Clinical nutrition最新文献

{"title":"Recognizing malnutrition in adults with critical illness: Guidance statements from the Global Leadership Initiative on Malnutrition.","authors":"R Fukushima, C W Compher, M I T D Correia, M C Gonzalez, L McKeever, K Nakamura, Z Y Lee, J J Patel, P Singer, C Stoppe, J C Ayala, R Barazzoni, M M Berger, T Cederholm, K Chittawatanarat, A Cotoia, J C Lopez-Delgado, C P Earthman, G Elke, W Hartl, M S Hasan, N Higashibeppu, G L Jensen, K J Lambell, C C H Lew, J I Mechanick, M Mourtzakis, G C C Nogales, T Oshima, S J Peterson, T W Rice, R Rosenfeld, P Sheean, F M Silva, P C Tah, M Uyar","doi":"10.1016/j.clnu.2025.03.011","DOIUrl":"https://doi.org/10.1016/j.clnu.2025.03.011","url":null,"abstract":"<p><strong>Background: </strong>Patients with critical illness may present with disease-related malnutrition upon intensive care unit (ICU) admission. They are at risk of development and progression of malnutrition over the disease trajectory because of inflammation, dysregulated metabolism, and challenges with feeding.</p><p><strong>Methods: </strong>The Global Leadership Initiative on Malnutrition (GLIM) convened a panel of 36 clinical nutrition experts to develop consensus-based guidance statements addressing the diagnosis of malnutrition during critical illness, using a modified Delphi approach with a requirement of ≥75% agreement.</p><p><strong>Results: </strong>CONCLUSION: Research using consistent etiologic and phenotypic variables offers great potential to assess the efficacy of nutrition interventions for critically ill patients with malnutrition. Assessment of these variables at during and beyond the ICU stay will clarify the trajectory of malnutrition and enable exploration of impactful treatment modalities at each juncture. GLIM offers a diagnostic approach that can be used to identify malnutrition in critically ill patients.</p>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “The effects of 6 months dietary counseling on diet quality and cardiovascular risk profile in patients with cardiovascular disease: A randomized controlled trial” [Clin Nutr 45 (2025) 101–110]","authors":"Iris van Damme ,&nbsp;Eva R. van Veldhuisen ,&nbsp;Auke J.C.F. Verkaar ,&nbsp;Remy H.H. Bemelmans ,&nbsp;Marcel M.C. Hovens ,&nbsp;Frank L.J. Visseren ,&nbsp;Charlotte Koopal ,&nbsp;Renate M. Winkels ,&nbsp;Johanna M. Geleijnse","doi":"10.1016/j.clnu.2025.03.010","DOIUrl":"10.1016/j.clnu.2025.03.010","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"48 ","pages":"Page 49"},"PeriodicalIF":6.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143706274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plasma amino acid profiles and gestational diabetes mellitus risk: A case-control study","authors":"Zhen Hong ,&nbsp;Lan Huang ,&nbsp;Qinwen Zhou ,&nbsp;Yulin Wu ,&nbsp;Xiaoping Lin ,&nbsp;Yuanhuan Wei ,&nbsp;Qinzhi Wei ,&nbsp;Guifang Deng ,&nbsp;Zheqing Zhang","doi":"10.1016/j.clnu.2025.03.008","DOIUrl":"10.1016/j.clnu.2025.03.008","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Gestational diabetes mellitus (GDM) is a prevalent pregnancy complication associated with adverse short-term and long-term health outcomes for both mother and child. This study aimed to investigate the association between plasma amino acid concentrations and the incidence of GDM from 2019 to 2021.</div></div><div><h3>Methods</h3><div>Plasma levels of 37 amino acids were precisely measured using triple quadrupole mass spectrometry. The principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA) models identified metabolic differences between GDM and non-GDM groups. Conditional logistic regression, generalized linear model, and quantile g-computation were employed to assess the associations between individual or combined amino acids and GDM risk/blood glucose levels. The discriminatory power of various factors associated with the risk of GDM was evaluated using the area under the receiver operating characteristic curve (AUC–ROC).