Clinical nutrition最新文献

{"title":"Letter to the Editor–“Ultra-processed products and risk of liver cancer: A prospective cohort study”","authors":"Xinyue Yang, Zhiqiang Zhang","doi":"10.1016/j.clnu.2024.10.016","DOIUrl":"10.1016/j.clnu.2024.10.016","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 61-62"},"PeriodicalIF":6.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446279","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":"Increasing plant protein in the diet induces changes in the plasma metabolome that may be beneficial for metabolic health. A randomized crossover study in males","authors":"Gaïa Lépine ,&nbsp;François Mariotti ,&nbsp;Marie Tremblay-Franco ,&nbsp;Marion Courrent ,&nbsp;Marie-Anne Verny ,&nbsp;Jérémie David ,&nbsp;Véronique Mathé ,&nbsp;Patrick Jame ,&nbsp;Anthony Anchisi ,&nbsp;Catherine Lefranc-Millot ,&nbsp;Caroline Perreau ,&nbsp;Laetitia Guérin-Deremaux ,&nbsp;Céline Chollet ,&nbsp;Florence Castelli ,&nbsp;Emeline Chu-Van ,&nbsp;Jean-François Huneau ,&nbsp;Didier Rémond ,&nbsp;Gisèle Pickering ,&nbsp;Hélène Fouillet ,&nbsp;Sergio Polakof","doi":"10.1016/j.clnu.2024.10.009","DOIUrl":"10.1016/j.clnu.2024.10.009","url":null,"abstract":"<div><h3>Background &amp; aim</h3><div>Dietary shifts replacing animal protein (AP) with plant protein (PP) sources have been associated with lowering cardiometabolic risk (CMR), but underlying mechanisms are poorly characterized. This nutritional intervention aims to characterize the metabolic changes induced by diets containing different proportions of AP and PP sources in males at CMR.</div></div><div><h3>Design</h3><div>This study is a 4-week, crossover, randomized, controlled-feeding trial in which 19 males with CMR followed two diets providing either 36 % for the control diet (CON-D) or 64 % for the flexitarian diet (FLEX-D) of total protein intake from PP sources. Plasma nontargeted metabolomes (LC-MS method) were measured in the fasted state and after a high-fat challenge meal at the end of each intervention arm. Lipogenesis and protein synthesis fluxes, flow-mediated dilatation (FMD) and gluco-lipidic responses were assessed after the challenge meal. Data were analyzed with mixed models, and univariate and multivariate models for metabolomics data.</div></div><div><h3>Results</h3><div>In both arms CMR improved with time, with decreased body weight (−0.9 %), insulin resistant (−34 %, HOMA-IR, Homeostatic Model Assessment for Insulin Resistance) and low-density lipoproteins (LDL)-cholesterol (−11 %). Diet had no effect on FMD or metabolic fluxes, but a trend (0.05 &lt; <em>p</em> ≤ 0.1) was observed for a stronger decrease in HOMA-IR and lower postprandial glucose after FLEX-D <em>vs</em> CON-D. The abundance of 21 and 37 metabolites differed between diets at fasted and fed states, respectively, including food intake biomarkers of AP (methylhistidine, eicosapentaenoic acid, hydroxyprolines) and PP sources (trigonelline, N-acetyl-ornithine). In fasted or fed states, indole acrylic acid and indole propionic acid, both products of tryptophan catabolism, were higher after FLEX-D <em>vs</em> CON-D, while the indispensable amino acids-related metabolites alpha-aminoadipic acid, hydroxymethylbutyric acids and propionylcarnitine were lower. In the postprandial state only, the ω-oxidation products dodecanedioic, tetradecanedioic and hexadecanedioic acids were higher after FLEX-D <em>vs</em> CON-D.</div></div><div><h3>Conclusions</h3><div>Despite little changes in risk factors after 4 wk, this study evidenced subtle metabolic adaptations in amino acids and lipid metabolism and gut microbiota activity occurring after higher PP source intake that may be beneficial to CMR.</div></div><div><h3>Clinicaltrials.gov study identifier</h3><div>NCT04236518.</div></div><div><h3>Clinical trial registry</h3><div>NCT04236518 on ClinicalTrials.gov.