Nutrition最新文献

{"title":"Comment on “Evaluation and validation of neutrophil to albumin ratio as a promising prognostic marker for all-cause mortality in patients with cancer: A multicenter cohort study”","authors":"Min Fu M.D.","doi":"10.1016/j.nut.2024.112445","DOIUrl":"10.1016/j.nut.2024.112445","url":null,"abstract":"","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140407108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysphagia risk evaluated by the Eating Assessment Tool-10 is associated with health-related quality of life in patients with chronic liver disease","authors":"Takao Miwa M.D. ,&nbsp;Tatsunori Hanai M.D., Ph.D. ,&nbsp;Itsuki Hayashi D.D.S. ,&nbsp;Sachiyo Hirata R.D. ,&nbsp;Kayoko Nishimura R.D. ,&nbsp;Shinji Unome M.D. ,&nbsp;Yuki Nakahata M.D. ,&nbsp;Kenji Imai M.D., Ph.D. ,&nbsp;Yohei Shirakami M.D., Ph.D. ,&nbsp;Atsushi Suetsugua M.D., Ph.D. ,&nbsp;Koji Takai M.D., Ph.D. ,&nbsp;Masahito Shimizu M.D., Ph.D.","doi":"10.1016/j.nut.2024.112440","DOIUrl":"10.1016/j.nut.2024.112440","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to reveal the prevalence and characteristics of individuals at risk of dysphagia in patients with chronic liver disease (CLD) and its association with health-related quality of life (HRQOL).</p></div><div><h3>Methods</h3><p>This cross-sectional study included 335 outpatients with CLD. Dysphagia risk, sarcopenia risk, malnutrition risk, and HRQOL were assessed using the Eating Assessment tool-10 (EAT-10), SARC-F, Royal Free Hospital-Nutrition Prioritizing Tool (RFH-NPT), and Chronic Liver Disease Questionnaire (CLDQ), respectively. Dysphagia risk and low HRQOL were based on EAT-10 ≥3 and CLDQ overall score &lt;5, respectively. Factors associated with dysphagia risk and low HRQOL were assessed using the logistic regression model.</p></div><div><h3>Results</h3><p>Dysphagia risk and lower HRQOL were observed in 10% and 31% of the patients, respectively. Patients with dysphagia risk were older, had lower liver functional reserve, were at higher risk for sarcopenia and malnutrition, and showed lower CLDQ overall score (median, 4.41 vs. 5.69; <em>P</em> &lt; 0.001) than those without. After adjustment, SARC-F (odds ratio [OR], 1.24; 95% confidence interval [CI], 1.02–1.50; <em>P</em> = 0.029) and RFH-NPT (OR, 1.71; 95% CI, 1.04–2.81; <em>P</em> = 0.034) scores were independently associated with dysphagia risk. EAT-10 (OR, 1.17; 95% CI, 1.04–1.30; <em>P</em> = 0.008) and SARC-F (OR, 1.37; 95% CI, 1.18–1.59; <em>P</em> &lt; 0.001) scores were also independently associated with low HRQOL.</p></div><div><h3>Conclusions</h3><p>Dysphagia risk was prevalent in approximately 10% of patients with CLD and was associated with a risk of sarcopenia and malnutrition. Furthermore, dysphagia risk was related to HRQOL in patients with CLD.</p></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140400872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should handgrip strength be considered when choosing the administration mode of oral nutritional supplements in geriatric patients? A secondary analysis of the MEDPass Trial","authors":"Katja Uhlmann M.Sc. ,&nbsp;Emilie Reber Ph.D. ,&nbsp;Katja A. Schonenberger Ph.D. ,&nbsp;Zeno Stanga ,&nbsp;Silvia Kurmann M.Sc.","doi":"10.1016/j.nut.2024.112429","DOIUrl":"10.1016/j.nut.2024.112429","url":null,"abstract":"<div><h3>Objective</h3><p>It is important to individualize nutrition therapy and to identify whether certain patient groups benefit from a specific intervention such as oral nutritional supplements (ONS). This study investigated whether patients with weak handgrip strength (HGS) benefit better from ONS administration in the Medication Pass Nutritional Supplement Program (MEDPass) mode regarding the individual coverage of energy and protein requirements throughout their hospitalization.</p></div><div><h3>Methods</h3><p>A secondary analysis of the intention-to-treat data set of the randomized controlled MEDPass trial was conducted. Weak HGS was defined as &lt;27 kg for men and &lt;16 kg for women. Linear mixed-effect models adjusted for the stratification factors energy density of ONS and nutritional risk screening 2002 score were used to address the aim of the study.