Clinical nutrition最新文献

{"title":"Comment on “Effects of ketogenic and low-carbohydrate diets on the body composition of adults with overweight or obesity: A systematic review and meta-analysis of randomised controlled trials”","authors":"Zi-Ying Li, Mei-Yuan Liu, Jheng-Yan Wu","doi":"10.1016/j.clnu.2025.07.035","DOIUrl":"10.1016/j.clnu.2025.07.035","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"Pages 234-235"},"PeriodicalIF":7.4,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828462","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 fasting-mimicking diets with low and high protein content on cardiometabolic health and autophagy: A randomized, parallel group study","authors":"Lucy Burns ,&nbsp;Scott Cooper ,&nbsp;Sarir Sarmad ,&nbsp;Guido Funke ,&nbsp;Antonio Di Mauro ,&nbsp;George C. Gaitanos ,&nbsp;Kostas Tsintzas","doi":"10.1016/j.clnu.2025.08.004","DOIUrl":"10.1016/j.clnu.2025.08.004","url":null,"abstract":"<div><h3>Background &amp; aim</h3><div>Very low-calorie, fasting-mimicking diets (FMD) have been shown to promote cardiometabolic health and autophagy. However, most studies have focused on low protein diets to stimulate autophagy and reduce ageing-related factors. The aim of this study was to investigate the physiological, metabolic and molecular effects of a 7-day plant-based FMD with low protein/high fat (LP) and high protein/low fat content (HP) in healthy humans and compare those responses to a non-intervention comparator control group.</div></div><div><h3>Methods</h3><div>Forty six healthy men and women were randomly assigned to one of three groups: CONTROL (isoenergetic diet), n = 16 (mean ± SD age 35.0 ± 9.5 yrs, BMI 23.3 ± 2.7 kg^.m⁻²); LP-FMD (850 Calories per day: 10 % protein/45 % fat), n = 15, (age 38.2 ± 10.7 yrs, BMI 23.4 ± 3.2 kg^.m⁻²); HP-FMD (850 Calories per day: 30 % protein/25 % fat), n = 15, (age 41.4 ± 8.8 yrs, BMI 25.1 ± 3.7 kg^.m⁻²). Blood and faecal sampling, DEXA scans and functional tests of cardiovascular health were performed before and after each 7-day treatment.</div></div><div><h3>Results</h3><div>Both FMDs reduced body weight and fat mass (interaction effects P &lt; 0.0001) but only HP-FMD reduced visceral fat mass relative to CONTROL [mean difference (95 % CI): −0.09 (−0.15 to −0.03) kg, P = 0.006]. Both FMDs reduced fasting plasma glucose by ∼10 % [LP-FMD: -0.41 (−0.80 to −0.02) mmol^.L⁻¹, P = 0.038; HP-FMD: [-0.46 (−0.74 to −0.17) mmol^.L⁻¹, P = 0.003] and IGF1 by ∼35 % [LP=FMD: −9.0 (−12.4 to −5.5) nmol^.L⁻¹, P &lt; 0.0001; HP-FMD: −5.4 (−8.6 to −2.1) nmol^.L⁻¹, P = 0.024] relative to CONTROL. The increase in serum hydroxybutyrate was higher in the LP- than HP-FMD [0.64 (0.13 to 1.15) mmol^.L⁻¹, P = 0.015]. Heart rate variability (P &lt; 0.0001), gut microbiome diversity (P = 0.003), circulating triglycerides (P = 0.009) and saturated fatty acids (P = 0.008) were improved in HP-FMD only. Both FMDs induced autophagy at the molecular level.</div></div><div><h3>Conclusion</h3><div>Both FMDs promoted cardiometabolic health and induction of autophagy, with HP-FMD selectively conferring novel benefits in body composition, circulating lipid profiles, heart rate variability and gut microbiome health. These findings suggest that FMDs with varied macronutrient compositions could be customised to better align with individual health goals and preferences.</div></div><div><h3>Clinical trial registry number</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> Identifier NCT06560996.</div></div><div><h3>URL of registration</h3><div><span><span>https://clinicaltrials.gov/study/NCT06560996</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"Pages 299-312"},"PeriodicalIF":7.4,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144840961","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 time-restricted eating on glycemic control in type 2 diabetes: A 12-week quasi-experimental single-arm study with 1-year follow-up","authors":"Wei Fu ,&nbsp;Kun Yang ,&nbsp;Rongsong Tang ,&nbsp;Jingpin Wang ,&nbsp;Ye Liu ,&nbsp;Guoqiang Liu ,&nbsp;Ran Lu ,&nbsp;Wenhui Zhang ,&nbsp;Lin Zhuo ,&nbsp;Jin Yang ,&nbsp;Qun Wang ,&nbsp;Tianpei Hong","doi":"10.1016/j.clnu.2025.08.002","DOIUrl":"10.1016/j.clnu.2025.08.002","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Time-restricted eating (TRE) is a newly emerging dietary strategy that reduces body weight and improves glucose tolerance in individuals with overweight or obesity. However, whether TRE is effective in improving glycemic control in individuals with diabetes remains unexplored. Herein, we aimed to investigate the effects of TRE intervention on glycemic control in patients with type 2 diabetes.