Association of proteomic markers with nutritional risk and response to nutritional support: A secondary pilot study of the EFFORT trial using an untargeted proteomics approach

Struja, Tristan; Laczkó, Endre; Wolski, Witold; Schlapbach, Ralph; Müeller, Beat; Roschitzki, Bernd; Schüetz, Philipp

doi:10.1016/j.clnesp.2022.01.035

Cited by 5 publications

(4 citation statements)

References 34 publications

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“…Also, proteonomic and metabolomic markers have been studied. 48,49 Because of their association with malnutrition, these different markers may be considered potential candidates for predicting response to nutrition treatment, but it is important to consider individual limitations of each marker. 50 Besides, hypothesis-generating studies on treatment response are lacking so far.…”

Section: Focusing On Different Illness-related Factors Bargetzi Et Al...mentioning

confidence: 99%

“…Other laboratory markers that are associated with malnutrition are urinary creatinine, urinary 3‐methylhistidine, serum cholesterol, blood lymphocyte count, serum insulin‐like growth factor‐1 (IGF1), serum leptin and many more. Also, proteonomic and metabolomic markers have been studied 48,49 . Because of their association with malnutrition, these different markers may be considered potential candidates for predicting response to nutrition treatment, but it is important to consider individual limitations of each marker 50 .…”

Section: Personalized Nutrition and The Use Of Biomarkersmentioning

confidence: 99%

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Inflammation and response to nutrition interventions

Wunderle,

Stumpf,

Schuetz

2024

J Parenter Enteral Nutr

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The complex interplay between nutrition and inflammation has become a major focus of research in recent years across different clinical settings and patient populations. Inflammation has been identified as a key driver for disease‐related malnutrition promoting anorexia, reduced food intake, muscle loss, and on a cellular level, insulin resistance, which together stimulate catabolism. However, these effects may well be bidirectional, and there is strong evidence showing that nutrition influences inflammation. Several single nutrients and dietary patterns with either proinflammatory or anti‐inflammatory properties have been studied, such as the long‐chain ω‐3 fatty acids eicosapentaenoic acid or docosahexaenoic acid. The Mediterranean diet combines several such nutrients and has been shown to improve medical outcomes in the outpatient setting. In addition, there is increasing evidence suggesting that inflammation affects the metabolism and modulates the response to nutrition support interventions. In fact, recent studies from the medical inpatient setting suggest that inflammation, mirrored by high levels of C‐reactive protein, diminishes the positive effects of nutrition support. This may explain the lack of positive effects of some nutrition trials in severely ill patients, whereas similar approaches to nutritional support have shown positive results in less severely ill patients. The use of biomarkers, such as C‐reactive protein, may help to identify patients with a lower response to nutrition, in whom other treatment options need to be used. There is need for additional research to understand how to best address the malnourished patient with inflammation by specifically lowering inflammation through anti‐inflammatory medical treatments and/or nutrition interventions.

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Section: Focusing On Different Illness-related Factors Bargetzi Et Al...mentioning

confidence: 99%

Section: Personalized Nutrition and The Use Of Biomarkersmentioning

confidence: 99%

Inflammation and response to nutrition interventions

Wunderle,

Stumpf,

Schuetz

2024

J Parenter Enteral Nutr

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“…[10][11][12][13] Other markers such as albumin 14 or different metabolomic parameters were not helpful. 15,16 Further knowledge of specific nutritional biomarkers to predict response to nutritional treatment may allow better phenotyping patients and help focus specific interventions on patients who may benefit the most. Among potential nutritional biomarkers, there is particular interest in visceral proteins such as serum albumin that has been used to characterise patients since the 1970's.…”

Section: Effect Of Early Nutritional Support On Frailty and Functiona...mentioning

confidence: 99%

“…In fact, different analyses showed that some nutrition biomarkers may help to identify patients who will have more or less benefit from nutrition support including biomarkers of inflammation (ie, C‐reactive protein [CRP]), markers of kidney function, and markers of sarcopenia 10–13 . Other markers such as albumin 14 or different metabolomic parameters were not helpful 15,16 . Further knowledge of specific nutrition biomarkers to predict response to nutrition treatment may allow better phenotyping of patients and help focus specific interventions on patients who may benefit the most.…”

Section: Introductionmentioning

confidence: 99%

Association between prealbumin, all‐cause mortality, and response to nutrition treatment in patients at nutrition risk: Secondary analysis of a randomized controlled trial

Bretscher

Buergin

Gurzeler

et al. 2023

J Parenter Enteral Nutr

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Introduction Due to the shorter half-life as compared with albumin, serum prealbumin concentrations have been proposed to be useful nutritional biomarkers for the assessment of patients at nutritional risk. In a post-hoc analysis of patients at nutritional risk from a randomized-controlled nutritional trial, we therefore tested the hypothesis that (a) prealbumin is associated with higher all-cause 180-day mortality rates and that (b) individualized nutritional support compared to usual care nutrition more effectively improves survival at 30 days in patients with low prealbumin levels compared to patients with normal prealbumin levels. MethodsWe performed a pre-specified cohort study in patients included in the pragmatic, Swiss, multicenter, randomized-controlled EFFORT trial comparing the effects of individualized nutritional support with usual care. We studied low prealbumin concentrations (<0.17 g/l) in a subgroup of 517 patients from one participating centre.Results A total of 306 (59.2%) patients (mean age 71.9 years, 53.6% men) had low admission prealbumin levels (<0.17 g/L). There was a significant association between low prealbumin levels and mortality at 180-days [115/306 (37.6%) vs. 47/211 (22.3%), fully adjusted hazard ratio (HR) 1.59, 95%CI 1.11 to 2.28, p=0.011]. Prealbumin levels significantly improved the prognostic value of the Nutritional Risk Screening total score regarding mortality prediction at short-and long-term. The difference in mortality between patients receiving individualized nutritional support and usual care nutrition was similar for patients with low prealbumin levels compared with patients with normal prealbumin levels [HR 0.90 (95%CI 0.51 to 1.59) vs. HR 0.88 (95%CI 0.35 to 2.23)] with no evidence for interaction (p=0.823). ConclusionAmong medical inpatients at nutritional risk, low admission prealbumin levels correlated with different nutritional markers and higher mortality risk; but patients with low or high prealbumin levels had a similar benefit from nutritional support. Further studies should identify nutritional markers that help further personalize nutritional interventions.

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