Nutrition & Metabolism最新文献

{"title":"Regulatory mechanisms of high-polyphenol dietary intervention on exercise-induced immunosuppression during high-intensity training periods in adolescent athletes: a systems biology analysis based on immune-metabolic pathways.","authors":"Qinshan Huang, Lei He, Jiahong Wu, Shun Yue","doi":"10.1186/s12986-026-01132-1","DOIUrl":"10.1186/s12986-026-01132-1","url":null,"abstract":"<p><strong>Background: </strong>Exercise-induced immunosuppression poses significant health risks for adolescent athletes during intensive training. This study investigated whether high-polyphenol dietary intervention could maintain immune homeostasis through immunometabolic reprogramming.</p><p><strong>Methods: </strong>Eighty adolescent athletes (aged 15-17) were randomized to receive either high-polyphenol supplementation (1200 mg/day: quercetin, EGCG, resveratrol, curcumin) or placebo during a 12-week high-intensity training period. Multi-omics profiling (transcriptomics, proteomics, metabolomics, microbiomics) was performed at baseline, weeks 4, 8, and 12.</p><p><strong>Results: </strong>The high-polyphenol group maintained CD4 + /CD8 + ratios above clinical thresholds (1.65 ± 0.29 vs. 1.38 ± 0.42, p < 0.001) at peak training. Regulatory T cells increased 17.2% while Th17 cells remained stable, yielding favorable Treg/Th17 ratios (3.09 ± 0.82 vs. 1.58 ± 0.54, p < 0.001). Multi-omics integration revealed 1,847 differentially expressed genes converging on NF-κB suppression, AMPK-mTOR activation, and Nrf2-mediated antioxidant responses. Gut microbiome analysis showed doubled butyrate-producing bacteria and twofold increased short-chain fatty acid production. Salivary IgA declined only 6.5% versus 29.3% in placebo (p < 0.001).</p><p><strong>Conclusions: </strong>High-polyphenol dietary intervention effectively prevents exercise-induced immunosuppression through coordinated immunometabolic reprogramming, establishing a practical strategy for maintaining immune resilience in adolescent athletes.</p>","PeriodicalId":19196,"journal":{"name":"Nutrition & Metabolism","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148055646","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":"Dietary folate intake and metabolic dysfunction-associated steatotic liver disease: a prospective cohort study.","authors":"Qingchun Li, Xinyu Zhang, Fengyuan Zhao, Dongfeng Zhang, Weijing Wang, Zhongyang Zhang, Feng Yang","doi":"10.1186/s12986-026-01141-0","DOIUrl":"10.1186/s12986-026-01141-0","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent chronic disease, but it remains unclear whether it is related to dietary folate. This research sought to investigate the association between dietary folate and MASLD.</p><p><strong>Methods: </strong>This cohort study utilized the UK Biobank (UKB) database (N = 58,047). Dietary folate intake was assessed using an online dietary questionnaire, and MASLD was ascertained through International Classification of Diseases, Tenth Revision (ICD-10). Cox proportional hazard regression, mediation analysis and restricted cubic splines (RCS) were employed to investigate the association and dose-response relationship between dietary and MASLD. The stability of findings was verified by stratified analyses and sensitivity analyses.</p><p><strong>Results: </strong>Dietary folate intake was observed to be negatively associated with MASLD in cohort studies. During a median follow-up of 12.18 years, 691 cases of MASLD occurred. The risk of MASLD decreased by 24% (HR = 0.76, 95% CI: 0.59-0.97) among the participants in the highest dietary folate intake relative to lowest quartile. The protective effect was more pronounced in participants aged < 60 years (HR = 0.63, 95% CI: 0.45-0.89), male (HR = 0.63, 95% CI: 0.44-0.89), and obese participants (HR = 0.68, 95% CI: 0.48-0.95). The research results remained robust in the sensitivity analyses that excluded participants with ≤ 2 years of follow-up time, extremely folate intake, and other conditions. C-reactive protein (CRP) explained 6.56% of the association between dietary folate and MASLD. The dietary folate intake had an L-shaped relationship with the risk of MASLD (P for nonlinearity = 0.003).</p><p><strong>Conclusions: </strong>Moderate folate intake (approximately 300 µg) may reduce the risk of MASLD, suggesting that promoting folate-rich diets may be a viable and cost-effective strategy for MASLD prevention.</p>","PeriodicalId":19196,"journal":{"name":"Nutrition & Metabolism","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13366692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982699","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 concentrations at admission and 28-day mortality in ST-elevation myocardial infarction.","authors":"Christa Meisinger, Dennis Freuer, Philip Raake, Jakob Linseisen, Timo Schmitz","doi":"10.1186/s12986-026-01139-8","DOIUrl":"10.1186/s12986-026-01139-8","url":null,"abstract":"<p><strong>Background: </strong>Amino acid metabolism plays a critical role in cardiovascular disease, yet its prognostic value in ST-elevation acute myocardial infarction (STEMI) remains underexplored. Therefore, we investigated whether specific plasma amino acid concentrations at admission for STEMI are associated with 28-day mortality.