized controlled trial","authors":"Keivan Sabooni ,&nbsp;Farnaz Farsi ,&nbsp;Shiva Safari ,&nbsp;Mohammad Mahjoubi ,&nbsp;Amir Hossein Davarpanah Jazi ,&nbsp;Delaram Moosavi ,&nbsp;Zahra Gholi ,&nbsp;Mohammad Kermansaravi ,&nbsp;Shahab Shahabi","doi":"10.1016/j.clnesp.2025.07.1122","DOIUrl":"10.1016/j.clnesp.2025.07.1122","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic and bariatric surgery (MBS) is an effective intervention for morbid obesity. Yet, rapid weight loss often indicates the early postoperative period, which can include substantial reductions in lean body mass. One Anastomosis Gastric Bypass (OAGB) is being used more frequently; however, data on the postoperative effects of whey protein supplementation in this specific procedure are still limited.</div></div><div><h3>Objective</h3><div>This double-blind, randomized controlled trial (RCT) aimed to investigate the effects of whey protein supplementation on weight loss, body composition, and nutritional markers in patients undergoing OAGB.</div></div><div><h3>Methods</h3><div>Seventy-eight participants (BMI 40–50 kg/m²) undergoing primary OAGB were randomized to receive either daily pure whey protein (2 × 15 g scoops; ∼22.6 g protein/day) or a visually identical placebo for three months. Anthropometric measurements, bioelectrical impedance analysis (body composition), and laboratory assessments were performed at baseline (preoperative) and 1 and 3 months postoperatively. Standard multivitamins and mineral supplementation were provided to all participants. Adherence was monitored through diaries and regular follow-up calls.</div></div><div><h3>Results</h3><div>Both groups demonstrated significant weight loss and improved fasting blood glucose, HbA1C, and lipid profiles three months post-surgery. No significant differences between groups emerged in total weight loss percentage or key nutritional markers (e.g., albumin). However, the whey protein group exhibited significantly lower reductions in fat-free mass, muscle mass, and total body water compared to the placebo group (p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>In patients undergoing OAGB, whey protein supplementation did not substantially alter total weight loss or biochemical markers within three months; however, it did help preserve lean body mass. While cost and adherence remain potential barriers, whey protein supplementation may offer a practical, tolerable option to support muscle mass retention in the early postoperative period.</div></div><div><h3>Registration</h3><div>This research was registered (30-04-2024) in the <span><span>https://irct.behdasht.gov.ir</span><svg><path></path></svg></span> with registration number: IRCT20240209060949N1.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 406-414"},"PeriodicalIF":2.6,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759327","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":"Body composition and absenteeism risk among employees","authors":"Keisuke Sato ,&nbsp;Naokazu Arasaki ,&nbsp;Shota Agena ,&nbsp;Satoshi Shimabukuro ,&nbsp;Yuki Sueyoshi ,&nbsp;Yuki Nakayama ,&nbsp;Seiji Tanaka ,&nbsp;Masaki Koike ,&nbsp;Takahiro Ogawa","doi":"10.1016/j.clnesp.2025.07.1119","DOIUrl":"10.1016/j.clnesp.2025.07.1119","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Presenteeism, defined as reduced work performance owing to illness or symptoms, and absenteeism, defined as absence from work owing to illness or injury, pose significant challenges to worker productivity. This study aimed to examine the association between the risk of absenteeism and body composition, including skeletal muscle mass index and fat mass index (FMI), among employees.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted with 55 employees from four companies between May and July 2024. The participants’ body compositions were assessed using bioelectrical impedance analysis, and presenteeism was measured using the version of the World Health Organization Health and Work Performance Questionnaire (WHO-HPQ). Both skeletal muscle mass index and fat mass index (FMI) were evaluated as key body composition parameters. Logistic regression analysis was performed to identify factors associated with absenteeism risk, defined as a relative presenteeism score of ≤0.8.</div></div><div><h3>Results</h3><div>The FMI was significantly higher in the absenteeism risk group than in the non-absenteeism risk group, particularly among women participants. Multivariate logistic regression analysis revealed that higher FMI (odds ratio [OR] = 1.55, 95 % confidence interval [CI] = 1.11–2.17, P = 0.011) and younger age (OR = 0.91, 95 % CI = 0.85–0.98, P = 0.011) were independently associated with absenteeism risk.</div></div><div><h3>Conclusions</h3><div>Higher FMI was independently associated with increased absenteeism risk, especially in women, and younger employees were more likely to be at risk of absenteeism. These associations may inform workplace health strategies; however, due to the cross-sectional design, no causal inferences can be drawn. Future longitudinal research is needed to determine whether improving body composition leads to reductions in absenteeism.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 545-550"},"PeriodicalIF":2.