</div></div><div><h3>Methods</h3><div>In this single-center, open-label, self-controlled trial, 18 overweight or obese adults with type 2 diabetes inadequately controlled on lifestyle modification alone or in combination with metformin and/or α-glycosidase inhibitors were enrolled to receive a 10-h TRE for 12 weeks. The effects of TRE on glucose metabolism, body weight, body composition and other metabolic parameters were evaluated in these participants following the intervention.</div></div><div><h3>Results</h3><div>The 12-week TRE intervention not only significantly reduced body weight (−1.72 ± 1.83 kg, <em>P</em> &lt; 0.001), but also remarkably improved glycemic control, with reduced glycated hemoglobin (HbA1c; −0.69 % ± 0.48 %, <em>P</em> &lt; 0.001) and fasting blood glucose (−0.90 ± 1.27 mmol/L, <em>P</em> = 0.008) levels. In addition, TRE also significantly reduced triglyceride level (−0.26 mmol/L [−0.52 to −0.04 mmol/L], <em>P</em> = 0.004) and fatty liver index (−8.64 [−15.4 to −2.87], <em>P</em> = 0.003) after 12 weeks of intervention. Notably, the benefits for HbA1c reduction lasted for up to 1 year.</div></div><div><h3>Conclusions</h3><div>TRE can improve glycemic control up to 1 year in individuals with type 2 diabetes. Our findings indicate that TRE may represent a novel diet management option for patients with type 2 diabetes.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"Pages 263-274"},"PeriodicalIF":7.4,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828461","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":"Dietary protein intake and body composition, sarcopenia and sarcopenic obesity: A prospective population-based study","authors":"Yahong Wu ,&nbsp;Tosca O.E. de Crom ,&nbsp;Zhangling Chen ,&nbsp;Elizabeth Benz ,&nbsp;Niels van der Schaft ,&nbsp;Alexandre Pinel ,&nbsp;Yves Boirie ,&nbsp;Doris Eglseer ,&nbsp;Eva Topinkova ,&nbsp;Josje D. Schoufour ,&nbsp;Peter J.M. Weijs ,&nbsp;Fernando Rivadeneira ,&nbsp;Cindy G. Boer ,&nbsp;Joyce B.J. van Meurs ,&nbsp;Trudy Voortman","doi":"10.1016/j.clnu.2025.07.033","DOIUrl":"10.1016/j.clnu.2025.07.033","url":null,"abstract":"<div><h3>Background&amp;aims</h3><div>Obesity and sarcopenia are major health concerns, particularly among older populations. Dietary protein may help preserve muscle mass and function, but high-protein diets, especially from animal sources, may also increase adipose mass. We investigated associations of total, animal, and plant protein intake with body composition trajectories, sarcopenia, and sarcopenic obesity.</div></div><div><h3>Methods</h3><div>We included 4576 participants (mean age 65.1 years, 56 % women) from the population-based Rotterdam Study. Dietary protein was measured using food-frequency questionnaires at baseline (2004–2009). Body composition was measured every 4–5 years using dual X-ray-absorptiometry. Handgrip strength (HGS) was assessed starting 2006 using a hydraulic dynamometer. Sarcopenia was determined based on low appendicular skeletal muscle and HGS; and sarcopenic obesity risk based on measures of lean mass, HGS and body fat. Analyses used linear mixed models and generalized estimate equation models.</div></div><div><h3>Results</h3><div>Higher total protein intake was associated with increased BMI over time (mean difference [95 %-confidence interval (CI)]: 0.86 kg/m² [0.01,1.71] per 5E% increase), and increased fat-mass index (1.33 [0.67,1.99]), body-fat-percentage (4.54[2.76,6.31]), and both gynoid and android fat percentage. Higher protein intake was also associated with a higher sarcopenic obesity risk (−0.85[-1.5,-0.2]), but with a lower sarcopenia risk (odds ratio: 0.62 [0.43,0.90]). These associations were mainly driven by animal protein.