Modern Laboratory Methods for Assessing Risks of Malnutrition and Sarcopenia in Patients with Severe Traumatic Injuries
S. A. Valiullina,
I. V. Ponina,
I. N. Novoselov,
T. A. Akhadov,
E. E. Matytsina,
O. V. Bozhko,
A. A. Burakov https://doi.org/10.46563/2026-1-3-2036
Abstract
Currently, the issues of sarcopenia and/or developing sarcopenic obesity in patients with severe injuries are receiving increasing attention. Weight loss, primarily due to reduced muscle mass, is a common comorbid condition in patients with severe illnesses and injuries and is closely associated with an unfavorable disease prognosis as well as with complications that may limit subsequent active rehabilitation. A major obstacle to analyzing sarcopenia development following trauma is the lack of consensus on its definition and diagnostic criteria.
At present, assessment of patient’s body composition is limited to anthropometric and radiological modalities, which only allow confirmation of the presence of sarcopenia. However, identification of prognostic biomarkers and biological phenotypes in injured patients allow to detect mild metabolic changes at the early stages of pathological processes. For example, the plasma metabolomic profile can directly reflect metabolic disorders associated with muscle atrophy, as plasma is the main carrier of metabolites. The present review analyzes studies on laboratory assessment of nutritional status and skeletal muscle condition in patients who have sustained severe trauma, as well as to the experimental works animal studies evaluating levels of individual amino acids in blood plasma and their effects on muscle mass.
The review underscores the need to identify early diagnostic criteria for monitoring body composition in patients after severe trauma, which is essential for developing new therapeutic strategies aimed at correcting the identified disorders.
Keywords
body composition,
sarcopenia,
sarcopenic obesity,
metabolomic analysis,
essential and non-essential amino acids,
severe trauma,
nutritional status,
skeletal muscle atrophy,
laboratory tests sarcopenia
Supporting agencies: The study was supported by the Moscow Clinical and Research Institute of Emergency Pediatric Surgery and Trauma―Dr. Roshal’s VNK No. 362 dated May 18, 2026.
About the Authors
S. A. Valiullina
Clinical and Research Institute of Emergency Pediatric Surgery and Trauma―Dr. Roshal’s Clinic ; The Russian National Research Medical University named after N.I. Pirogov
Russian Federation
Competing Interests:
Russian Federation
Svetlana A. Valiullina, MD, Dr. Sci. (Medicine), Professor, Deputy Director for Strategic Development, Head of the Center of Medical Rehabilitation; Professor at the Department of Hospital Pediatrics at Institute of Motherhood and Childhood
Moscow
Competing Interests:
The authors declare no relationships, activities, or interests with third parties (individuals or legal entities) over the past 36 months whose interests might be affected by the content of the article.
I. V. Ponina
Clinical and Research Institute of Emergency Pediatric Surgery and Trauma―Dr. Roshal’s Clinic
Russian Federation
Competing Interests:
Russian Federation
Irina V. Ponina, MD, Cand. Sci. (Medicine)
Moscow
Competing Interests:
The authors declare no relationships, activities, or interests with third parties (individuals or legal entities) over the past 36 months whose interests might be affected by the content of the article.
I. N. Novoselov
Clinical and Research Institute of Emergency Pediatric Surgery and Trauma―Dr. Roshal’s Clinic ; Russian Medical Academy of Continuous Professional Education
Russian Federation
Competing Interests:
Russian Federation
Irina N. Novoselova, MD, Dr. Sci. (Medicine), Chief Researcher at the Center of Medical Rehabilitation; Professor at the Department of Physical Therapy, Sports Medicine and Medical Rehabilitation
Moscow
Competing Interests:
The authors declare no relationships, activities, or interests with third parties (individuals or legal entities) over the past 36 months whose interests might be affected by the content of the article.
T. A. Akhadov
Clinical and Research Institute of Emergency Pediatric Surgery and Trauma―Dr. Roshal’s Clinic
Russian Federation
Competing Interests:
Russian Federation
Tolibdzhon A. Akhadov, MD, Dr. Sci. (Medicine), Professor, Scientific Director of the Department of Radiological Diagnostics
Moscow
Competing Interests:
The authors declare no relationships, activities, or interests with third parties (individuals or legal entities) over the past 36 months whose interests might be affected by the content of the article.
E. E. Matytsina
Clinical and Research Institute of Emergency Pediatric Surgery and Trauma―Dr. Roshal’s Clinic
Russian Federation
Competing Interests:
Russian Federation
Erzheni E. Matytsina, Researcher at the Research Department (Rehabilitation)
Moscow
Competing Interests:
The authors declare no relationships, activities, or interests with third parties (individuals or legal entities) over the past 36 months whose interests might be affected by the content of the article.