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 146-157"},"PeriodicalIF":6.6,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496401","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":"Metabolic kinetics and muscle and brain health markers in older adults, and the role of age and presence of chronic morbidities: A large cross-sectional cohort study","authors":"Minchae C. Kang,&nbsp;Nicolaas E.P. Deutz,&nbsp;Sarah K. Kirschner,&nbsp;Mariëlle P.K.J. Engelen","doi":"10.1016/j.clnu.2024.10.015","DOIUrl":"10.1016/j.clnu.2024.10.015","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background &amp; aims&lt;/h3&gt;&lt;div&gt;Older adults are at risk for muscle and cognitive function decline during advanced aging, but the underlying metabolic mechanisms and the role of aging-associated chronic morbidities remain unclear. In the present study, we examined whether protein and amino acid kinetics in older adults with and without chronic morbidities are different when 50–70 and 70–90 of age and related to markers of muscle and brain health declines.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In a large cross-sectional observational study, 575 older adults from 12 trials (2014–2022) were stratified based on their age (50-70y vs. 70-95y) and the presence of chronic morbidities. The main outcomes were whole-body production (WBP) and interconversions of amino acids by stable amino acid tracers, body composition, and muscle and cognitive performance. Additionally, the association between metabolic markers and muscle and brain health was assessed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Overall lower muscle strength, muscle and fat mass, and cognitive function (p &lt; 0.03), but no mood disturbances, were found in 70–95y compared to 50-70y older adults. Presence of morbidities was associated with lower muscle strength and mass, and cognitive function, but higher visceral adipose tissue, and mood disturbances (p &lt; 0.05). Aging was associated with suppressed WBP of most amino acids, &lt;em&gt;de novo&lt;/em&gt; arginine production, and net protein breakdown, but higher myofibrillar protein breakdown (p &lt; 0.007). Presence of morbidities was associated with lower WBP of glutamine, glutamate, histidine, isoleucine, phenylalanine, tyrosine, and net protein breakdown, and higher WBP of valine and taurine (p &lt; 0.04). Age showed significant negative correlations with WBP of nearly all amino acids, &lt;em&gt;de novo&lt;/em&gt; arginine production and net protein breakdown (r: [-0.407, −0.136], p &lt; 0.01) but a positive correlation with WBP of myofibrillar protein breakdown (r = 0.133, p = 0.009). Lean mass showed positive correlations with &lt;em&gt;de novo&lt;/em&gt; arginine production and net protein breakdown and WBP of all amino acids except for isoleucine (r: [0.16, 0.799], p &lt; 0.005). MoCA showed a positive correlation with WBP of leucine and valine (r: [0.163, 0.2], p &lt; 0.03). Worse cognitive performance was positively associated with WBP of tau-methylhistidine and taurine (r: [0.13, 0.141], p &lt; 0.04), but negatively associated with WBP of glycine and valine, &lt;em&gt;de novo&lt;/em&gt; arginine production, and net protein breakdown (r: [-0.222, −0.115], p &lt; 0.05).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Comprehensive phenotyping of a large group of older adults revealed differences in metabolic health in response to advanced aging and chronic morbidities. Poor muscle health accompanied by advanced aging was associated with overall metabolic downregulation, except for enhanced myofibrillar (muscle) protein breakdown. Presence of chronic morbidities was further associated w","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 36-47"},"PeriodicalIF":6.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446207","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":"Analysis of fat oxidation capacity during cardiopulmonary exercise testing indicates long-lasting metabolic disturbance in patients with post-covid-19 syndrome","authors":"René Garbsch ,&nbsp;Hendrik Schäfer ,&nbsp;Frank C. Mooren ,&nbsp;Boris Schmitz","doi":"10.1016/j.clnu.2024.10.010","DOIUrl":"10.1016/j.clnu.2024.10.010","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Post-COVID-19 Syndrome (PCS) is characterized by symptoms including fatigue, reduced physical performance, dyspnea, cognitive impairment, and psychological distress. The mechanisms underlying the onset and severity of PCS point to mitochondrial dysfunction as significant contributor. This study examined fat oxidation as a function of mitochondrial capacity during exercise.</div></div><div><h3>Methods</h3><div>Single-center prospective cohort study during inpatient rehabilitation. Cardiopulmonary exercise testing and assessment of fatigue using questionnaires were performed at admission and discharge. Detailed spirometric breath-by-breath data were used to calculate substrate oxidation rates.