Asia Pacific journal of clinical nutrition最新文献

{"title":"The impact of tea consumption on the risk of depression: A Mendelian randomization and Bayesian weighting algorithm study.","authors":"Guifeng Zhuo, Wei Chen, Jinzhi Zhang, Mingyang Su, Xiaomin Zhu, Shanshan Pu, Naibing Liao, Deqing Huang, Xiangyi Chen, Lin Wu","doi":"10.6133/apjcn.202412_33(4).0010","DOIUrl":"10.6133/apjcn.202412_33(4).0010","url":null,"abstract":"<p><strong>Background and objectives: </strong>The precise impact of tea consumption on the risk of depression remains unclear. This study aimed to explore the relationship between the consumption patterns of tea and the likelihood of depression onset, utilizing a two-sample Mendelian randomization (MR) methodology.</p><p><strong>Methods and study design: </strong>We utilized available genome-wide association study (GWAS) datasets on tea intake and depressive disorders. To investigate the causal relationship between tea consumption and depression, we employed a set of two-sample Mendelian Randomization (MR) methods. These included the inverse-variance weighted (IVW) analysis, weighted median approach, and MR-Egger regression. Additionally, we utilized MR-PRESSO and the MR-Egger intercept test for the detection of pleiotropic effects. To ensure the robustness and consistency of our findings, a sensitivity analysis was carried out, applying the 'leave-one-out' strategy. The Bayesian weighted Mendelian randomization (BWMR) was employed to conduct additional testing on the obtained results.</p><p><strong>Results: </strong>The study's outcomes revealed a causal association between increased tea intake and an increased risk of depression (Inverse-Variance Weighted Analysis: Odds Ratio [OR] = 1.029, 95% Confidence Interval [CI]: 1.003-1.055, p = 0.027). This was observed despite variations in instrumental variables and the nonexistence of horizontal pleiotropy. Furthermore, the robustness of our Mendelian Randomization investigation was affirmed through the implementation of the 'leave-one-out' method in our sensitivity analysis. The findings from BWMR were in line with those obtained from IVW (BWMR: OR=1.030, 95% CI: 1.003-1.057, p = 0.029).</p><p><strong>Conclusions: </strong>The results from this study indicate a substantial and positive causal link between the regularity of tea drinking and the risk of depression onset.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"33 4","pages":"554-561"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11389803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nomogram for predicting nutritional risk before gastric cancer surgery.","authors":"Changhua Li, Jinlu Liu, Congjun Wang, Yihuan Luo, Lanhui Qin, Peiyin Chen, Junqiang Chen","doi":"10.6133/apjcn.202412_33(4).0007","DOIUrl":"10.6133/apjcn.202412_33(4).0007","url":null,"abstract":"<p><strong>Background and objectives: </strong>Gastric cancer (GC) is the fourth leading cause of cancer death worldwide. Patients with GC have higher nutritional risk. This study aimed to construct a nomogram model for predicting preoperative nutritional risk in patients with GC in order to assess preoperative nutritional risk in patients more precisely.</p><p><strong>Methods and study design: </strong>Patients diagnosed with GC and undergoing surgical treatment were included in this study. Data was collected through clinical information, laboratory testing, and radiomics-derived characteristics. Least absolute shrinkage selection operator (LASSO) regression analysis and multi-variable logistic regression were employed to construct a clinical prediction model, which takes the form of a logistic nomogram. The effectiveness of the nomogram model was evaluated using receiver operat-ing characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA).</p><p><strong>Results: </strong>A total of three predictors, namely body mass index (BMI), hemoglobin (Hb) and radiomics characteristic score (Radscore) were identified by LASSO regression analysis from a total of 21 variables studied. The model constructed using these three predictors displayed medium prediction ability. The area under the ROC curve was 0.895 (95% CI 0.844-0.945) in the training set, with a cutoff value of 0.651, precision of 0.957, and sensitivity of 0.718. In the validation set, it was 0.880 (95% CI 0.806-0.954), with a cutoff value of 0.655, precision of 0.930, and sensitivity of 0.698. DCA also confirmed the clinical benefit of the combined model.