</div></div><div><h3>Conclusion</h3><div>Higher protein intake, particularly from animal food sources, is protective against sarcopenia but also linked to a higher obesity risk. A balanced protein intake advice for older persons should be formulated based on individual needs and health status to prevent sarcopenia, obesity, and sarcopenic obesity.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"53 ","pages":"Pages 26-34"},"PeriodicalIF":7.4,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144879393","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 to letter to the editor: The potential of body mass index-adjusted calf circumference as a proxy for low muscle mass in the global leadership initiative on malnutrition criteria","authors":"Shuzo Miyahara,&nbsp;Keisuke Maeda,&nbsp;Akiyuki Yasuda,&nbsp;Shosuke Satake,&nbsp;Hidenori Arai","doi":"10.1016/j.clnu.2025.07.038","DOIUrl":"10.1016/j.clnu.2025.07.038","url":null,"abstract":"","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"53 ","pages":"Pages 49-50"},"PeriodicalIF":7.4,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887244","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 isolated single fibers, fiber mixtures, and fiber-rich whole foods on glucose homeostasis in individuals with overweight and obesity: A systematic review and meta-analysis","authors":"Hatice Colak ,&nbsp;Gillian N.F. Larik ,&nbsp;Marleen A. van Baak ,&nbsp;Emanuel E. Canfora","doi":"10.1016/j.clnu.2025.08.003","DOIUrl":"10.1016/j.clnu.2025.08.003","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Increasing evidence from epidemiological studies indicates that dietary fibers are protective against the development of type 2 diabetes mellitus. Supplementation of dietary fiber may therefore be a strategy to improve metabolic health in individuals with overweight and obesity at high risk to develop type 2 diabetes mellitus (T2DM). However, results from intervention studies are inconsistent, which may be related to the form of supplementation. In this systematic review and meta-analysis, we evaluated randomized controlled trials (RCTs) investigating the effects of dietary fiber administered as single isolated fibers, mixtures of isolated fibers, or fiber-rich whole foods on markers of insulin resistance and glucose homeostasis in individuals with overweight or obesity without T2DM.</div></div><div><h3>Methods</h3><div>PubMed, Scopus, Web of Science and Embase databases were searched for RCTs comparing the effects of fiber supplementation with placebo treatments on glucose homeostasis. Changes in outcome parameters were analyzed using random effects meta-analyses to estimate effect size and 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>A total of 51 eligible papers (n = 3420 participants) with a study duration between one and twelve months were included in the meta-analysis. Dietary fiber supplementation improved fasting glucose concentrations −0.07 mmol/L (95 % CI: −0.12, −0.02; P = 0.0005; I² = 54 %), reduced fasting insulin levels −5.89 pmol/L (95 % CI -9.18, −2.60, P = 0.0004; I² = 89 %), and decreased HOMA-IR -0.38 (95 % CI: −0.68, −0.08; P &lt; 0.00001; I² = 94 %). In addition, subgroup analysis revealed that supplementation of single fibers improved fasting insulin, Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), hemoglobin A1c (HbA1c) and insulin area under the curve (AUC). Isolated fiber mixtures in addition reduced fasting glucose but not insulin AUC. Supplementation of whole foods only improved HbA1c.</div></div><div><h3>Conclusion</h3><div>Dietary fiber supplementation improved glucose homeostasis and insulin sensitivity in individuals with overweight and obesity without T2DM. Although differential effects were observed based on the form of fiber supplementation, no form of fiber supplementation could be considered superior.