</div></div><div><h3>Results</h3><div>A total of 969 pregnant women were included in this case–control study. OPLS-DA model identified 16 biomarkers that differentiated the GDM and non-GDM groups. After adjusting for potential covariates and correcting for multiple testing, conditional logistic regression analysis revealed that certain key amino acids, such as valine and isoleucine, were positively associated with the incidence of GDM, while glycine and serine were negatively associated with GDM risk (OR = 0.753–1.671, <em>P</em>_<em>fdr</em> = &lt;0.001–0.001). Generalized linear model analysis showed that specific amino acids, including alpha-aminoadipic acid and arginine, were positively associated with blood glucose levels, while glycine and serine were negatively associated (<em>β</em> = −0.211–0.365, <em>P</em>_<em>fdr</em> = &lt;0.001–0.045). Additionally, mixtures of the identified amino acids were significantly associated with an increased risk of GDM (<em>P</em> &lt; 0.001). The combination of selected amino acids showed the highest ability to identify GDM in comparison with traditional risk factors and specific amino acids (AUC-ROC = 0.761, 95 % CI: 0.729–0.792). The Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis identified two metabolic pathways related to GDM risk: “Glycine, Serine, and Threonine Metabolism” and “Arginine biosynthesis”.</div></div><div><h3>Conclusions</h3><div>The overall amino acid profile, rather than disturbances in specific amino acids, may serve as a more important prevention or therapeutic target for GDM.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"48 ","pages":"Pages 90-100"},"PeriodicalIF":6.6,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive comparison of two commonly used BMI thresholds for non-communicable diseases and multimorbidity in the Chinese population","authors":"Hong Fan ,&nbsp;Matina Kouvari ,&nbsp;Chengnan Guo ,&nbsp;Zhenqiu Liu ,&nbsp;Xin Zhang ,&nbsp;Haili Wang ,&nbsp;Yi Li ,&nbsp;Tiejun Zhang ,&nbsp;Christos S. Mantzoros","doi":"10.1016/j.clnu.2025.03.016","DOIUrl":"10.1016/j.clnu.2025.03.016","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Various body mass index (BMI) thresholds are used to classify overweight and obesity in the Chinese population. We compared two commonly applied BMI classifications for Chinese population: World Health Organization (WHO) criteria (overweight: BMI≥23 kg/m²; obesity: BMI≥25 kg/m²) and China Working Group criteria (overweight: BMI≥24 kg/m²; obesity: BMI≥28 kg/m²) across 14 non-communicable diseases and multimorbidity.</div></div><div><h3>Methods</h3><div>This research utilized data from the China Health and Retirement Longitudinal Study at baseline and after 9 years of follow-up (2011–2020). The sample comprised of 13,519 individuals in 2011 (mean age: 59 (10) years, mean BMI: 23.4 (3.6) kg/m², female: 53.20 %), with 9841 followed up in 2020. BMI classifications were: a. normal weight (18.5≤BMI&lt;23) <em>vs</em>. borderline overweight (23≤BMI&lt;24) <em>vs</em>. overweight (BMI≥24) b. non-obesity (18.5≤BMI&lt;25) <em>vs</em>. borderline obesity (25≤BMI&lt;28) <em>vs.</em> obesity (BMI≥28). Borderline categories represented the overlapping between the two classifications. Cox proportional hazards model was used to evaluate the associations between weight status (including borderline weight) and multiple diseases, using both WHO and China criteria for BMI thresholds. Sensitivity analyses excluded smokers, those diagnosed within the first 2 years in prospective analysis, and those diagnosed within the past three years in cross-sectional analysis, respectively. Subgroup analysis by gender and age was conducted.</div></div><div><h3>Results</h3><div>Overweight prevalence was 50.99 % based on WHO criteria and 40.10 % based on China criteria. Obesity prevalence was 30.65 % and 10.97 %, respectively. BMI exhibited a positive or J-shaped association with multiple cardiometabolic factors (ie, hypertension, dyslipidemia, diabetes, heart disease, stroke) and multimorbidity. Individuals with normal weight experienced a lower risk of hypertension, dyslipidemia, diabetes [hazard ratio (95 % confidence interval): 0.71 (0.60–0.83), 0.71 (0.59–0.84), 0.64 (0.50–0.81), respectively] compared to those with borderline overweight.</div></div><div><h3>Conclusions</h3><div>Different BMI classifications greatly affect overweight and obesity estimates and have implications for predicting morbidity and mortality. Although using the China Working Group's lenient BMI threshold (BMI&lt;24 for normal and &lt;28 for overweight) may help prevent multimorbidity and most NCDs, using the WHO's stricter BMI thresholds (BMI&lt;23 and BMI&lt;25 respectively) may offer even greater cardiometabolic benefits.