</p><p><strong>Conclusions: </strong>This simple and dependable nomogram model for clinical prediction can assist physicians in assessing preoperative nutritional risk in GC patients in a time-efficient and accurate manner to facilitate early identification and diagnosis.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"33 4","pages":"529-538"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11389810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A survey of the Nutrition Care Process in Japanese acute care hospitals using a nationwide web-based questionnaire.","authors":"Keisuke Maeda, Fumie Egashira, Junko Ueshima, Yuri Horikoshi, Satoru Kamoshita","doi":"10.6133/apjcn.202412_33(4).0006","DOIUrl":"10.6133/apjcn.202412_33(4).0006","url":null,"abstract":"<p><strong>Background and objectives: </strong>Study aim was to determine the levels and barriers of the Nutrition Care Process (NCP), a practical method of individualized nutrition support.</p><p><strong>Methods and study design: </strong>Delegate of registered dietitians (RDs) from acute-care hospitals answered our nationwide web-based questionnaire (April-June, 2023) to determine the implementation status of screening, assessment, intervention (including planning), and monitoring (components of the NCP).</p><p><strong>Results: </strong>Of 5,378 institutions contacted, 905 (16.8%) responded. For Screening, 80.0% screened all inpatients: primary personnel in charge were RDs (57.6%); the most used screening tool was Subjective Global Assessment (SGA) (49.2%). For Assessment, 66.1% assessed all inpatients: food intake (93.3%) was most evaluated whereas muscle mass and strength (13.0%, 8.8%) were least evaluated. For Intervention, 43.9% did so within 48h of hospital admission: oral nutritional supplement (92.9%) was the most common RDs intervention and parenteral nutrition (29.9%) was used less. For Monitoring, 18.5% of institutions had monitoring frequency of ≥ 3 times/week whilst 23.0% had monitoring less than once a week for severely malnourished patients. Energy and protein intake (93.7%, 84.3%) were most monitored and lipid intake (30.1%) was less monitored.</p><p><strong>Conclusions: </strong>Barriers of NCP included inefficient staffing systems and unsuitable tools in Screening, inaccurate patient targeting and lack of important evaluation items in Assessment, delayed timing and incomplete contents in Intervention, and inadequate fre-quency and lack of important evaluation items in Monitoring. An increase in RDs staffing in acute-care general wards, widespread NCP instruction manuals, and education about the tools and evaluation items utilized in nutritional management are possible solutions.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"33 4","pages":"515-528"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11389816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing diagnostic accuracy for iron deficiency in pregnant women through mean reticulocyte volume.","authors":"Guofang Shu, Haizhen Du, Yuexin Zhang, Zhi He, Yuan Xue, Mingjie Chen, Molong Li","doi":"10.6133/apjcn.202412_33(4).0008","DOIUrl":"10.6133/apjcn.202412_33(4).0008","url":null,"abstract":"<p><strong>Background and objectives: </strong>Women are more prone to iron deficiency (ID) anemia when pregnant. The diagnostic use of mean reticulocyte volume (MRV) in identifying ID anemia during pregnancy has not been thoroughly investigated. The objective of this study is to evaluate the effectiveness of MRV in diagnosing ID in pregnant women.</p><p><strong>Methods and study design: </strong>Firstly, MRV of 20 healthy female volunteers (healthy group) was measured on specific days for one month. Subsequently, clinical data from 724 pregnant women were thoroughly examined. These women were divided into two groups: 282 with ID (research group) and 442 without ID (control group). Parameters such as MRV, reticulocyte hemoglobin equivalent (RHE), red blood cell volume distribution width-standard deviation (RDW-SD), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), hematocrit (HCT), reticulocyte count (RET), MRV/MCV ratio, and serum ferritin (SF) were analyzed and compared.</p><p><strong>Results: </strong>MRV remained consistent over a period of one month for 20 healthy individuals. In addition, there were significant differences in MRV, RHE, RDW-SD, MCV, MCH, MCHC, HCT, RET, and MRV/MCV between the research group and control group. The receiver operating characteristic (ROC) analysis showed that the areas under the curve (AUCs) for these measures were as follow: 0.840, 0.837, 0.676, 0.654, 0.639, 0.602, 0.571, 0.550, and 0.816, respectively. Ultimately, there was a substantial disparity in MRV prior to and following therapy with oral iron treatments.