</p><p><strong>Methods: </strong>This analysis was based on data from 724 patients with STEMI aged 29 to 98 years who were admitted to the University Hospital Augsburg between May 2009 and July 2013. Immediately after admission arterial blood samples were taken from these patients and a panel of amino acids was measured by a high-throughput nuclear magnetic resonance spectroscopy platform (Nightingale Health, Finland). Multivariable logistic regression models were conducted to examine the associations between the amino acids phenylalanine, tyrosine, glycine, alanine, histidine, glutamine, as well as branched-chain amino acids (BCAAs; a group that includes valine, isoleucine, and leucine) and 28-day mortality. P values were False discovery rate (FDR) adjusted.</p><p><strong>Results: </strong>Altogether, 47 patients died within 28 days after admission. There were significant positive associations found between plasma levels of phenylalanine, glycine, tyrosine, valine, and alanine and 28-day mortality. Phenylalanine showed the highest effect estimate (OR: 1.84; 95% CI 1.34-2.53). No significant associations were observed for the remaining amino acids.</p><p><strong>Conclusions: </strong>The acute phase of STEMI is associated with changes in plasma amino acid levels that may reflect alterations in energy metabolism and metabolic stress. The associations between amino acid fluctuations and 28-day mortality highlight the potential of metabolomic profiling to refine early risk stratification.</p>","PeriodicalId":19196,"journal":{"name":"Nutrition & Metabolism","volume":"23 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982676","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":"Composite dietary antioxidant index and risk of metabolic dysfunction - associated steatotic liver disease: evidence from a prospective cohort study.","authors":"Matin Sepehrinia, Sina Bazmi, Ali Nikparast, Elahe Etesami, Farhad Vahid, Gholamali Javdan, Hananeh Rozbahani, Jalaledin Mirzay Razaz, Mohammad Shafi Kuchay, Reza Homayounfar","doi":"10.1186/s12986-026-01138-9","DOIUrl":"10.1186/s12986-026-01138-9","url":null,"abstract":"<p><strong>Background and aims: </strong>Oxidative stress plays a crucial role in the pathogenesis of metabolic dysfunction-associated steatotic liver disease (MASLD). While antioxidant-rich diets may help reduce this stress and possibly reduce MASLD risk, there is little long-term evidence. This prospective study examined the link between the Composite Dietary Antioxidant Index (CDAI) and MASLD risk.</p><p><strong>Methods: </strong>This study followed 5,988 participants (49.3% male) without MASLD at baseline from the Monitoring of Metabolic Diseases Risk Factors in Tehran (MMRT) cohort. Dietary intake was assessed using a validated 125-item food frequency questionnaire to determine the CDAI. Cases of MASLD were identified using transient elastography and at least one cardiometabolic risk factor. The association between CDAI and MASLD risk was analyzed through multivariable logistic regression.</p><p><strong>Results: </strong>Following a five-year follow-up, 550 new cases of MASLD were identified. After adjusting for multiple confounders, individuals in the highest quartile of CDAI exhibited a 40% reduction in the risk of developing MASLD compared to those in the lowest quartile (OR: 0.60, 95% CI: 0.40-0.89; p-trend = 0.002). Additionally, each one-unit increment in CDAI significantly corresponded to an 8% decrease in MASLD risk. An inverse dose-response relationship was also observed between CDAI and incident MASLD, with C-reactive protein (CRP) mediating 48% of this association. Among CDAI components, increased consumption of Vitamin C and Vitamin E was independently associated with a significantly reduced risk of MASLD.</p><p><strong>Conclusion: </strong>A higher intake of dietary antioxidants was significantly associated with a reduced risk of developing MASLD. These results indicate that encouraging antioxidant-rich dietary patterns may serve as a lifestyle modification approach for the primary prevention of MASLD.