</p></div><div><h3>Results</h3><p>We included 188 participants. Energy and protein coverage did not differ between the patients with weak or normal HGS depending on ONS administration mode (<em>P</em> = 0.084, <em>P</em> = 0.108). Patients with weak HGS and MEDPass administration mode tended to have the lowest energy and protein coverage (estimated mean, 77.2%; 95% confidence interval [CI], 69.3%–85% and estimated mean, 95.1%; 95% CI, 85.3%–105%, respectively). Patients with weak HGS and conventional ONS administration had the highest energy and protein coverage (estimated mean, 90%; 95% CI, 82.8%–97.2% and estimated mean, 110.2%; 95% CI, 101.3%–119%, respectively).</p></div><div><h3>Conclusion</h3><p>No clear recommendations regarding the mode of ONS administration depending on HGS can be made. In clinical practice, appetite and satiety in patients with weak HGS should be monitored, and the ONS administration mode should be adjusted accordingly.</p></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0899900724000790/pdfft?md5=a9ad228390ce63a88c695bf3bcdca150&pid=1-s2.0-S0899900724000790-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140279937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between oral frailty and sarcopenia among frailty clinic outpatients: A cross-sectional study","authors":"Koki Kawamura ,&nbsp;Keisuke Maeda ,&nbsp;Shuzo Miyahara ,&nbsp;Akio Shimizu ,&nbsp;Yuria Ishida ,&nbsp;Junko Ueshima ,&nbsp;Ayano Nagano ,&nbsp;Hitoshi Kagaya ,&nbsp;Yasumoto Matsui ,&nbsp;Hidenori Arai ,&nbsp;Naoharu Mori","doi":"10.1016/j.nut.2024.112438","DOIUrl":"10.1016/j.nut.2024.112438","url":null,"abstract":"<div><h3>Objectives</h3><p>In this study, we aimed to investigate the prevalence of oral frailty and explore its relationship with oral function and sarcopenia among older outpatients.</p></div><div><h3>Materials and Methods</h3><p>In this cross-sectional study, we retrospectively included older patients who visited a frailty outpatient clinic. We assessed total oral frailty employing, among other measures, oral diadochokinesis (/ta/ sound) for tongue–lip movement and tongue pressure. Patients who did not meet the cut-off values for three or more of these were classified as having oral frailty. Sarcopenia was assessed according to Asian Working Group for Sarcopenia 2019 criteria and analyzed for the relationship with oral function.</p></div><div><h3>Results</h3><p>The mean ± standard deviation age of the 111 patients was 77.2 ± 5.7 y; 63 were women (57%). Fifteen patients (14%) had either sarcopenia or dynapenia. The overall prevalence of oral frailty was 38%, with no significant difference in its prevalence between the sarcopenia/dynapenia group (44%) and the robust (no sarcopenia/dynapenia) group (35%). The following oral function assessments significantly differed between the sarcopenia/dynapenia group and the robust group: median (interquartile range) total oral frailty score, 2 (2–4) and 2 (1–3) (<em>P</em> = 0.019); tongue–lip motor function, 5.4 ± 1.2 and 5.9 ± 1.2 times/s (<em>P</em> = 0.049); and tongue pressure, 27.3 ± 8.5 kPa and 31.7 ± 8.0 kPa (<em>P</em> = 0.009).</p></div><div><h3>Conclusions</h3><p>Approximately 40% of patients exhibited a decline in oral function regardless of the presence of sarcopenia. Sarcopenia and dynapenia may particularly affect tongue function. Although assessing patients for sarcopenia is crucial, separate evaluations of oral function should also be considered.</p></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140272672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parenteral nutrition consensus report from KEPAN","authors":"Ferda Sohret Kahveci ,&nbsp;Kutay Demirkan ,&nbsp;Mutlu Doganay ,&nbsp;Ismail Gomceli ,&nbsp;Kursat Gundogan ,&nbsp;Arzu Topeli ,&nbsp;Guzin Tumer ,&nbsp;Mehmet Uyar ,&nbsp;Osman Abbasoglu","doi":"10.1016/j.nut.2024.112424","DOIUrl":"10.1016/j.nut.2024.112424","url":null,"abstract":"<div><h3>Objectives</h3><p>Medical nutrition therapy is one of the core components of patient management, although its implication is still limited in Daily practice globally. Clinicians are in need of guidance that will ease the application of medical nutrition therapy. The pre- and post-graduate curriculum for medical nutrition therapy is limited in most regions, worldwide. A report that is short, clear, and having clear-cut recommendations that will guide the primary healthcare professionals in indications, choice, practical application, follow-up, and stopping parenteral nutrition (PN) would facilitate the application and success of medical nutrition therapy. KEPAN is the Clinical Enteral and Parenteral Nutrition Society of Turkey and is an active member of the European Society for Clinical Nutrition and Metabolism (ESPEN).