</p><p><strong>Conclusions: </strong>In healthy women, MRV remains stable and is a reliable ID marker, which can be used to assess oral iron treatment effectiveness during pregnancy.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"33 4","pages":"539-544"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11389799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of vitamin C and hawthorn beverage formula on blood pressure and oxidative stress in heat-exposed workers: a cluster-randomized controlled trial.","authors":"Wei Du, Shuhan Zhang, Jiajia Yang, Hongmin Fan","doi":"10.6133/apjcn.202412_33(4).0005","DOIUrl":"10.6133/apjcn.202412_33(4).0005","url":null,"abstract":"<p><strong>Background and objectives: </strong>There is no evidence on antioxidant-rich diets in preventing hypertension in heat-exposed workers. We aimed to evaluate the effects of formula supplemented with vitamin C (Vit C) and hawthorn beverage on reducing blood pressure (BP) and oxidative stress levels in heat-exposed workers.</p><p><strong>Methods and study design: </strong>In the 40-day cluster-randomized controlled trial, four heat-exposed shift-teams were enrolled and randomly assigned to the intervention and control groups. The intervention group was given one Vit C tablet (130 mg) and a 500 mL hawthorn beverage containing 278.7 mg flavonoids daily whereas the control group was given 500 mL of slightly salted water daily; both groups were provided education on a healthy diet. BP and creatinine-corrected urinary 8-isoprostane-prostaglandin F2α (8-iso-PGF2α/Cr) concentrations were assessed at baseline, Day 17 (only BP) and Day 41, respectively.</p><p><strong>Results: </strong>Compared with the control group, the systolic BP (SBP), diastolic BP (DBP), and log10-transformed 8-iso-PGF2α/Cr in the inter-vention group decreased by 7.41 mmHg, 7.93 mmHg and 0.232, respectively, from baseline to day 41 (all p<0.05). When comparing BP levels at baseline, DBP in the intervention group was reduced by 5.46 mmHg when compared to control (p<0.05) among participants with lower baseline BP; SBP and DBP experienced reductions of 9.74 and 9.22 mmHg among participants with higher baseline BP (both p<0.05).</p><p><strong>Conclusions: </strong>Supplementation of Vit C and flavonoids rich hawthorn beverage to heat-exposed workers prevented elevated BP caused by heat exposure which may be attributed to its oxidative stress inhibition effects.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"33 4","pages":"503-514"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11389814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resting energy expenditure in patients with liver cirrhosis: Indirect calorimetry vs. predictive equations.","authors":"Wen Wang, Tingting Yang, Ning Li, Qiankun Luo, Tao Qin, Mengxing Tian, Xin Jin, Lei Lei","doi":"10.6133/apjcn.202412_33(4).0009","DOIUrl":"10.6133/apjcn.202412_33(4).0009","url":null,"abstract":"<p><strong>Background and objectives: </strong>The objective of our study was to explore the accuracy of previously published prediction equations in predicting resting energy expenditure (REE) in patients with liver cirrhosis (LC). We also aimed to develop a novel equation to estimate REE for Chinese patients with LC.</p><p><strong>Methods and study design: </strong>In 90 patients with LC, the agreement between REE measured by Indirect calorimetry (IC) and predictive equations was quantified using paired T-test and visualized using a Bland-Altman Plot. Pearson correlation coefficient (R) was used to measure a linear correlation between REE measured by IC and different predictive equations. Stepwise multiple regression analysis was used to create a new REE equation.</p><p><strong>Results: </strong>The estimated REEs of previous equations were underestimated against REE measured by IC (1610 ± 334 kcal). Lean body mass (LBM) was positively correlated with REE measured by IC (r = 0.723, p < 0.01). The newly derived estimation equation for REE (kcal) was 1274.3 - 209.0 * sex - 5.73 * age + 3.69 * waist circumference + 22.89 * LBM. The newly derived estimation equation was found to have a Pearson-r value of 0.765 compared with REE measured by IC.</p><p><strong>Conclusions: </strong>REE in liver cirrhosis was underestimated by using predictive equations. The new predictive equation developed by using age, sex, waist circumference, and LBM may help estimate REE in Chinese patients with LC accurately and easily.