</p>","PeriodicalId":19196,"journal":{"name":"Nutrition & Metabolism","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13366599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982659","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":"Phenotypic age acceleration: a novel biomarker associated with increased risk of metabolic dysfunction-associated fatty liver disease.","authors":"Fangfei Xie, Yu'e Shen, Jing Zhao, Xunzhi Geng, Nimei Zeng, Renfang Han, Yi Wang, Yun Wang, Wenbin Xu, Jingyi Fan","doi":"10.1186/s12986-026-01131-2","DOIUrl":"10.1186/s12986-026-01131-2","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated fatty liver disease (MAFLD) poses a growing public health challenge, but traditional metabolic markers may not fully capture individual risk, especially in individuals with normal metabolic phenotypes. Phenotypic age acceleration (PhenoAgeAccel), a composite biomarker reflecting systemic aging burden, may offer additional value for risk stratification.</p><p><strong>Methods: </strong>We conducted a two-stage study involving a case-control analysis (6,343 MAFLD cases vs. 6,343 chronological age- and sex-matched controls) and a prospective cohort analysis (7,997 participants initially free of fatty liver disease). PhenoAgeAccel was derived from chronological age and nine clinical biomarkers. Associations between PhenoAgeAccel and MAFLD were assessed using conditional logistic regression and competing risk models, with adjustments for lifestyle factors, comorbidities and medication histories.</p><p><strong>Results: </strong>In the case-control analysis, each 5-year increase in PhenoAgeAccel was associated with 66% higher odds of MAFLD after multivariable adjustment (OR = 1.66, 95% CI: 1.56-1.77). In the prospective cohort, PhenoAgeAccel remained significantly associated with incident MAFLD (HR = 1.45, 95% CI: 1.32-1.59). While the main analyses estimated the overall association, subgroup analyses examined whether this association varied across different populations. These suggested stronger associations in females (vs. males), individuals with younger chronological age (vs. older age), and those without hypertension or diabetes (vs. those with hypertension or diabetes, respectively). PhenoAgeAccel demonstrated better discriminative ability (AUC = 0.622) than traditional fibrosis scores (FIB-4, NFS, BARD), with a high negative predictive value (88.8%).</p><p><strong>Conclusions: </strong>PhenoAgeAccel was associated with MAFLD risk in a Chinese health examination population, providing information beyond chronological age and common metabolic factors. It may serve as a useful indicator for identifying individuals with normal metabolic phenotypes but accelerated biological aging, particularly in those without overt metabolic risk factors.</p>","PeriodicalId":19196,"journal":{"name":"Nutrition & Metabolism","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13361082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974295","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":"Dynamic prognostic nutritional index and 28-day mortality in sepsis: a joint modeling analysis.","authors":"Feng Xu, Jinjiang Li, Wei Zhao, Shijing Ding, Jing Cao","doi":"10.1186/s12986-026-01137-w","DOIUrl":"10.1186/s12986-026-01137-w","url":null,"abstract":"<p><strong>Background: </strong>Although the Prognostic Nutritional Index (PNI) is associated with sepsis outcomes, admission values may primarily reflect acute illness severity. We examined whether longitudinal PNI provides prognostic value beyond baseline risk.</p><p><strong>Methods: </strong>In this retrospective cohort study of 492 adults with sepsis, baseline PNI was assessed using Kaplan-Meier analysis and adjusted restricted cubic splines. A joint model was used to link repeated PNI measurements from days 1 to 7 with time to 28-day mortality while accounting for informative dropout due to death or discharge. Time-dependent Cox models were further used to compare dynamic PNI with albumin and total lymphocyte count.</p><p><strong>Results: </strong>Baseline PNI showed a non-significant trend toward survival separation (log-rank p = 0.063) and was not independently associated with 28-day mortality after multivariable adjustment (p = 0.122). By contrast, dynamic PNI was independently associated with mortality in time-dependent analyses (HR 0.730, p = 0.032), whereas albumin and total lymphocyte count were not. Joint modeling likewise demonstrated a significant independent association between longitudinal PNI and mortality (HR 0.831, p < 0.001).</p><p><strong>Conclusion: </strong>Baseline PNI showed limited independent prognostic value, whereas longitudinal PNI provided additional prognostic information and showed modestly better predictive performance than its individual components.