</div></div><div><h3>Results</h3><div>Patients (N = 187; 38 % women; 49.7 ± 11.4 years) were referred to rehabilitation 253.4 ± 130.6 days after infection. Lead symptoms included fatigue/exercise intolerance (79.9 %), shortness of breath (77.0 %), and cognitive dysfunction (55.1 %). Fat oxidation capacity was disturbed in PCS patients overall (AUC: 11.3 [10.7–11.9]) compared to healthy controls (p &lt; 0.0001), with hospitalization during acute infection predicting the level of disturbance (p &lt; 0.0001). Low exercise capacity and high fatigue scores resulted in reduced fat oxidation (both p &lt; 0.0001). In particular, younger males were affected by significantly reduced fat oxidation capacity (sex: p = 0.002; age: p &lt; 0.001). Metabolic disturbance was significantly improved during exercise-based rehabilitation (AUC: 14.9 [14.4–15.4]; p &lt; 0.0001), even for the group of younger impaired males (+44.2 %; p &lt; 0.0001). Carbohydrate oxidation was not impaired.</div></div><div><h3>Conclusions</h3><div>PCS-specific restrictions in fat oxidation may indicate persistent mitochondrial dysfunction. Clinical assessment of PCS patients should include detailed breath-by-breath analysis during exercise to identify metabolic alterations especially in the group of younger males identified in this report. Exercise-based rehabilitation results in improved exercise capacity and fat oxidation and thus likely mitochondrial function. Clinical Trials: NCT06468722.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 26-35"},"PeriodicalIF":6.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446208","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":"Bioelectrical impedance analysis (BIA) phase angle in stroke patients: A systematic review","authors":"Chiara Francesca Gheri ,&nbsp;Luca Scalfi ,&nbsp;Maria Luisa Eliana Luisi ,&nbsp;Olivia Di Vincenzo","doi":"10.1016/j.clnu.2024.10.001","DOIUrl":"10.1016/j.clnu.2024.10.001","url":null,"abstract":"<div><h3>Background and aims</h3><div>Phase angle (PhA), a raw variable of bioelectrical impedance analysis (BIA), is an index of muscle structure and quality and might have a potential role in the evaluation of nutritional status.</div><div>The aim of this systematic review was to evaluate in stroke patients: baseline PhA and its changes during hospital stay; the association of PhA with clinical features of patients, comorbidities, nutritional status or sarcopenia, and clinical outcomes.</div></div><div><h3>Methods</h3><div>Systematic research on electronic databases (PubMed, Scopus, and Web of Science) up to June 14th, 2024 was performed according to PRISMA checklist.</div><div>Using PECOS strategy, “P” (patients) = stroke patients, “E” (exposure) = lowest PhA values, “C” (comparison) = versus greatest PhA values, “O” (outcome) = nutritional and clinical outcomes, and “S” (study design) = all study types.</div><div>Methodological quality was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies (NIH).</div></div><div><h3>Results</h3><div>Eighteen papers met the inclusion criteria, with a low risk of bias. In stroke patients, evidence suggests that PhA was associated with malnutrition, sarcopenia and sarcopenic obesity, as well as with physical function. In addition, patients with low PhA had a longer hospital stay, higher inflammatory status and higher incidence of urinary tract infections and hospital-acquired pneumonia.</div></div><div><h3>Conclusions</h3><div>Selected papers, although not conclusive, show that in acute and subacute stroke patients PhA was inversely associated with malnutrition and poor physical function. PhA could be a marker of health status and disease progression. PhA may be useful in a more comprehensive evaluation of nutritional status to be used for diagnosis and implementing therapy.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 63-72"},"PeriodicalIF":6.