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"33 4","pages":"545-553"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11389802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bedtime banana and milk intake on sleep and biochemical parameters.","authors":"Muteber Gizem Keser, Aysun Yuksel, Ahmet Hakan Ekmekci, Husamettin Vatansev","doi":"10.6133/apjcn.202412_33(4).0002","DOIUrl":"10.6133/apjcn.202412_33(4).0002","url":null,"abstract":"<p><strong>Background and objectives: </strong>This study aimed to evaluate the effects of milk and banana given as a bedtime snack to patients with primary insomnia on sleep parameters and some biochemical parameters such as brain-derived neurotrophic factor, leptin, and ghrelin.</p><p><strong>Methods and study design: </strong>21 patients with insomnia who met the inclusion criteria participated in this study. The patients were divided into 3 parallel groups: banana, milk and control. The intervention group were given either 1 portion of banana or just 200 mL of whole-fat milk at bedtime. The control group did not consume any non-routine food. Venous blood samples were taken at baseline and after the study from patients to measure brain-derived neurotrophic factor, leptin and ghrelin concentrations. Sleep quality and architecture were determined by polysomnography and Pittsburg Sleep Quality Index.</p><p><strong>Results: </strong>Pittsburg Sleep Quality Index scores of the banana and milk group were found to be lower after intervention (p<0.05). In terms of polysomnography, the total sleep time of the milk group was found to be significantly higher than baseline. Serum ghrelin concentration of the milk group decreased significantly compared to baseline.</p><p><strong>Conclusions: </strong>Bedtime milk or banana intake was effective in dealing with insomnia. Foods rich in tryptophan, such as banana and milk, given at bedtime, may improve sleep parameters and appetite hormones.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"33 4","pages":"481-489"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11389809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal cancer surgery in the elderly: The effects of preoperative oral nutritional supplements - A retrospective study.","authors":"Shu-An Wang, Jingyue Gu, Xiaotian Chen, Jiayao Yang, Yan Xu","doi":"10.6133/apjcn.202412_33(4).0013","DOIUrl":"10.6133/apjcn.202412_33(4).0013","url":null,"abstract":"<p><strong>Background and objectives: </strong>The current study aimed to explore the effect of nutritional prehabilitation on the clinical prognosis of elderly patients undergoing abdominal cancer surgery.</p><p><strong>Methods and study design: </strong>A retrospective study was conducted, where participants were divided into two groups based on whether they received oral nutritional supplementation at the first outpatient visit. The nutritional prehabilitation group (n=41) adopted a nutritional prehabilitation mode (a standard energy intake of 25-30 kcal/kg· d was recommended). While the control group (n=55) received routine care. All patients underwent laparoscopic surgery according to the National Comprehensive Cancer Network (NCCN) guidelines. Changes in nutritional status, complications, psychological status, symptoms, hospitalization days, and expenditures were compared between the two groups.</p><p><strong>Results: </strong>Both groups of patients experienced weight loss. However, the decline in body weight in the prehabilitation group was less than that in the control group (-1.88 vs. -2.56 kg, p < 0.001). In the comparison of nutritional prehabilitation group and control group, significant improvements were observed in the Hospital Anxiety Scale scores (5 vs. 5, p = 0.01) and MD Anderson Symptom Inventory scores (3 vs. 0, p < 0.001) respectively. The infection rate in the nutritional prehabilitation group was lower than that in the control group (17.1% vs. 36.4%, p = 0.04). Additionally, patients in the nutritional prehabilitation group had significantly fewer hospitalization days at discharge (14.3 vs. 17.1 days, p = 0.03).</p><p><strong>Conclusions: </strong>In elderly patients undergoing abdominal cancer surgery, a nutritional prehabilitation model may help maintain better physical and mental status, reduce infection rates, and shorten hospitalization days.