Effect of an intensified individual nutrition therapy on serum metabolites in critically ill patients – A targeted metabolomics analysis of the ONCA study

Gonzalez‐Granda, Anita; Seethaler, Benjamin; Haap, Michael; Riessen, Reimer; Bischoff, Stephan C.

doi:10.1016/j.clnesp.2021.04.002

Cited by 10 publications

(4 citation statements)

References 33 publications

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“…When the serum total PSA is higher than 4.0 ng/mL, prostate cancer is highly suspected. However, the serum PSA content of some prostate cancer patients is less than 4.0 ng/mL, and the definitive diagnosis of prostate cancer should be combined with clinical imaging and pathological examinations ( 9 , 10 ). To further distinguish prostate cancer patients with PSA < 4.0 ng/mL from those with PSA < 4.0 ng/mL, ROC curve analysis was used to obtain three diagnostic models: the sensitivities and specificities were 56.1% and 100% for 5-hydroxymethyl-2-furoic acid, 63.4.0% and 100% for ethylmalonic acid, and 87.8% and 90% for pyroglutamic acid, respectively ( Figure 4A ).…”

Section: Resultsmentioning

confidence: 99%

“…When prostate cancer occurs, the original tissue barrier is severely damaged due to the abnormal infiltration and growth of cancer tissue, resulting in massive leakage of PSA into the blood. PSA is a sensitive marker for the diagnosis of prostate cancer but does not have specificity ( 10 ). To further distinguish prostate cancer patients with PSA > 4.0 ng/mL and PSA < 4.0 ng/mL, our results confirmed that the serum content of pyroglutamic was higher in patients with PSA < 4.0 ng/mL than in patients with PSA > 4.0 ng/mL.…”

Section: Discussionmentioning

confidence: 99%

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Serum organic acid metabolites can be used as potential biomarkers to identify prostatitis, benign prostatic hyperplasia, and prostate cancer

Han²,

Luo³

et al. 2023

Front. Immunol.

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BackgroundNoninvasive methods for the early identify diagnosis of prostatitis, benign prostatic hyperplasia (BPH), and prostate cancer (PCa) are current clinical challenges.MethodsThe serum metabolites of 20 healthy individuals and patients with prostatitis, BPH, or PCa were identified using untargeted liquid chromatography-mass spectrometry (LC-MS). In addition, targeted LC-MS was used to verify the organic acid metabolites in the serum of a validation cohort.ResultsOrganic acid metabolites had good sensitivity and specificity in differentiating prostatitis, BPH, and PCa. Three diagnostic models identified patients with PROSTATITIS: phenyllactic acid (area under the curve [AUC]=0.773), pyroglutamic acid (AUC=0.725), and pantothenic acid (AUC=0.721). Three diagnostic models identified BPH: citric acid (AUC=0.859), malic acid (AUC=0.820), and D-glucuronic acid (AUC=0.810). Four diagnostic models identified PCa: 3-hydroxy-3-methylglutaric acid (AUC=0.804), citric acid (AUC=0.918), malic acid (AUC=0.862), and phenyllactic acid (AUC=0.713). Two diagnostic models distinguished BPH from PCa: phenyllactic acid (AUC=0.769) and pyroglutamic acid (AUC=0.761). Three diagnostic models distinguished benign BPH from PROSTATITIS: citric acid (AUC=0.842), ethylmalonic acid (AUC=0.814), and hippuric acid (AUC=0.733). Six diagnostic models distinguished BPH from prostatitis: citric acid (AUC=0.926), pyroglutamic acid (AUC=0.864), phenyllactic acid (AUC=0.850), ethylmalonic acid (AUC=0.843), 3-hydroxy-3-methylglutaric acid (AUC=0.817), and hippuric acid (AUC=0.791). Three diagnostic models distinguished PCa patients with PROSTATITISA < 4.0 ng/mL from those with PSA > 4.0 ng/mL: 5-hydromethyl-2-furoic acid (AUC=0.749), ethylmalonic acid (AUC=0.750), and pyroglutamic acid (AUC=0.929). Conclusions: These results suggest that serum organic acid metabolites can be used as biomarkers to differentiate prostatitis, BPH, and PCa.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Serum organic acid metabolites can be used as potential biomarkers to identify prostatitis, benign prostatic hyperplasia, and prostate cancer

Han²,

Luo³

et al. 2023

Front. Immunol.