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459820","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":"Association of moderate alcohol intake with the risks of cirrhosis and steatotic liver disease: Results from a large population-based cohort study","authors":"Hongliang Xue ,&nbsp;Liqing Wang ,&nbsp;Yuankai Wu ,&nbsp;Xinyu Liu ,&nbsp;Jingcheng Jiang ,&nbsp;Sun On Chan ,&nbsp;Xu Chen ,&nbsp;Wenhua Ling ,&nbsp;Chao Yu","doi":"10.1016/j.clnu.2024.10.014","DOIUrl":"10.1016/j.clnu.2024.10.014","url":null,"abstract":"<div><h3>Background&amp;aims</h3><div>There is uncertainty about the associations between moderate alcohol consumption and liver-related outcomes. We aimed to explore the associations of moderate drinking with cirrhosis, steatotic liver disease (SLD), and liver cancer in a large cohort study.</div></div><div><h3>Methods</h3><div>A total of 215,559 non-drinkers and moderate drinkers (&lt;20 g/day alcohol for females or &lt; 30 g/day for males) were enrolled between 2006 and 2010 and followed up to 2022. The primary outcome is incident cirrhosis, and the secondary outcomes are the incidence of steatotic liver disease and liver cancer. Hazard ratios (HRs) and 95 % confidence intervals (CIs) were calculated for liver-related outcomes in relation to moderate drinkers, as well as the quantity and type of their alcohol intake. All analyses were stratified by sex.</div></div><div><h3>Results</h3><div>A total of 705 cirrhosis, 2010 SLD, and 350 liver cancer cases were documented during a median follow-up period of 12.7 years. Compared with non-drinkers, moderate drinkers had a lower risk of SLD (HR: 0.77; 95 % CI: 0.66, 0.89). Among the moderate drinkers, alcohol intake [per standard deviation (SD) increment] was associated with an increased risk of incident cirrhosis (HR: 1.11; 95 % CI: 1.02, 1.20), but the association was attenuated after restricting alcohol intake to no more than 16 g/day. Wine consumption (per SD increment of the percentage of wine consumption of total alcohol intake) had an inverse association with incident cirrhosis and SLD (HR: 0.82; 95 % CI: 0.75, 0.89 for cirrhosis; HR: 0.91; 95 % CI: 0.87, 0.96 for SLD). The inverse associations between moderate wine use and SLD were likely to be sex-dependent (<em>P</em> for interaction = 0.01).</div></div><div><h3>Conclusions</h3><div>The excessive alcohol threshold of 30 g/day for males may be set high for liver health. Further work is needed to make sex-specific recommendations on moderate drinking for liver health.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 75-83"},"PeriodicalIF":6.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459819","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":"Effects of the interaction between body mass index and dietary patterns on severe NAFLD incidence: A prospective cohort study","authors":"Yuxiao Wang ,&nbsp;Jing Li ,&nbsp;Congying Song ,&nbsp;Jingwen Zhang ,&nbsp;Zhidong Liu ,&nbsp;Wenjun Zhou ,&nbsp;Xiaoyan Huang ,&nbsp;Guang Ji ,&nbsp;Ying Shan ,&nbsp;Liang Dai","doi":"10.1016/j.clnu.2024.10.008","DOIUrl":"10.1016/j.clnu.2024.10.008","url":null,"abstract":"<div><h3>Background</h3><div>It remains unclear whether the associations between dietary patterns and non-alcoholic fatty liver disease (NAFLD) vary by body mass index (BMI). We aimed to explore the association between dietary patterns and severe NAFLD incidence, and further investigate the interaction of BMI with dietary patterns.</div></div><div><h3>Methods</h3><div>In a prospective cohort study using UK Biobank data, we included White participants with baseline food frequency questionnaire (FFQ) information. Principal component analysis (PCA) with varimax rotation was performed to identify major dietary patterns. The primary outcome was severe NAFLD, defined as hospitalization due to NAFLD or non-alcoholic steatohepatitis (NASH). We employed cause-specific Cox regression for competing risks to assess the association and calculated the relative excess risk due to interaction (RERI) to estimate the interaction of BMI.</div></div><div><h3>Results</h3><div>This study included 307,130 participants with a median follow-up of 12.68 years. 3104 cases of severe NAFLD were identified. PCA analysis revealed two primary dietary patterns: a prudent diet (RC1) and a meat-based diet (RC2). Multivariate analysis showed a standard deviation (SD) increase in RC1 was associated with lower severe NAFLD risk (HR 0.91 [95 % CI 0.88 to 0.94]), while a SD increase in RC2 was associated with higher risk (1.10 [1.05 to 1.14]). Significant interactions were observed between baseline BMI ≥25 kg/m² and dietary patterns (RC1: RERI: −0.22 [95 % CI –0.43 to −0.003]; RC2: 0.29 [0.03 to 0.56]).