</div><div>The study was registered in PROSPERO as CRD42023427415.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"Pages 236-251"},"PeriodicalIF":7.4,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828459","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":"Low adipose tissue infiltration in skeletal muscle is a protective phenotype of all-cause death in patients undergoing dialysis","authors":"Jing Zheng ,&nbsp;Shi-yuan Wang ,&nbsp;Guo-hao Zheng ,&nbsp;Jian Zhang ,&nbsp;Shi-mei Hou ,&nbsp;Yu-nuo Li ,&nbsp;Li Tian ,&nbsp;Li Yuan ,&nbsp;Dong-yang Yin ,&nbsp;Hui-min Chen ,&nbsp;Min Li ,&nbsp;Yao Wang ,&nbsp;Jing-yuan Cao ,&nbsp;Yan-zhi Li ,&nbsp;Jing-jie Xiao ,&nbsp;Min Yang ,&nbsp;Xiao-liang Zhang ,&nbsp;Bi-Cheng Liu ,&nbsp;Bin Wang","doi":"10.1016/j.clnu.2025.07.028","DOIUrl":"10.1016/j.clnu.2025.07.028","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>A newly developed low-attenuation muscle index (LAMI) reflects the relationship of the degree of adipose tissue infiltration in low-attenuation muscle and the skeletal muscle quality on computed tomography (CT) images. We investigated the relationship between CT-derived LAMI and ratio of low-attenuation muscle area to skeletal muscle area (LAMA/SMA) at transverse process of the first lumbar vertebra (L1) and all-cause death in dialysis patients.</div></div><div><h3>Methods</h3><div>This retrospective cohort study of initial-dialysis patients enrolled from January 1, 2014, to June 30, 2020. The endpoint of all-cause death was recorded up to December 31, 2022. Patients were divided into low- (n = 408) and high- (n = 425) LAMI groups according to the sex-based LAMI cutoff value. Baseline clinical data, CT-derived parameters, survival rates and survival times were compared between the two groups. Restricted cubic spline was used to explore the relationships between LAMI and all-cause death separately for men and women. Multivariate Cox regression analysis and stepwise Cox regression analysis were used to analyze the association between LAMI and all-cause death.</div></div><div><h3>Results</h3><div>A total of 833 patients were eligible to analysis, and 536 (64.35 %) patients were male. The median follow-up time was 3.86 years (range, 0–9.11), and 225 (27.01 %) patients died during follow-up period. The low-LAMI group exhibited significantly lower low-attenuation muscle radiodensity [6.35(4.33,7.67)HU <em>vs.</em> 7.58(6.06,8.92)HU] and LAMA/SMA ratio [0.35(0.27,0.44) <em>vs.</em> 0.43(0.34, 0.51)], yet significantly greater skeletal muscle radiodensity (41.50 [7.09]HU <em>vs.</em> 29.60 [7.46]HU) compared to the high-LAMI group (all <em>P</em> &lt; 0.001). Additionally, this group had a significantly lower incidence of all-cause death (20.3 % <em>vs.</em> 33.4 %) and significantly longer survival time (50.97[24.98]months <em>vs.</em> 44.90[23.92]months) (both <em>P</em> &lt; 0.001). According to the sex-based restricted cubic spline models, linear relationships between LAMI and all-cause death were found for men and women (both nonlinear <em>P</em> &gt; 0.05). Multivariate Cox regression analysis and stepwise Cox regression analysis revealed that a low LAMI and a low LAMA/SMA ratio were both independent protective factors of all-cause death in dialysis patients (all <em>P</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>Adipose tissue infiltration in skeletal muscle is not always a harmful phenotype for dialysis patients, when its area is relatively localized.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"Pages 162-170"},"PeriodicalIF":7.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144781223","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":"Adherence to a Mediterranean dietary pattern is associated with biochemical remission in patients with Crohn's disease","authors":"Lior Mor-Sasson ,&nbsp;Chen Sarbagili-Shabat ,&nbsp;Shiri Sherf-Dagan ,&nbsp;Shira Zelber-Sagi ,&nbsp;Nathaniel Aviv Cohen ,&nbsp;Yulia Ron ,&nbsp;Ayal Hirsch ,&nbsp;Tamar Thurm ,&nbsp;Nitsan Maharshak ,&nbsp;Naomi Fliss-Isakov","doi":"10.1016/j.clnu.2025.07.036","DOIUrl":"10.1016/j.clnu.2025.07.036","url":null,"abstract":"<div><h3>Background</h3><div>The Mediterranean Diet (MD) was recently found to have benefits for patients with Crohn's Disease (CD) in various stages of the disease, though adherence to it may be limited during active disease. We aimed to evaluate the association between adherence to the MD and changes in fecal calprotectin (FC) levels among patients with CD in clinical and biochemical remission.