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“…Given the recent commercialization of a new generation of accurate and simple devices (the Q-NRG, Cosmed, Rome, Italy and Baxter, Deerfield, IL, USA), the implementation of an individualized nutritional care program is now possible and easier in daily practice [ 26 ]. Nutrition guided by indirect calorimetry during the ICU stay has been shown to be associated with reduced nutritional deficits and reduced catabolism [ 27 ], a lower incidence of ICU-acquired weakness [ 28 ] and decreased mortality [ 29 ]. This positive impact of indirect calorimetry needs to be confirmed in further large studies in ICU, but also in post-ICU settings.…”

Section: Discussionmentioning

confidence: 99%

Measured Energy Expenditure Using Indirect Calorimetry in Post-Intensive Care Unit Hospitalized Survivors: A Comparison with Predictive Equations

et al. 2022

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Actual energy needs after a stay in intensive care units (ICUs) are unknown. The aims of this observational study were to measure the energy expenditure (mEE) of ICU survivors during their post-ICU hospitalization period, and to compare this to the estimations of predictive equations (eEE). Survivors of an ICU stay ≥ 7 days were enrolled in the general ward during the first 7 days after ICU discharge. EE was measured using the Q-NRG calorimeter in canopy mode. This measure was compared to the estimated EE using the Harris–Benedict (HB) equation multiplied by a 1.3 stress factor, the Penn–State (PS) equation or the 30 kcal weight-based (WB) equation. A total of 55 adults were included (67.3% male, age 60 (52–67) y, body mass index 26.1 (22.2–29.7) kg/m2). Indirect calorimetry was performed 4 (3–6) d after an ICU stay of 12 (7–16) d. The mEE was 1682 (1328–1975) kcal/d, corresponding to 22.9 (19.1–24.2) kcal/kg/day. The eEE values derived using HB and WB equations were significantly higher than mEE: 3048 (1805–3332) and 2220 (1890–2640) kcal/d, respectively (both p < 0.001). There was no significant difference between mEE and eEE using the PS equation: 1589 (1443–1809) kcal/d (p = 0.145). The PS equation tended to underestimate mEE with a bias of −61.88 kcal and a wide 95% limit of agreement (−717.8 to 594 kcal). Using the PS equation, agreement within 15% of the mEE was found in 32/55 (58.2%) of the patients. In the present cohort of patients who survived a prolonged ICU stay, mEE was around 22–23 kcal/kg/day. In this post-ICU hospitalization context, none of the tested equations were accurate in predicting the EE measured by indirect calorimetry.

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“…It seems unusual that in other areas of critical care, patients' physiological parameters are so closely monitored and treatment titrated to actual measurements (for example mean arterial pressure) but not for nutrition. Promising improvements have been shown in meta-analyses or small studies trying to provide nutrition in a more individualised and personalised approach, including the use of glycemiccontrol EN to improve blood glucose control and lower insulin use, an attempt to find differences in metabolic profile according to energy delivery using metabolomics, a combination of high protein intake and early exercise on functional outcomes, investigation of beta-hydroxy-beta-methylbutyrate compared to placebo and the attenuation of muscle wasting [21][22][23][24][25]. Although not providing definitive answers as yet, this work indicates that more thought is being paid to how individualised and personalised nutrition might benefit particular patients.…”

Section: Why Studied Interventions May Not Have Made a Differencementioning

confidence: 99%

Nutrition before, during and after critical illness

Ridley

Lambell

2022

Current Opinion in Critical Care

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Purpose of reviewThis review describes considerations preintensive care unit (ICU), within ICU and in the post-ICU period regarding nutrition management and the current state of the literature base informing clinical care.Recent findingsWithin ICU, studies have focussed on the first 5–7 days of illness in mechanically ventilated patients who are heterogeneous and with minimal consideration to premorbid nutrition state. Many evidence gaps in the period within ICU remain, with the major ones being the amount of protein to provide and the impact of longer-term nutrition interventions. Personalised nutrition and nutrition in the post-ICU period are becoming key areas of focus.SummaryNutrition for the critically ill patient should not be viewed in isolated time periods; what happens before, during and after ICU is likely important to the overall recovery trajectory. It is critical that the impact of nutrition on clinical and functional outcomes across hospitalisation is investigated in specific groups and using interventions in ways that are biologically plausible to impact. Areas that show promise for the future of critical care nutrition include interventions delivered for a longer duration and inclusion of oral nutrition support, individualised nutrition regimes, and use of emerging bedside body composition techniques to identify patients at nutritional risk.

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Effect of an intensified individual nutrition therapy on serum metabolites in critically ill patients – A targeted metabolomics analysis of the ONCA study

Cited by 10 publications

References 33 publications

Serum organic acid metabolites can be used as potential biomarkers to identify prostatitis, benign prostatic hyperplasia, and prostate cancer

Serum organic acid metabolites can be used as potential biomarkers to identify prostatitis, benign prostatic hyperplasia, and prostate cancer

Measured Energy Expenditure Using Indirect Calorimetry in Post-Intensive Care Unit Hospitalized Survivors: A Comparison with Predictive Equations

Nutrition before, during and after critical illness

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