</p></div><div><h3>Method</h3><p>In this study, we present the KEPAN PN consensus report on optimal PN use in medical nutrition therapy as outlined by the works of academicians experienced in the clinical application of PN (nine working group academicians and 10 expert group academicians).</p></div><div><h3>Results</h3><p>This report provides 22 clear-cut recommendations in a question-answer format.</p></div><div><h3>Conclusions</h3><p>We believe that this report could have a significant impact on the optimum use of PN in the context of medical nutrition therapy when clinicians manage everyday patients.</p></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140268503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing gut barrier integrity: Upregulation of tight junction proteins by chitosan oligosaccharide through the ERK1/2 signaling pathway","authors":"Yin Li ,&nbsp;Lianyun Wu ,&nbsp;Yanhong Yong Ph.D. ,&nbsp;Xueting Niu ,&nbsp;Yuan Gao ,&nbsp;Qiu Zhou ,&nbsp;Huili Xie ,&nbsp;Xiaoxi Liu Ph.D. ,&nbsp;Youquan Li Ph.D. ,&nbsp;Zhichao Yu Ph.D. ,&nbsp;A.M. Abd El-Aty Ph.D. ,&nbsp;Xianghong Ju Ph.D.","doi":"10.1016/j.nut.2024.112428","DOIUrl":"10.1016/j.nut.2024.112428","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to explore the protective mechanism of chitosan oligosaccharide (COS) against lipopolysaccharide (LPS)-induced inflammatory responses in IEC-6 cells and dextran sodium sulfate (DSS)-induced colitis in mice.</p></div><div><h3>Methods</h3><p>The cell inflammation model was constructed by LPS in vitro and enteritis model by DSS in vivo.</p></div><div><h3>Results</h3><p>Following LPS exposure, IEC-6 cell proliferation significantly decreased, epithelial cell integrity was compromised, and TNF-α and IL-1β levels were increased. However, COS pretreatment reversed these changes. <em>In vivo</em>, DSS-treated mice exhibited evident pathological alterations, including heightened inflammatory levels and significantly decreased expression of tight junction proteins and critical proteins in the Mitogen activated proteins kinase signaling pathway. Nevertheless, COS administration notably reduced inflammatory levels and increased the expression of tight junction proteins and key proteins in the Mitogen activated proteins kinase signaling pathway.</p></div><div><h3>Conclusions</h3><p>Our findings suggest that COS safeguards gut barrier integrity by upregulating tight junction proteins through the ERK1/2 signaling pathway. Therefore, COS has emerged as a promising candidate for novel drug interventions against inflammatory bowel disease.</p></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140169950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ketogenic Diet as a Treatment and Prevention Strategy for Cancer: A Therapeutic Alternative","authors":"Neha, Rishabh Chaudhary","doi":"10.1016/j.nut.2024.112427","DOIUrl":"https://doi.org/10.1016/j.nut.2024.112427","url":null,"abstract":"Cancer remains a significant global health problem, contributing substantially to morbidity and mortality rates. While traditional treatments like surgery, chemotherapy, and radiation therapy are mainstays in cancer care, their efficacy as standalone modalities is often limited. Consequently, there is a growing interest in novel approaches that may enhance therapeutic outcomes. Over recent years, both preclinical and clinical investigations have highlighted the potential of the ketogenic diet as a complementary strategy in cancer treatment. The ketogenic diet, characterized by low carbohydrate, high fat, and moderate protein intake, has emerged as a promising avenue for augmenting the efficacy of conventional therapies by altering the metabolic dynamics of cancer cells. Research suggests that integrating the ketogenic diet with standard treatment protocols may enhance the anti-tumor effects of chemotherapy, improve treatment tolerability, and enhance overall quality of life. This review aims to elucidate the underlying mechanisms that drive the purported anti-cancer properties of the ketogenic diet. By