Sex differences in clinical presentation, treatment response, and side effects of nutritional therapy among patients at nutritional risk A secondary analysis of the randomized clinical trial EFFORT.

BACKGROUND

Considering sex-specific factors has become an increasingly recognized area for research and practice. In the field of clinical nutrition, there is insufficient evidence regarding differences in clinical presentation, treatment response, and side effects of nutritional therapy among female and male patients.

METHODS

This secondary analysis investigated differences among female and male patients at risk for malnutrition regarding initial presentation, clinical outcomes, and treatment response in patients included in the Effect of Early NutritionalSupporton Frailty, Functional Outcomes, and Recovery of Malnourished Medical Inpatients Trial (EFFORT), a randomized controlled trial comparing individualized nutritional support to usual care.

RESULTS

Of 2,028 patients included in the trial 964 were female and 1,064 were male. The nutritional history and clinical presentation of female patients was different: they consumed less food and had a greater loss of appetite than the male population. Male patients had higher risk for mortality at 180 days (27% compared to 19%, adjusted HR 1.35 [95%CI 1.12, 1.63]) and further adverse clinical outcomes. However, there was no difference in the effect of nutritional support on mortality among female and male patients (HR 0.76 [95%CI 0.45, 1.27] compared to 0.81 [95%CI 0.54, 1.21]; p for interaction =0.939).

CONCLUSION

Results of this multicenter randomized trial suggest that multimorbid female inpatients, have a different clinical presentation and are more prone to loss of appetite and reduced daily dietary intake compared to male inpatients. Importantly, the favorable response to nutritional interventions was similar in both sexes.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02517476.

Informations de copyright

Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest ☐ The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. ☒ The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Philipp Schuetz reports a relationship with Roche, Thermo Fisher, bioMérieux, Nestlé Health Science and Abbott Nutrition. that includes: funding grants. Zeno Stanga reports a relationship with Nestlé Health Science, Fresenius Kabi and B. Braun that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.