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752595","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":"Plasma albumin in patients with severe anorexia nervosa admitted to a specialized medical unit","authors":"Jeanie Meincke Egedal ,&nbsp;Gry Sørdal Lorentzen ,&nbsp;Magnus Sjögren ,&nbsp;Georgios Paslakis ,&nbsp;René Klinkby Støving","doi":"10.1016/j.clnesp.2025.07.1120","DOIUrl":"10.1016/j.clnesp.2025.07.1120","url":null,"abstract":"<div><h3>Objective</h3><div>Anorexia nervosa (AN) is a condition characterized by chronic malnutrition. This study aims to determine the frequency of hypoalbuminemia in individuals with severe, medical unstable AN and its associations with inflammation and mortality.</div></div><div><h3>Method</h3><div>Data were collected from electronic health records on patients admitted to a specialized, medical unit in Denmark between 2017 and 2021. A total of 159 records were initially registered, with 127 meeting the inclusion criteria. Clinical characteristics, laboratory values and vital signs were analyzed. Patients were divided into groups based on their plasma albumin (PA) levels, being hypoalbuminemic (&lt;36 g/L), normoalbuminemic (36–50 g/L), and hyperalbuminemic (&gt;50 g/L), respectively. Statistical analyses were made using Welches t-test, Fisher's exact and a multivariable logistic regression was performed to assess the association between albumin status and mortality, adjusting for BMI and illness duration.</div></div><div><h3>Results</h3><div>78.6 % of patients exhibited normoalbuminemia, 7.1 % were hypoalbuminemic, and 14.3 % were hyperalbuminemic. The hypoalbuminemic group had higher mean body temperature (p = 0.041), higher mean platelet count (p = 0.046), and a lower mean hemoglobin level (p = 0.046). Mortality was strikingly higher in the hypoalbuminemic group with 4 (44 %) deceased, compared to 5 (5.1 %) in the normoalbuminemic group (p = 0.012) during the 2017–2021 period, with no statistically significant difference in age between the two groups (p = 0.067). Logistic regression revealed a significantly increased risk of death in the hypoalbuminemic group (OR = 6.39, p = 0.038).</div></div><div><h3>Discussion</h3><div>Despite the severity of the illness, most patients with AN maintained normal PA levels, probably due to adaptive physiological mechanisms. PA level assessments could aid in identifying high-risk patients, as hypoalbuminemia was associated with inflammation and increased mortality.</div></div><div><h3>Conclusion</h3><div>Despite significant nutritional restrictions, even individuals with severe and extreme AN maintain normal PA levels. Hypoalbuminemia was associated with increased mortality.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 400-405"},"PeriodicalIF":2.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752597","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":"Effect of dietary fat intake on metabolic endotoxemia: Mechanisms and clinical insights","authors":"Aseel Jawamis,&nbsp;Hayder AL-Domi,&nbsp;Najd Al Sarayreh","doi":"10.1016/j.clnesp.2025.07.1124","DOIUrl":"10.1016/j.clnesp.2025.07.1124","url":null,"abstract":"<div><h3>Background and aims</h3><div>Dietary fat intake is recognized as a key influencer of metabolic endotoxemia; however, the exact nature of this relationship is not fully understood. This review aims to critically evaluate the effect of dietary fat intake on metabolic endotoxemia and elucidate the mechanisms linking dietary fats, metabolic endotoxemia, and chronic low-grade inflammation.</div></div><div><h3>Methods</h3><div>A comprehensive literature search from 2007 to 2025 was undertaken using PubMed, Google Scholar, ScienceDirect, and the Cochrane Library. The keywords used were “metabolic endotoxemia,” “dietary fat,” “fat intake,” “high-fat diet,” and “lipopolysaccharide.” Relevant human, animal, and mechanistic studies were reviewed, while non-English, duplicate, or irrelevant publications were excluded. A critical analysis of study methodologies and evidence quality was conducted.</div></div><div><h3>Results</h3><div>High-fat diet could lead to increased lipopolysaccharide (LPS) levels, subsequently triggering low-grade inflammation and metabolic dysfunction. Increased LPS transport through chylomicrons, disruption of the gut barrier, and changes in the microbiota that support LPS-producing bacteria are the primary drivers of this impact. Moreover, the type of dietary fats plays a significant role in metabolic endotoxemia; polyunsaturated fats may offer protective effects, whereas saturated fat facilitates LPS translocation. Different results have been obtained from the ketogenic diet, suggesting it may have anti-inflammatory effects in some circumstances while aggravating endotoxemia in others.</div></div><div><h3>Conclusions</h3><div>Dietary fat intake and metabolic endotoxemia have a complex relationship that is affected by gut microbiota, hepatic LPS clearance, total caloric intake, and overall metabolic health. Future studies should focus on long-term, well-controlled trials to better understand these relationships and guide dietary recommendations.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 415-420"},"PeriodicalIF":2.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752596","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":"Influence of body composition and anthropometric profile on postprandial triglycerides","authors":"Tyler J. Godsey ,&nbsp;Bryant H. Keirns ,&nbsp;Christina M. Sciarrillo ,&nbsp;Madison Dixon ,&nbsp;Samantha Hart ,&nbsp;Kara Poindexter ,&nbsp;Sam R. Emerson","doi":"10.1016/j.clnesp.2025.07.1121","DOIUrl":"10.1016/j.clnesp.2025.07.1121","url":null,"abstract":"<div><h3>Purpose</h3><div>The postprandial triglyceride response is a strong indicator of cardiovascular risk. The influence of anthropometrics and body composition on this response is incompletely understood. The objective of this study was to determine relationships between body composition and anthropometric measurements with postprandial triglycerides in a large sample of adults.