</div></div><div><h3>Conclusions</h3><div>Targeted dietary modifications are vital for specific populations at risk of severe NAFLD, considering the significant interaction observed between BMI and dietary patterns.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 92-100"},"PeriodicalIF":6.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496467","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":"Letter to the Editor–“Risk factors for low muscle mass, malnutrition, and (probable-) sarcopenia in adults with or without a history of cancer in the UK Biobank”","authors":"Lu-fang Huang,&nbsp;Rui-xuan Li","doi":"10.1016/j.clnu.2024.10.003","DOIUrl":"10.1016/j.clnu.2024.10.003","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 15-16"},"PeriodicalIF":6.6,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446291","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":"Reply–Letter to the Editor: Review of “Dietary patterns, inflammatory biomarkers and cognition in older adults: An analysis of three population-based cohorts”","authors":"Natalia Ortega,&nbsp;Leona Schütte,&nbsp;Patricia O. Chocano-Bedoya","doi":"10.1016/j.clnu.2024.10.013","DOIUrl":"10.1016/j.clnu.2024.10.013","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 3-4"},"PeriodicalIF":6.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142441030","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":"Apolipoprotein C-III in association with metabolic-dysfunction associated steatotic liver disease: A large, multicenter study","authors":"Matina Kouvari ,&nbsp;Laura Valenzuela-Vallejo ,&nbsp;Valentina Guatibonza-Garcia ,&nbsp;Ornella Verrastro ,&nbsp;Evangelos Axarloglou ,&nbsp;Sophia C. Mylonakis ,&nbsp;Jacob George ,&nbsp;Georgios Papatheodoridis ,&nbsp;Geltrude Mingrone ,&nbsp;Christos S. Mantzoros","doi":"10.1016/j.clnu.2024.10.007","DOIUrl":"10.1016/j.clnu.2024.10.007","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>The available literature on the effect of apolipoprotein C-III (ApoC-III) inhibition in MASLD reveals inconsistencies. The aim of the present work was to examine levels of ApoC-III in the entire spectrum of metabolic-dysfunction associated steatotic liver disease (MASLD).</div></div><div><h3>Methods</h3><div>This is a multicenter study involving patients enrolled in two gastroenterology-hepatology clinics (Greece and Australia) and in a bariatric-metabolic surgery clinic (Italy), with liver biopsy before and after bariatric surgery or lifestyle modification.</div></div><div><h3>Results</h3><div>Comparing simple MASL to steatohepatitis (MASH) with fibrosis stage F ≥ 2 (at-risk MASH), revealed a marginally significant trend for decreased ApoC-III levels in the latter group (<em>p</em> = <em>0.07</em>). Multi-adjusted analysis revealed an inverse association between ApoC-III and at-risk MASH (Odds Ratio_{per 1 mg/dL increase in ApoC-III} = 0.91, 95 % Confidence Interval (0.83, 0.99)). ApoC-III interacted with triglycerides in predicting at-risk MASH (<em>p-for-interaction</em> = <em>0.002</em>). Participants with ApoC-III &gt; median (∼3.75 mg/dL) and normal triglycerides (triglyceridese≤150 mg/dL) had the lowest likelihood to present at-risk MASH (31.8 %) in contrast with participants with ApoC-III &lt; median and hypertriglyceridemia among whom at-risk MASH was recorded in 57.1 %. In multi-adjusted analysis participants with normal triglycerides and high ApoC-III had 64 % lower odds of at-risk MASH compared with their counterparts with ApoC-III &lt; median (OR = 0.36, 95%CI (0.14, 0.86)). Among participants with hypertriglyceridemia, those with ApoC-III &lt; median had less prevalent at-risk MASH compared with those with ApoC-III ≥ median (OR = 0.54, 95%CI (0.32, 0.98)); however in all cases significance was lost when liver enzymes were taken into account.</div></div><div><h3>Conclusions</h3><div>In advanced disease stages, ApoC-III levels seem to be decreased and advanced organ damage may be a potential explanation. Mendelian randomization studies are needed to confirm or refute this hypothesis.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"43 12","pages":"Pages 101-108"},"PeriodicalIF":6.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496465","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}