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"33 4","pages":"581-588"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11389808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between eicosapentaenoic acid and docosahexaenoic acid consumption and inflammatory bowel disease in adults: The National Health and Nutrition Examination Survey (NHANES) 2009-2010.","authors":"Ya-Jie Wang, Pan Dou, Yi-Sheng Pan","doi":"10.6133/apjcn.202412_33(4).0011","DOIUrl":"10.6133/apjcn.202412_33(4).0011","url":null,"abstract":"<p><strong>Background and objectives: </strong>Current evidence on the associations of dietary eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) consumption with the risk of inflammatory bowel disease (IBD) is inconsistent. This study aimed to investigate the relationship between dietary EPA and DHA consumption with the incidence of IBD in a population of the United States, which potentially provides insights for global nutritional prevention and control strategies for IBD.</p><p><strong>Methods and study design: </strong>Data were sourced from the National Health and Nutrition Examination Survey for the years 2009-2010. EPA and DHA consumption was measured using twice 24-h dietary recall questionnaires. In the arthritis questionnaire, the incidence of IBD was inquired via a sub-analysis for arthropathy. To assess the relationship between dietary EPA and DHA consumption with the incidence of IBD, binary logistic regression and limited cubic spline models were used.</p><p><strong>Results: </strong>A total of 4,242 individuals aged 20 years and older participated in this survey. IBD was diagnosed in 52 individuals, representing a prevalence of 1.23%. The 95% confidence interval for crude odds ratios (ORs) of IBD in quartiles 2 and 3 of dietary EPA consumption was 0.14 (0.04-0.55) (p<0.05) and 0.36 (0.18-0.73) (p<0.05) when compared to quartile 1, respectively. The 95% confidence interval for crude ORs of IBD in quartile 4 of dietary DHA consumption was 0.09(0.02-0.35) (p<0.05) when compared to quartile 1.</p><p><strong>Conclusions: </strong>For the National Health and Nutrition Examination Survey in 2009-2010, increased dietary EPA and DHA consumption may be related to a decreased risk of IBD in Americans aged 20 and above.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"33 4","pages":"562-568"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11389807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimize individualized energy delivery for septic patients using predictive deep learning models.","authors":"Lu Wang, Li Chang, Ruipeng Zhang, Kexun Li, Yu Wang, Wei Chen, Xuanlin Feng, Mingwei Sun, Qi Wang, Charles Damien Lu, Jun Zeng, Hua Jiang","doi":"10.6133/apjcn.202409_33(3).0005","DOIUrl":"10.6133/apjcn.202409_33(3).0005","url":null,"abstract":"<p><strong>Background and objectives: </strong>We aim to establish deep learning models to optimize the individualized energy delivery for septic patients.</p><p><strong>Methods and study design: </strong>We conducted a study of adult septic patients in ICU, collecting 47 indicators for 14 days. We filtered out nutrition-related features and divided the data into datasets according to the three metabolic phases proposed by ESPEN: acute early, acute late, and rehabilitation. We then established optimal energy target models for each phase using deep learning and conducted external validation.</p><p><strong>Results: </strong>A total of 179 patients in training dataset and 98 patients in external validation dataset were included in this study, and total data size was 3115 elements. The age, weight and BMI of the patients were 63.05 (95%CI 60.42-65.68), 61.31(95%CI 59.62-63.00) and 22.70 (95%CI 22.21-23.19), respectively. And 26.0% (72) of the patients were female. The models indicated that the optimal energy targets in the three phases were 900kcal/d, 2300kcal/d, and 2000kcal/d, respectively. Excessive energy intake increased mortality rapidly in the early period of the acute phase. Insufficient energy in the late period of the acute phase significantly raised the mortality as well. For the rehabilitation phase, too much or too little energy delivery were both associated with elevated death risk.</p><p><strong>Conclusions: </strong>Our study established time-series prediction models for septic patients to optimize energy delivery in the ICU. We recommended permissive underfeeding only in the early acute phase. Later, increased energy intake may improve survival and settle energy debts caused by underfeeding.</p>","PeriodicalId":8486,"journal":{"name":"Asia Pacific journal of clinical nutrition","volume":"33 3","pages":"348-361"},"PeriodicalIF":1.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11389806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}