</p>","PeriodicalId":19196,"journal":{"name":"Nutrition & Metabolism","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13361467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147960156","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":"Association of diet quality and fiber intake with carotid intima-media thickness in a young adult population of the Tehran lipid and Glucose study.","authors":"Firoozeh Hosseini-Esfahani, Maryam Barzin, Somayeh Hosseinpour-Niazi, Maryam Mahdavi, Sara Sadeghi, Pooneh Dehghan, Parvin Mirmiran, Majid Valizadeh, Fereidoun Azizi","doi":"10.1186/s12986-026-01100-9","DOIUrl":"10.1186/s12986-026-01100-9","url":null,"abstract":"<p><strong>Background: </strong>Previous studies showed a probable association of dietary variables with carotid intima media thickness (CIMT), as a surrogate marker of subclinical atherosclerosis. This study aimed to evaluate the association of the global diet quality score (GDQS) and macronutrient intakes with CIMT values in adults.</p><p><strong>Methods: </strong>This cross-sectional study was performed on 941 young adults that were selected from the Tehran Lipid and Glucose Study. Dietary intake was evaluated using a valid and reliable food frequency questionnaire. CIMT was measured using an ultrasound examination. Multivariate-adjusted linear and logistic regression was used to determine the association of the GDQS and macronutrient intakes with CIMT. High CIMT was defined as CIMT ≥ 90th percentile values for age and sex derived from this study.</p><p><strong>Results: </strong>The mean age of participants was 28.2 ± 4.25 years (51% men). The GDQS and its categories did not have a significant inverse association with CIMT (β = 0.001, P = 0.23), while we observed a significant inverse association between fiber intake and CIMT (β=-0.003, P = 0.02). Adults with higher quartiles of fiber intake had a lower odds ratio of high CIMT in comparison to the first quartile (OR: Q1: Ref., Q2: 0.61, Q3: 0.74, Q4: 0.53; P trend = 0.04), independent of confounding factors. There were no significant associations between other macronutrient intakes and CIMT value.</p><p><strong>Conclusion: </strong>Among macronutrients, dietary fiber intake, which often contains phytochemicals, was found to be inversely associated with CIMT value in a young adult Tehranian population. There were no associations between diet quality, as measured by the GDQS, healthy and unhealthy subgroups, and CIMT values.</p>","PeriodicalId":19196,"journal":{"name":"Nutrition & Metabolism","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13360481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147942102","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 Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and the risk of cancer, cardiovascular diseases, hypertension, all-cause, and cardiovascular diseases mortality: a systematic review and meta-analysis of observational studies.","authors":"Hamid Ahmadirad, Yahya Pasdar, Jalal Moludi, Mohammad Sedighi, Mehdi Moradinazar, Farshad Teymoori, Seyed Mostafa Nachvak, Parvin Mirmiran, Hossein Farhadnejad","doi":"10.1186/s12986-026-01135-y","DOIUrl":"10.1186/s12986-026-01135-y","url":null,"abstract":"<p><strong>Background: </strong>Recent studies have focused on the relationship between the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet and the risk of chronic diseases and mortality. The present systematic review and meta-analysis aimed to review and compile the available research and assess the possible relationship of the MIND diet score with cancer, cardiovascular diseases (CVDs), hypertension (HTN), and mortality risks.</p><p><strong>Methods: </strong>A comprehensive and systematic search was performed in online databases including PubMed, Scopus, and Web of Science up to July 2025. Hazard ratios(HRs) or odds ratios(ORs) and their 95% confidence intervals(CIs) were extracted from the included studies, then to estimate the pooled results, the random-effects model with inverse variance weighting method was used.</p><p><strong>Results: </strong>Twenty-three observational studies fulfilled the inclusion criteria and were included in the present meta-analysis. The findings found that higher adherence to the MIND diet was related to the decreased risk of cancers(RR:0.45, 95%CI:0.31-0.65;P < 0.001; I² = 43.9%,P-heterogeneity = 0.129), all-cause(RR:0.86, 95%CI:0.81-0.92;P < 0.001; I² = 74.0%,P-heterogeneity < 0.001) and CVDs mortality(RR:0.78, 95%CI:0.67-0.90;P = 0.001; I² = 71.4%,P-heterogeneity = 0.002); however, there is no significant relationship between MIND diet score and risk of HTN(RR:0.88, 95%CI:0.76-1.03; P = 0. 097; I² = 45.5%, P-heterogeneity = 0.088) and CVDs(RR:0.86, 95%CI:0.68-1.08; P = 0.200; I² = 82.4%, P-heterogeneity < 0.001).</p><p><strong>Conclusions: </strong>Our findings suggested that the greater adherence to the MIND diet may be associated with lower risk of cancer, all-cause mortality, and CVDs-mortality; however, no significant association was observed between the MIND diet and risk of HTN and CVDs. These findings should be interpreted cautiously due to substantial heterogeneity, potential publication bias, a moderate risk of bias, and the observational nature of the included studies. Further research is warranted to assess the long-term effects and potential relationship of the MIND diet with risk of these chronic outcomes.