</div></div><div><h3>Methods</h3><div>A prospective cohort of patients with CD in clinical and biochemical remission [Harvey-Bradshaw Index (HBI) &lt; 5 and FC &lt; 250 μg/g]. Patients with FC ≤ 150 μg/g were further categorized as those in deep biochemical remission. The Israeli Mediterranean dietary screener (I-MEDAS) was used to assess adherence to the MD. The median score of the study sample was used as a cut-off for the classification of “adherent” or “non-adherent”.</div></div><div><h3>Results</h3><div>A total of 96 patients were included in the analysis. Over time, adherence rate to the MD decreased by 25 % among those who were adherent at baseline and increased by 43.8 % among those who were non-adherent at baseline. Patients who were adherent at baseline had higher rates of deep remission at baseline compared with those who were non-adherent at baseline (96.2 % vs. 79.1 % respectively, p = 0.009), and higher rates of remission and deep remission at 3 months (97.5 % vs. 78.6 %, p = 0.011; and 87.5 % vs. 64.3 %, p = 0.023 respectively), but not at 6 months. Throughout follow-up, the change in FC levels was negatively correlated with the change in adherence to low intake of detrimental MD components (r = −0.340, p = 0.006), but not with high intake of beneficial components (p = 0.733).</div></div><div><h3>Conclusion</h3><div>Adherence to the MD was associated with lower FC levels at baseline and after 3 months. Future studies should examine the long-term effects of MD adherence on the maintenance of clinical and biochemical remission in CD.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"53 ","pages":"Pages 51-59"},"PeriodicalIF":7.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887243","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":"Dynamics of oxidative stress and antioxidant capacity in relation to renal outcomes in septic patients with acute kidney injury: A cross-sectional and follow-up study","authors":"Tsai-Jung Wang ,&nbsp;Wei-Ru Lin ,&nbsp;Shih-Chien Huang ,&nbsp;Cheng-Hsu Chen ,&nbsp;Chen-Yu Wang ,&nbsp;Yi-Chia Huang","doi":"10.1016/j.clnu.2025.07.031","DOIUrl":"10.1016/j.clnu.2025.07.031","url":null,"abstract":"<div><h3>Background &amp; aims</h3><div>Sepsis frequently results in acute kidney injury (AKI), a common complication among critically ill patients. Understanding the dynamics of oxidative stress and antioxidant capacity in septic patients, particularly those with AKI, could improve the monitoring and prediction of renal outcomes. This study aimed to evaluate fluctuations in oxidative stress and antioxidant capacities in septic patients with and without AKI at the time of admission to the intensive care unit (ICU) and one week later. In addition, it sought to investigate the potential correlation between specific oxidative stress and antioxidant markers and renal outcomes.</div></div><div><h3>Methods</h3><div>A cross-sectional and follow-up study was conducted, involving 124 critically ill septic patients. The patients were divided into groups according to the presence of AKI at admission to the ICU. Epidemiological, clinical data, and biochemical measurements of oxidative stress and antioxidant capacity were collected on days 1 and 7 of ICU admission.