Aktuelle Ernährungsmedizin 2025; 50(02): e1
DOI: 10.1055/s-0045-1809080
Abstracts
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Comparison Of The Inflammatory Biomarkers Il-6, Tnf-Α, And Crp To Predict Treatment Response To Nutritional Therapy In Medical Patients At Risk Of Malnutrition

E Martin
1   University of Basel, Basel
2   Medical University Department, Division of General Internal and Emergency Medicine, Division of Endocrinology, Diabetes and Metabolism, Kantonsspital Aarau, Aarau
,
A Wittig
1   University of Basel, Basel
2   Medical University Department, Division of General Internal and Emergency Medicine, Division of Endocrinology, Diabetes and Metabolism, Kantonsspital Aarau, Aarau
,
C Wunderle
2   Medical University Department, Division of General Internal and Emergency Medicine, Division of Endocrinology, Diabetes and Metabolism, Kantonsspital Aarau, Aarau
,
P Tribolet
2   Medical University Department, Division of General Internal and Emergency Medicine, Division of Endocrinology, Diabetes and Metabolism, Kantonsspital Aarau, Aarau
3   Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
4   Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
,
T A Lutz
5   Vetsuisse Faculty, Institute of Veterinary Physiology
,
C Köster-Hegmann
6   Vetsuisse Faculty, Institute of Veterinary Physiolog, University of Zurich, Zurich
,
Z Stanga
7   Bern University Hospital, Division of Diabetes, Endocrinology, Nutritional Medicine, and Metabolism, Bern
,
B Müller
2   Medical University Department, Division of General Internal and Emergency Medicine, Division of Endocrinology, Diabetes and Metabolism, Kantonsspital Aarau, Aarau
8   Medical faculty, University of Basel, Basel, Switzerland
,
P Schuetz
2   Medical University Department, Division of General Internal and Emergency Medicine, Division of Endocrinology, Diabetes and Metabolism, Kantonsspital Aarau, Aarau
8   Medical faculty, University of Basel, Basel, Switzerland
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Introduction: Inflammation is a key driver of disease-related malnutrition and patients with high inflammation may not show the same benefits from nutritional therapy as other patients.

Objectives: We compared the prognostic ability of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) and C-reactive protein (CRP) to predict outcome and response to nutritional therapy, respectively, within a large cohort of patients from a previous nutritional trial.

Methods: This is a secondary analysis of the Swiss-wide, multicenter, randomized controlled Effect of early nutritional therapy on Frailty, Functional Outcomes, and Recovery of malnourished medical inpatients Trial (EFFORT) trial comparing individualized nutritional support with usual care nutrition in medical inpatients. The primary endpoint was 30-day all-cause mortality

Results: We included 996 patients with an overall mortality rate of 6% within 30 days. Compared to patients with low IL-6 level<11.2pg/mL, patients with high levels had a more than 3-fold increase in mortality at 30-days (adjusted HR 3.5, 95% CI 1.95-6.28, p<0.001), but a less pronounced mortality benefit from individualized nutritional therapy as compared to usual nutritional care (hazard ratio 0.82 vs. 0.32). CRP and TNF-α were not associated with mortality, but patients with increased CRP levels>100mg/dl also had a diminished response to nutritional intervention (hazard ratio 1.25 vs. 0.47).

Conclusion: Our findings support the thesis that a high inflammatory state is linked to reduced benefits from nutritional therapy. Both CRP and IL-6 effectively predict treatment response, but IL-6 additionally serves as a prognostic marker for increased mortality. This finding might help to develop improved treatment strategies for patients with elevated inflammatory profiles [1] [2] [3].



Publication History

Article published online:
25 May 2025

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