inducing a metabolic state characterized by ketosis, the diet creates an unfavorable metabolic environment for cancerous cells, potentially hindering their growth and proliferation. Through a comprehensive analysis of preclinical and clinical data, this review aims to explain the therapeutic potential of the ketogenic diet as an adjunctive treatment strategy in cancer. Understanding the metabolic underpinnings of the ketogenic diet and its impact on tumor biology is essential for optimizing its clinical utility and informing treatment decisions. By exploring the synergistic interactions between the ketogenic diet and conventional therapies, clinicians and researchers may reveal new avenues for improving cancer care and outcomes.","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140169908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of CFTR modulator therapy on body composition as assessed by thoracic computed tomography: A follow-up study","authors":"Víctor Navas-Moreno ,&nbsp;Fernando Sebastian-Valles ,&nbsp;Víctor Rodríguez-Laval ,&nbsp;Carolina Knott-Torcal ,&nbsp;Mónica Marazuela ,&nbsp;Nuria Sánchez de la Blanca ,&nbsp;Jose Alfonso Arranz Martín ,&nbsp;Rosa María Girón ,&nbsp;Miguel Antonio Sampedro-Núñez","doi":"10.1016/j.nut.2024.112425","DOIUrl":"10.1016/j.nut.2024.112425","url":null,"abstract":"<div><h3>Objective</h3><p>Treatment with cystic fibrosis transmembrane conductance regulator (CFTR) modulators in individuals with cystic fibrosis (CF) has brought a significant change in forced expiratory volume in 1 second (FEV₁) and clinical parameters. However, it also results in weight gain. The aim of our study is to evaluate the effect of CFTR modulator treatment on body composition, measured by computed tomography (CT).</p></div><div><h3>Methods</h3><p>Adult subjects with CF under follow-up at La Princesa University Hospital were recruited. All of them were on elexacaftor–tezacaftor–ivacaftor (ELX/TEZ/IVA) treatment. Body composition analysis was conducted using CT scans and an open-source software. The results were then compared with bioimpedance estimations, as well as other clinical and spirometry data.</p></div><div><h3>Results</h3><p>Our sample consisted of 26 adult subjects. The fat mass compartments on CT scans correlated with similar compartments on bioimpedance, and normal-density muscle mass exhibited a strong correlation with phase angle. Higher levels of very low-density muscle prior to treatment were associated with lower final FEV₁ and less improvement in FEV₁ after therapy. We observed an increase in total body area (<em>P</em> &lt; 0.001), driven by increases in total fat mass (<em>P</em> &lt; 0.001), subcutaneous fat (<em>P</em> &lt; 0.001), visceral fat (<em>P</em> = 0.002), and intermuscular fat (<em>P</em> = 0.022). The only muscle compartment that showed an increase after treatment was very low-density muscle (<em>P</em> = 0.032).</p></div><div><h3>Conclusions</h3><p>CT scans represent an opportunity to assess body composition on CF. Combination treatment with CFTR modulators, leads to an improvement in FEV₁ and to an increase in body mass in all compartments primarily at the expense of fat mass.</p></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0899900724000753/pdfft?md5=37731ab897e1a9f46b513cb34060da94&pid=1-s2.0-S0899900724000753-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140170330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of nutritional counseling with overweight pregnant women on child growth at 6 months: A randomized controlled trial","authors":"Izabela S. Santos ,&nbsp;Mariana R. Carvalho ,&nbsp;Naiara F. Baroni ,&nbsp;Lívia C. Crivellenti ,&nbsp;Daniela S. Sartorelli","doi":"10.1016/j.nut.2024.112426","DOIUrl":"10.1016/j.nut.2024.112426","url":null,"abstract":"<div><h3>Objective</h3><p>Studies that have investigated the effect of nutritional counseling during the prenatal period on the follow-up outcomes of children at 6 mo have produced inconclusive results. The present study aimed to investigate the effect of nutritional counseling, based on the NOVA food classification, encouraging the consumption of fresh and minimally processed foods, with overweight adult pregnant women on infant growth at 6 mo of age.