</div></div><div><h3>Methods</h3><div>For this secondary analysis, body composition and postprandial triglycerides of 142 participants from five studies in our laboratory were used. Individuals participated in a validated abbreviated fat tolerance test (9 kcal/kg body weight; 70 % fat) with triglycerides measured at baseline and 4 h post-meal. Body composition and anthropometric measurements included body mass index (BMI), relative body fat, relative muscle mass, waist circumference, and visceral adipose tissue (VAT).</div></div><div><h3>Results</h3><div>Four-hour postprandial triglycerides were greater in obesity class I compared to people with normal BMI, as well as higher in people with higher relative body fat, more VAT, greater waist circumference and lower relative muscle mass. After adjusting for age, sex and study, significant but weak to moderate positive correlations were observed between 4-h triglycerides and BMI, waist circumference, relative body fat and VAT, while a significant but weak inverse correlation was observed with relative muscle mass. In ROC analyses, relative muscle mass was the only significant predictor of an elevated 4-h triglyceride concentration (&gt;175 mg/dL).</div></div><div><h3>Conclusion</h3><div>In our current sample, individuals with elevated relative body fat, VAT, waist circumference, BMI, and decreased relative muscle mass exhibited greater postprandial triglyceride responses, although correlations between anthropometric and body composition parameters were relatively weak. These results shed light on the relationship between body composition and the postprandial triglyceride response.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 389-399"},"PeriodicalIF":2.6,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728416","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":"Difference between cystatin C- and creatinine-based estimated glomerular filtration rate and risk of frailty: Mediating role of high-sensitivity C-reaction protein in older adults","authors":"Fan Zhang ,&nbsp;Yuanjing Zhao ,&nbsp;Yan Bai ,&nbsp;Liuyan Huang ,&nbsp;Jiao Li ,&nbsp;Yifei Zhong","doi":"10.1016/j.clnesp.2025.07.1112","DOIUrl":"10.1016/j.clnesp.2025.07.1112","url":null,"abstract":"<div><h3>Background and aims</h3><div>This cross-sectional study aims to investigate the difference in estimated glomerular filtration rate (eGFR_diff) based on cystatin c and creatinine and risk of frailty among elderly individuals and to explore the mediating role of high-sensitivity C-reactive protein (hs-CRP).</div></div><div><h3>Methods</h3><div>eGFR_diff was calculated using both absolute difference (eGFR_diff _absolute) and ratio (eGFR_diff _relative) between cystatin C- and creatinine-based calculations. Frailty status was assessed by the frailty index ranging from 0 to 100 and frailty was defined as ≥ 25. We employed logistic regression models to examine the association between different eGFR_diff measures and frailty risk, adjusting for sociodemographic factors, lifestyle, and health status. Restricted cubic spline for fitting the nonlinear association between eGFR_diff and frailty status. The mediating role of hs-CRP was explored using mediation analysis.</div></div><div><h3>Results</h3><div>Our analysis included 4989 participants with a median age of 66 years. Approximately 25 % of participants were identified with a frailty condition. In the fully adjusted model, each 15-unit higher eGFR_{diff absolute} was associated with 17.0 % lower odds of prevalent frailty (odds ratio [OR] = 0.830; 95 % confidence interval [95 % CI]: 0.768, 0.897), for each 10 % increase in eGFR_{diff relative}, the corresponding OR was 0.383 (95 % CI: 0.267, 0.549). Compared with participants with similar eGFR_diff (i.e., −15&lt; eGFR_{diff absolute} &lt;15 mL/min/1.73 m²), participants in the negative group (i.e., &lt; −15 mL/min/1.73 m²) were associated with 61.9 % higher odds of prevalent frailty (OR = 1.619; 95 % CI: 1.353, 1.937). Compared with participants with eGFR_{diff relative} &lt;0.6, participants with ≥0.6 were associated with a 56.2 % lower incidence of frailty (OR = 0.438; 95 % CI: 0.304, 0.634). The magnitude of associations was not materially altered in all sensitivity analyses. eGFR_diff was significantly associated with elevated hs-CRP, and elevated hs-CRP was significantly associated with increased risk of frailty. 5.2 % (95 % CI: 1.4 %, 13.9 %) of eGFR_diff-associated frailty was significantly associated with elevated hs-CRP.</div></div><div><h3>Conclusions</h3><div>Negative eGFR_diff was significantly associated with a higher risk of frailty, and the eGFR_diff-associated frailty risk may be partially mediated by hs-CRP. Further research is needed to explore the underlying mechanisms and validate these findings in diverse populations.</div></div>","PeriodicalId":10352,"journal":{"name":"Clinical nutrition ESPEN","volume":"69 ","pages":"Pages 375-383"},"PeriodicalIF":2.6,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728413","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}