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"48 ","pages":"Pages 70-79"},"PeriodicalIF":6.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Circulating myostatin as a biomarker of muscle mass and strength in individuals with cancer or obesity” [Clin Nutr 43(7) (2024 Jul) 1800–1808","authors":"Laura Orioli ,&nbsp;Sofia Samaras ,&nbsp;Kiswendsida Sawadogo ,&nbsp;Marie de Barsy ,&nbsp;Pascale Lause ,&nbsp;Yannick Deswysen ,&nbsp;Benoit Navez ,&nbsp;Jean-Paul Thissen ,&nbsp;Audrey Loumaye","doi":"10.1016/j.clnu.2025.03.014","DOIUrl":"10.1016/j.clnu.2025.03.014","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"48 ","pages":"Page 48"},"PeriodicalIF":6.6,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New insights on the use of mini nutritional assessment: Impact of alternative calf circumference cutoffs","authors":"Jarson P. Costa-Pereira ,&nbsp;Carla M. Prado ,&nbsp;Maria Cristina Gonzalez ,&nbsp;Iasmin M. Sousa ,&nbsp;Amanda M.J. Ferreira ,&nbsp;Poliana C. Cabral ,&nbsp;Eduardo C. Costa ,&nbsp;Claudia P.S. Pinho Ramiro ,&nbsp;Ana P.T. Fayh","doi":"10.1016/j.clnu.2025.03.015","DOIUrl":"10.1016/j.clnu.2025.03.015","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background &amp; aims&lt;/h3&gt;&lt;div&gt;The Mini Nutritional Assessment – Short Form (MNA&lt;sub&gt;SF&lt;/sub&gt;) is an easy, quick, and validated tool for screening and diagnosing malnutrition among older individuals. Despite its clinical relevance, using body mass index (BMI) and a universal calf circumference (CC) cutoff might pose limitations. Therefore, our study aimed to investigate the potential of using sex-specific and BMI-adjusted CC cutoff values within the MNA-SF to classify nutritional status and assess its prognostic significance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Older patients hospitalized with varied diagnoses were included. BMI and CC measurements were conducted by registered dietitians. MNA-SF, which considers either BMI or CC, was utilized to classify nutritional status. Patients scoring 0–7 points were classified as malnourished. Four different approaches for MNA-SF were considered: Traditional: i) using BMI, ii) the alternative/surrogate using a non-sex specific CC &lt; 31 cm; Newly adapted approaches: iii) using sex-specific CC cutoff values ≤ 34 cm for men and ≤33 cm for women, without BMI adjustment factors; iv) using sex-specific BMI-adjusted CC cutoff values ≤ 34 cm for men and ≤33 cm for women. BMI adjustment factors were: −3 cm of CC for BMI 25–29.9 kg/m&lt;sup&gt;2&lt;/sup&gt;, -7 cm for BMI 30–39.9 kg/m&lt;sup&gt;2&lt;/sup&gt;, and -12cm for BMI ≥40 kg/m&lt;sup&gt;2&lt;/sup&gt;. The prevalence of nutritional categories across different MNA-SF approaches was estimated. Cox regression analysis and Receiver Operating Characteristic (ROC) curve analysis were performed to evaluate and compare their predictive significance for overall survival.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;This study included 242 patients (58.8 % men, median age of 68 years, interquartile range: 64 to 74). Cancer was the most frequent reason for hospitalization (36.6 %). Scores in MNA-SF were significantly lower when using sex-specific unadjusted &amp; BMI-adjusted CC. The frequency of malnutrition ranged from 21.9 % (MNA-SF using BMI) to 41.7 % (MNA-SF&lt;sub&gt;adj.CC&lt;/sub&gt;&lt;sub&gt;≤&lt;/sub&gt;&lt;sub&gt;34/33&lt;/sub&gt;). The incidence of mortality was significantly higher among malnourished patients classified using the sex-specific unadjusted (58.2 %) and BMI-adjusted CC approaches (63.3 %), compared to 38.2 % and 40 % when using BMI and the non-sex-specific CC &lt; 31 cm, respectively. All approaches had similar survival prediction (area under the ROC curves 65–67 %), and were independently associated with mortality. Using BMI-adjusted CC with sex-specific cutoff values (≤33/34) within the MNA-SF significantly improved survival prediction sensitivity (63.6 % versus 38.2 % with BMI and 40 % with CC &lt; 31). Malnourished patients classified by MNA-SF using sex-specific and BMI-adjusted CC cutoff values ≤ 33/34 exhibited the highest risk of mortality based on hazard ratios, compared to those classified by MNA-SF using BMI or CC &lt; 31.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Our study demonstrates that using s","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"48 ","pages":"Pages 60-69"},"PeriodicalIF":6.