</div></div><div><h3>Results</h3><div>The results indicated that plasma concentrations of advanced oxidation protein products (AOPP) were significantly higher in patients with AKI on both evaluation days. Notable differences in antioxidant capacities, including plasma glutathione (GSH), glutathione peroxidase (GPx), and superoxide dismutase, were observed between the two groups. In patients with AKI, plasma oxidative stress and antioxidant capacity demonstrated a close relationship. Specifically, plasma GSH concentrations on day 1 were correlated with increased odds of major adverse kidney events within 14 and 28 days (MAKE14 and MAKE28), while elevated plasma GPx activities on day 7 were associated with reduced odds of MAKE14 and MAKE28.</div></div><div><h3>Conclusions</h3><div>Monitoring plasma GSH concentrations on the 1st day of ICU admission, in conjunction with the evaluation of plasma GPx activities on the 7th day, may serve as pivotal indicators for predicting renal outcomes in critically septic patients.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"Pages 253-262"},"PeriodicalIF":7.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828460","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":"Early nutritional and inflammation assessment predicts prognosis in patients with cancer across tumor origin and metastaticc status","authors":"Juliette Renard ,&nbsp;Jean-Philippe Durand ,&nbsp;Sixtine De Percin ,&nbsp;Jennifer Arrondeau ,&nbsp;Johanna Noel ,&nbsp;Audrey Thomas-Schoemann ,&nbsp;Manuela Tiako Meyo ,&nbsp;Clémentine Villeminey ,&nbsp;Jérôme Alexandre ,&nbsp;Pascaline Boudou-Rouquette ,&nbsp;François Goldwasser ,&nbsp;Guillaume Beinse","doi":"10.1016/j.clnu.2025.07.029","DOIUrl":"10.1016/j.clnu.2025.07.029","url":null,"abstract":"<div><h3>Background and aims</h3><div>Clinical complexity of patients with cancer represents a challenge when aiming to implement individualized clinical management strategies. Despite their impact on patient outcomes, the burden of cancer-associated cachexia and inflammation remains underestimated by cancer physicians. We aimed to evaluate the performances of an early multi-dimensional patient assessment, integrating a comprehensive nutritional and inflammatory evaluation, for patient categorization and prognostication, independently of tumor features.</div></div><div><h3>Methods</h3><div>Oncology outpatients evaluated in the setting of a systematic, structured clinical evaluation before anti-cancer treatment [Cochin Hospital, 2017–2023] were included. Retrospective analyses were conducted on routine-practice clinical and biological data, including a comprehensive nutritional and inflammatory assessment. Data were prospectively implemented in structured records, and automatically extracted post-hoc. Unsupervised clustering used principal components identified by factorial analysis of mixed data (N = 53 features). Associations with overall survival (OS) were analyzed using Cox regression.</div></div><div><h3>Results</h3><div>Among 1370 patients included, 28 % had localized tumors. Main tumor origins were lung (25 %), digestive (18 %), sarcoma (17 %), gynecological/breast (15 %), prostate (9 %), and urinary tract (8 %). Median OS was 28 months [25–31] (N = 833 deaths) (median follow-up = 52 months). Five clusters were identified, described based on contributing features: “fit” (47 %), “older comorbid” (26 %), “dysmetabolic” (10 %), “digestive/liver injured” (2 %), and “critically impaired/inflamed” (15 %) patients. Hazard ratio for OS were 1.84 [1.55–2.19], 1.71 [1.34–2.16], 2.07 [1.28–3.31], and 2.96 [2.43–3.61] for cluster 2–5 respectively (reference: “fit” patients), after adjustment on tumor origin and metastatic status.</div></div><div><h3>Conclusions</h3><div>Early, cancer-agnostic, host-centered evaluation of oncology patients identified five main clusters outlining the complexity of patients with cancer, where nutritional and inflammatory features are among key determinants of prognosis independently of tumor origin or metastatic status. Further investigations are warranted to evaluate the benefit of early personalized intervention in each cluster of patients.</div></div>","PeriodicalId":10517,"journal":{"name":"Clinical nutrition","volume":"52 ","pages":"Pages 313-322"},"PeriodicalIF":7.4,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144840964","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}