Annals of Clinical Nutrition and Metabolism

Original Articles

Epigallocatechin gallate increases fatty acid oxidation but not 24-hour survival in lipopolysaccharide-induced endotoxic shock in mice: Takayuki Irahara, Ryusuke Katsuki, Dai Oishi, Tsuguaki Terashima, Md. Monirul Islam, Umme Salma, Shohag Majumder, Ridwan Ahmed, Eizo Watanabe; Ann Clin Nutr Metab 2026;18(1):27-33. Published online March 30, 2026; DOI: https://doi.org/10.15747/ACNM.25.0036

Graphical Abstract Abstract PDF: Purpose
This study aimed to explore the effects of epigallocatechin gallate (EGCG) in critically ill patients using a mouse model.
Methods
C57BL/6 mice were divided into control and EGCG groups (n=8 per group). The EGCG group received a 0.1% EGCG solution for 2 weeks, after which the mice were intraperitoneally injected with a lethal dose of lipopolysaccharide to induce acute endotoxic shock. Indirect calorimetry was performed for 24 hours. Changes in body weight, epididymal fat weight, and survival were measured, together with serum lipid levels, interleukin-6 (IL-6), and superoxide dismutase (SOD) concentrations. The expression of peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α) was determined using quantitative real-time polymerase chain reaction, and its serum concentration was subsequently measured.
Results
Indirect calorimetry showed a significant increase in fatty acid oxidation (P<0.0001) in the EGCG group, along with significant decreases in body weight and epididymal fat weight (P<0.01 and P<0.05, respectively). Survival did not differ significantly between groups (P=0.197). Serum lipid levels, IL-6, and SOD showed numerical differences, although these differences were not statistically significant. Furthermore, hepatic PGC-1α expression showed a tendency toward upregulation, and serum PGC-1α levels were significantly higher (P<0.05).
Conclusion
EGCG stimulates endogenous lipid metabolism through PGC-1α activation and may suppress inflammatory responses; therefore, it may represent a potentially useful nutrient for acute nutritional therapy.

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Prognostic significance of serum creatinine and sarcopenia for 5-year overall survival in patients with colorectal cancer in Korea: a comparative study: Jiahn Choi, Hye Sun Lee, Jeonghyun Kang; Ann Clin Nutr Metab 2024;16(2):66-77. Published online August 1, 2024; DOI: https://doi.org/10.15747/ACNM.2024.16.2.66

Abstract PDF Supplementary Material: Purpose: Previous studies have demonstrated that the serum creatinine level and skeletal muscle index (SMI) (correlated with the overall survival [OS] of patients with colorectal cancer [CRC]). However, the combined significance of these 2 factors is not fully understood. The goal of this study was to investigate the prognostic potential of the combination of these two factors in patients with CRC.
Methods: The patients were categorized into subgroups based on preoperative serum creatinine level, with a cut-off value of 1.01 mg/dL for males and 0.80 mg/dL for females. The patients were further categorized into 4 groups based on SMI. Data were analyzed using the Cox proportional hazards model and Harrell’s concordance index (C-index).
Results: Poor 5-year OS was observed in patients with high SMI and high serum creatinine levels (hazard ratio [HR]=1.676, 95% confidence interval [CI]=1.110–2.529, P=0.013), low SMI and low serum creatinine levels (HR=1.916, 95% CI=1.249–2.938, P=0.002), and low SMI and high serum creatinine levels (HR=2.172, 95% CI=1.279–3.687, P=0.004) compared to those of patients with high SMI and low serum creatinine levels. Grouping patients based on both SMI and serum creatinine levels led to improved prognostic stratification (C-index, 0.626; 95% CI=0.587–0.666) compared to grouping based on SMI (CI difference=0.062, 95% CI=0.031–0.103, P=0.0011) or serum creatinine (CI difference=0.043, 95% CI=0.017–0.081, P=0.0072) alone.
Conclusion: Incorporating both SMI and serum creatinine levels enhances the prognostic stratification for 5-year OS in patients with CRC, surpassing the prognostic power of grouping solely based on SMI or creatinine.

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Clinical Implications of the Cut-off Value of the Preoperative Prognostic Nutritional Index in Patients with Early Stage Gastric Cancer: Ji Hye Jung, Ji Yeong An, You Na Kim, Min Gew Choi, Jun Ho Lee, Tae Sung Sohn, Jae Moon Bae, Sung Kim; Surg Metab Nutr 2019;10(2):59-65. Published online December 30, 2019; DOI: https://doi.org/10.18858/smn.2019.10.2.59

Abstract PDF: Purpose:
The perioperative nutritional status is a potential prognostic factor in gastric cancer patients. This study assessed the optimal cut-off value of the prognostic nutritional index (PNI) for predicting the survival of patients with early stage gastric cancer and evaluated its power for predicting the survival after gastric cancer surgery.
Materials and Methods:
This study reviewed the data of 8,014 patients with stage T1N0~1M0 and T2~3N0M0 gastric cancer who underwent a curative gastrectomy without adjuvant chemotherapy between January 2006 and December 2015. The log-rank test on SAS was conducted to determine the preoperative PNI cut-off value that indicated the most significant difference in survival, and the clinical features and oncological outcomes were analyzed according to the cut-off value of the preoperative PNI.
Results:
The preoperative PNI cut-off value that indicated the most significant difference in survival was 43.7. Using this cut-off value, patients were classified into high PNI and low PNI groups. The five-year overall survival rate was 96.9% and 81.5% for the high and low PNI group, respectively (P<0.001). Considering each stage (Ia, Ib, and IIa), the overall survival rates were significantly higher for the high PNI group than the low PNI group. Multivariable analysis revealed the cut-off value of the preoperative PNI to be among the independent risk factors for survival.
Conclusions:
The cut-off value of the preoperative PNI that could be used to determine the significant differences in the survival of patients with early stage gastric cancer was identified and proven to have a significant impact on predicting survival.

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