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143706273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Real-world experience of Teduglutide use in adults with short bowel syndrome: A seven-year international multicenter survey” Clin Nutr 2025 Feb 17:47:54–67","authors":"Francisca Joly ,&nbsp;Denise Jezerski ,&nbsp;Ulrich-Frank Pape ,&nbsp;Adriana Crivelli ,&nbsp;Elisabeth Hütterer ,&nbsp;Charlotte Bergoin ,&nbsp;Anna S. Sasdelli ,&nbsp;Umberto Aimasso ,&nbsp;Stéphane M. Schneider ,&nbsp;Florian Poullenot ,&nbsp;David Seguy ,&nbsp;Brooke Chapman ,&nbsp;Jacek Sobocki ,&nbsp;Nunzia Regano ,&nbsp;Georg Lamprecht ,&nbsp;Sabrina Layec ,&nbsp;Lidia Santarpia ,&nbsp;Nada Rotovnik Kozjek ,&nbsp;Livia Gallitelli ,&nbsp;Rafael Lopez-Urdiales ,&nbsp;Loris Pironi","doi":"10.1016/j.clnu.2025.03.005","DOIUrl":"10.1016/j.clnu.2025.03.005","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"48 ","pages":"Pages 35-37"},"PeriodicalIF":6.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of infant cow's milk protein consumption on subsequent IgE-mediated cow's milk allergic outcomes in a high-risk pediatric population","authors":"Liat Azani ,&nbsp;Tami Landau ,&nbsp;Michael Brandwein ,&nbsp;Mali Salmon-Divon","doi":"10.1016/j.clnu.2025.03.007","DOIUrl":"10.1016/j.clnu.2025.03.007","url":null,"abstract":"<div><h3>Background</h3><div>Cow's milk allergy typically develops earlier than other food allergies. The timing of cow's milk introduction during infancy may impact the development of IgE-mediated food sensitivity and allergy.</div></div><div><h3>Objective</h3><div>To explore the association between cow's milk consumption and the development of IgE-mediated and cow's milk sensitization and allergy in a high-risk pediatric population.</div></div><div><h3>Methods</h3><div>This secondary analysis used data from the Consortium for Food Allergy Research (CoFAR2) cohort, a multi-center, cross sectional study, examining peanut allergy progression in high-risk infants with pre-existing egg and/or milk allergies and/or atopic dermatitis aged 3–15 months. Skin prick tests and a physician assessment were conducted at the first visit. Univariate and multivariate regression models assessed the impact of cow's milk introduction in the hospital and at home on subsequent milk sensitization and allergy.</div></div><div><h3>Results</h3><div>Infants that did not consume milk formula had higher odds of developing milk sensitization (OR 2.17, CI 1.29–3.70, p &lt; 0.05) and lower odds of developing milk allergy (OR 0.59, CI 0.38–0.92, p = 0.02) compared to those who started formula before four months. Starting formula after four months showed a slight, non-significant increase in milk sensitization (OR 1.07 CI 0.51–2.32, p &gt; 0.05) and allergy (OR 1.78, CI 0.89–3.66, p &gt; 0.05). Infants not introduced to cow's milk products by the first visit were significantly more likely to develop sensitization and allergy, compared to those introduced before four months of age (OR sensitization 5.92 CI 2.91–12.32, p &lt; 0.001, OR allergy 1.95, CI 1.02–3.93, p &lt; 0.05). Introducing cow's milk after four months also significantly increased sensitization odds compared to early introduction (OR 1.61 CI 0.74–352, p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Early introduction of cow's milk protein in at-risk infants may lower the risk of IgE-mediated milk sensitization and allergy. The timing of introduction is crucial in shaping sensitivity and allergy outcomes, highlighting the need for further research regarding infant dietary practices to reduce milk allergy development.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"48 ","pages":"Pages 38-47"},"PeriodicalIF":6.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143684770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High plasma fibroblast growth factor 19 is associated with improved prognosis in patients with acute ischemic stroke","authors":"Xiao Ren ,&nbsp;Pinni Yang ,&nbsp;Lulu Sun ,&nbsp;Yiming Jia ,&nbsp;Chongke Zhong ,&nbsp;Jing Zhang ,&nbsp;Qilu Zhang ,&nbsp;Tan Xu ,&nbsp;Xiaowei Zheng ,&nbsp;Yonghong Zhang","doi":"10.1016/j.clnu.2025.03.013","DOIUrl":"10.1016/j.clnu.2025.03.013","url":null,"abstract":"<div><h3>Objective</h3><div>To prospectively investigate the relationships between plasma fibroblast growth factor 19 (FGF-19) and clinical outcomes in patients with acute ischemic stroke.