</p></div><div><h3>Methods</h3><p>A randomized controlled trial with 195 pairs of pregnant overweight women and their infants at 6 mo of age was conducted in a Brazilian municipality. The pregnant women were allocated to the control group (CG) or intervention group (IG) at the beginning of the pregnancy. The IG received three sessions of nutrition counseling throughout the pregnancy. Linear regression models were used to investigate the effect of the nutritional counseling on infant growth.</p></div><div><h3>Results</h3><p>One hundred ninety-five mother–infant pairs with complete data were included (96 CG, and 99 IG). The mean ± SD infant weight (g) at 6 mo was 7856.1 ± 1.1, and length (cm) was 67.0 ± 2.9. There were no differences in maternal and newborn characteristics between the groups. In the linear regression models, the counseling had no effect on anthropometric parameters of the infants at 6 mo of age: weight-for-length <em>Z</em>-score (β 0.089 [95% CI −0.250; 0.427], <em>P</em> = 0.61); length-for-age <em>Z</em>-score (β 0.032 [95% CI −0.299; 0.363], <em>P</em> = 0.85); weight-for-age <em>Z</em>-score (β 0.070 [95% CI −0.260; 0.400], <em>P</em> = 0.68); BMI-age <em>Z</em>-score (β 0.072 [95% CI −0.270; 0.414], <em>P</em> = 0.68).</p></div><div><h3>Conclusions</h3><p>There was no effect on infant growth at 6 mo of age after the nutritional counseling during pregnancy. Future studies are needed to confirm this hypothesis.</p></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140169904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors and predictive model for malnutrition in poststroke disabled patients: A multicenter cross-sectional study","authors":"Hongji Zeng ,&nbsp;Ang Cai ,&nbsp;Weijia Zhao ,&nbsp;Junfa Wu ,&nbsp;Yu Ding ,&nbsp;Xi Zeng","doi":"10.1016/j.nut.2024.112423","DOIUrl":"10.1016/j.nut.2024.112423","url":null,"abstract":"<div><h3>Background</h3><p>Although malnutrition has been shown to influence the clinical outcome of poststroke disabled patients, the associated factors and the prediction model have yet to be uncovered.</p></div><div><h3>Objectives</h3><p>This study aims to assess the current prevalence and factors associated with malnutrition in poststroke disabled patients and establish a prediction model.</p></div><div><h3>Methods</h3><p>A multicenter cross-sectional survey among Chinese poststroke disabled patients (≥18 y old) was conducted in 2021. Information on patients’ basic data, medical history, Barthel Index, dysphagia, and nutritional status was collected. A multivariable logistic regression model was used to identify the factors that influence malnutrition. Nomogram was developed and internal validation was conducted using 5-fold cross-validation. External validation was performed using the data from a preliminary survey. Receiver operating characteristic (ROC) analysis, calibration curves, and decision curve analysis (DCA) were used to analyze the predictive value of the nomogram.</p></div><div><h3>Results</h3><p>Four hundred fifty-seven cases were enrolled, with the prevalence of malnutrition as 71.77%. Age (aOR = 1.039, 95% CI: 1.006–1.078), pulmonary infection (aOR = 4.301, 95% CI: 2.268–14.464), dysphagia (aOR = 24.605, 95% CI: 4.966–191.058), total intake volume (aOR = 0.997, 95% CI: 0.995–0.999), Barthel Index (aOR = 0.965, 95% CI: 0.951–0.980), and nasogastric tube (aOR = 16.529, 95% CI: 7.418–52.518) as nutrition support mode (compared to oral intake) were identified as the associated factors of malnutrition in stroke-disabled patients (<em>P</em> &lt; 0.05). ROC analysis showed that the area under the curve (AUC) for nomogram was 0.854 (95% CI: 0.816–0.892). Fivefold cross-validation showed the mean AUC as 0.829 (95% CI: 0.784–0.873). There were no significant differences between predicted and actual probabilities. The DCA revealed that the model exhibited a net benefit when the risk threshold was between 0 and 0.4.</p></div><div><h3>Conclusions</h3><p>Age, pulmonary infection, dysphagia, nutrition support mode, total intake volume, and Barthel Index were factors associated with malnutrition in stroke-related disabled patients. The nomogram based on the result exhibited good accuracy, consistency and values.</p></div>","PeriodicalId":19482,"journal":{"name":"Nutrition","volume":null,"pages":null},"PeriodicalIF":4.4,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140170087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}