</p><p><strong>Systematic review registration: </strong>CRD420251014343.</p>","PeriodicalId":19196,"journal":{"name":"Nutrition & Metabolism","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13347894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147942073","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":"Molecular and cellular mechanisms of muscle-adipose tissue crosstalk driving sarcopenic obesity: an integrative review of human, animal, and in vitro models.","authors":"Mahmoud A Seliem, Mamdouh A Ragab","doi":"10.1186/s12986-026-01123-2","DOIUrl":"10.1186/s12986-026-01123-2","url":null,"abstract":"<p><p>Sarcopenic Obesity is a complex geriatric syndrome that is not simply the co-occurrence of sarcopenia and obesity but is a synergistic pathophysiological relationship in which the sum of the risk factors is greater than the sum of the individual conditions. This integrative review proposes that sarcopenic obesity is fundamentally an illness of impaired bidirectional communication between skeletal muscle and adipose tissue that function as dynamic endocrine organs that interact through a vast repertoire of bioactive molecules. We critically analyze the molecular signaling pathways responsible for this crosstalk and the simultaneous hyperactivation of the Ubiquitin-Proteasome System and NF-κB pathways. Furthermore, highlighting the paradigm-shifting role of the Exosomal miRNA Regulatory Network, we explored how adipose-derived extracellular vesicles deliver atromiRs (e.g., miR-27a, Let-7d-3p) to myocytes and cause insulin resistance and regenerative failure, and the loss of myocyte-derived miR-146a-5p eliminates an important brake on adipogenesis. Also, we explored cellular mechanisms such as macrophage phenotypic switching (metaflammation), mitochondrial lipotoxicity, and the newly emerging gut-microbiota-muscle axis. Finally, we explored advanced experimental models, such as organ-on-a-chip systems, and explored the clinical paradox of GLP-1 receptor agonist-induced muscle loss. We conclude that future therapeutic frontiers are in the area of combination therapies and miRNA mimics to reinstate this broken molecular dialogue.</p>","PeriodicalId":19196,"journal":{"name":"Nutrition & Metabolism","volume":"23 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13169740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147931949","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":"Beyond muscle mass: methodological rigor and clinical translation in interventions for sarcopenic obesity with type 2 diabetes.","authors":"DuJiang Yang, GuoYou Wang","doi":"10.1186/s12986-025-01063-3","DOIUrl":"10.1186/s12986-025-01063-3","url":null,"abstract":"<p><strong>Background: </strong>The recent study by Han et al. (2025) presents a timely investigation into combined resistance training and nutritional support for elderly type 2 diabetic patients with sarcopenic obesity, reporting benefits for glucose metabolism. While promising, their findings necessitate a critical methodological and conceptual examination to contextualize their contribution and guide future research.</p><p><strong>Main body: </strong>This letter identifies several substantive limitations in the aforementioned study. First, the reliance on surrogate markers of glucose metabolism (HOMA-IR, fasting glucose) over gold-standard measures (e.g., hyperinsulinemic-euglycemic clamps) and the focus on muscle quantity over quality and function, as per contemporary consensus definitions, undermine the clinical relevance of the metabolic and sarcopenia-related outcomes. Second, the nutritional intervention lacks sufficient detail and standardization, particularly regarding protein type and timing, while failing to account for confounding micronutrient status. Third, the short-term (12-week) duration, inadequate consideration of polypharmacy, and lack of comprehensive safety data (e.g., hypoglycemia, musculoskeletal injury) significantly limit the generalizability and clinical translatability of the results to the complex, multimorbid geriatric population.</p><p><strong>Conclusion: </strong>We posit that the field must advance beyond simplistic measures of muscle mass and glucose. Future trials should integrate dynamic metabolic assessments, composite functional endpoints, standardized and reproducible nutritional protocols, longer follow-up periods, and rigorous safety monitoring. Only through such methodological rigor can muscle-building interventions be effectively translated into meaningful clinical practice for this high-risk cohort.</p>","PeriodicalId":19196,"journal":{"name":"Nutrition & Metabolism","volume":"23 1","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13162470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147931888","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}