</div></div><div><h3>Methods</h3><div>Plasma FGF-19 levels at baseline were measured for 3048 patients with ischemic stroke, and all patients were followed up at one year after stroke onset. The primary outcome was a combination of death and major disability (modified Rankin Scale score of ≥3) at one year after stroke onset, and secondary outcomes included major disability, death, recurrent stroke, vascular events and the combination of death and vascular events.</div></div><div><h3>Results</h3><div>During the 1-year of follow-up, 682 (22.38 %) patients experienced the primary outcome; 503 had a major disability and 179 died. After multivariate adjustment, higher plasma FGF-19 was significantly associated with decreased risk of the primary outcome (odds ratio = 0.48, 95 % confidence interval = 0.36–0.66). Each 1-SD increase of log-transformed FGF-19 (0.93 pg/mL) was associated with 20 % decreased risk of the primary outcome. The addition of FGF-19 to the conventional risk factors significantly improved prediction of the primary outcome in ischemic stroke patients (net reclassification index = 25.10 %, <em>p</em> &lt; 0.001; integrated discrimination improvement = 1.25 %, <em>p</em> &lt; 0.001). Furthermore, patients with both high FGF-19 (≥573.7 pg/mL) and low FGF-21 (&lt;740.1 pg/mL) levels had the lowest incidences of all study outcomes.</div></div><div><h3>Conclusions</h3><div>High plasma FGF-19 levels were associated with improved prognosis in patients with acute ischemic stroke, suggesting that FGF-19 may be a potential biomarker of good prognosis for ischemic stroke.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"48 ","pages":"Pages 16-24"},"PeriodicalIF":6.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of maternal serum folate, vitamin B12 and their imbalance with gestational diabetes mellitus: The mediation effects of the methionine cycle related metabolites","authors":"Xiyao Liu ,&nbsp;Xiaoling Zeng ,&nbsp;Jiaqi Wang ,&nbsp;Yanmei Hou ,&nbsp;Wei Li ,&nbsp;Yaxin Lou ,&nbsp;Meijing An ,&nbsp;Qianling Zhou ,&nbsp;Zhiwen Li","doi":"10.1016/j.clnu.2025.03.009","DOIUrl":"10.1016/j.clnu.2025.03.009","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Maternal high level of folate and low level of vitamin B12, namely “folate and vitamin B12 imbalance”, has been found to be associated with metabolic disorders, such as gestational diabetes mellitus (GDM). The aims of this study were to explore the associations of maternal serum folate, vitamin B12 and their imbalance in early pregnancy with GDM, and to explore the potential mediation effects of the methionine cycle related metabolites on the above associations.</div></div><div><h3>Methods</h3><div>This nested case–control study (172 GDM case–control pairs) was conducted based on a prospective birth cohort. Serum concentrations of 5-methyltetrahydrofolate (5-MTHF), vitamin B12 and methionine cycle related metabolites [S-adenosylmethionine (SAM), S-adenosylhomocysteine (SAH) and Homocysteine (Hcy)] were detected. 5-MTHF (nmol/L)/vitamin B12 (pmol/L) times 1000 was calculated to indicate the imbalance status of folate and vitamin B12. Conditional logistic regression was performed to analyze the associations of 5-MTHF, vitamin B12 and their imbalance with GDM. The mediation effect models were applied to explore the mechanism.</div></div><div><h3>Results</h3><div>High serum level of 5-MTHF in early pregnancy was related to a higher risk of GDM (OR = 2.00, 95%CI: 1.19–3.37). Compared with the group of the lowest tertile concentration of vitamin B12, the group of the highest concentration had a lower risk of GDM (OR = 0.33, 95%CI: 0.11–0.97). Higher 5-MTHF/vitamin B12 was associated with a higher risk of GDM (OR = 1.67, 95%CI: 1.08–2.56). Besides, no significant mediation effect of methionine cycle related metabolites was found on the associations of folate, vitamin B12 and the imbalance status with the risk of GDM.</div></div><div><h3>Conclusions</h3><div>High maternal serum folate, low vitamin B12 levels and the resulting imbalance may increase the risk of GDM. The theory of “folate trap” could not explain the effect of folate, vitamin B12 and their imbalance on GDM.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"48 ","pages":"Pages 50-59"},"PeriodicalIF":6.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143706272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}