O. V. Bozhko
Clinical and Research Institute of Emergency Pediatric Surgery and Trauma―Dr. Roshal’s Clinic
Russian Federation
Competing Interests:
Russian Federation
Olga V. Bozhko, MD, Cand. Sci. (Medicine), Senior Researcher at the Research Department (Rehabilitation)
Moscow
Competing Interests:
The authors declare no relationships, activities, or interests with third parties (individuals or legal entities) over the past 36 months whose interests might be affected by the content of the article.
A. A. Burakov
Clinical and Research Institute of Emergency Pediatric Surgery and Trauma―Dr. Roshal’s Clinic
Russian Federation
Competing Interests:
Russian Federation
Aleksey A. Burakov, Researcher at the Center of Medical Rehabilitation
Moscow
Competing Interests:
The authors declare no relationships, activities, or interests with third parties (individuals or legal entities) over the past 36 months whose interests might be affected by the content of the article.
References
1. Puthucheary ZA, Astin R, McPhail MJW, et al. Metabolic phenotype of skeletal muscle in early critical illness. Thorax. 2018;73(10):926–935. doi: 10.1136/thoraxjnl-2017-211073
2. Zhao Q, Shen H, Su KJ, et al. A joint analysis of metabolomic profiles associated with muscle mass and strength in Caucasian women. Aging. 2018;10(10):2624–2635. doi: 10.18632/aging.101574
3. Chang Y, Yoo HJ, Kim SJ, et al. A targeted metabolomics approach for sepsis-induced ARDS and its subphenotypes. Crit Care. 2023;27(1):263. doi: 10.1186/s13054-023-04552-0
4. Puthucheary ZA, Rawal J, McPhail M, et al. Acute skeletal muscle wasting in critical illness. JAMA. 2013;310(15):1591‒1600. doi: 10.1001/jama.2013.278481
5. Gamrin-Gripenberg L, Sundström-Rehal M, Olsson D, et al. An attenuated rate of leg muscle protein depletion and leg free amino acid efflux over time is seen in ICU long-stayers. Crit Care. 2018;22(1):13. doi: 10.1186/s13054-017-1932-6 EDN: HMZWWE
6. Xiao F, Guo F. Impacts of essential amino acids on energy balance. Mol Metab. 2022;57:101393. doi: 10.1016/j.molmet.2021.101393 EDN: QVOUQB
7. Fiehn O. Metabolomics: the link between genotypes and phenotypes. Plant Mol Biol. 2002;48(1-2):155‒171.
8. Lepper C, Partridge TA, Fan CM. An absolute requirement for Pax7-positive satellite cells in acute injury-induced skeletal muscle regeneration. Development. 2011;138(17):3639‒3646. doi: 10.1242/dev.067595
9. Norton R, Kobusingye O. Global health: injuries. N Engl J Med. 2013;368(18):1723‒1730. doi: 10.1056/NEJMra1109343 EDN: RHHQMF
10. Henriksen HH, Marín de Mas I, Nielsen LK, et al. Endothelial cell phenotypes demonstrate different metabolic patterns and predict mortality in trauma patients. Int J Mol Sci. 2023;24(3):2257. doi: 10.3390/ij ms24032257 EDN: AYYUUI
11. Hunt TK, Aslam RS, Beckert S, et al. Aerobically derived lactate stimulates revascularization and tissue repair via redox mechanisms. Antioxid Redox Signal. 2007;9(8):1115‒1124. doi: 10.1089/ars.2007.1674
12. Stückelberger G, Weuster M, Hana A, et al. Metabolomics after trauma in experimental models: a systematic review. Langenbecks Arch Surg. 2026;411(1):61. doi: 10.1007/s00423-025-03917-z EDN: PCEWEP
13. Braidy N, Guillemin GJ, Mansour H, et al. Changes in kynurenine pathway metabolism in the brain, liver and kidney of aged female Wistar rats. FEBS J. 2011;278(22):4425‒4434. doi: 10.1111/j.1742-4658.2011.08366.x
14. Dukes A, Davis C, El Refaey M, et al. The aromatic amino acid tryptophan stimulates skeletal muscle IGF1/p70s6k/ mTor signaling in vivo and the expression of myogenic genes in vitro. Nutrition. 2015;31(7-8):1018‒1024. doi: 10.1016/j.nut.2015.02.011
15. Toyoshima K, Nakamura M, Adachi Y, et al. Increased plasma proline concentrations are associated with sarcopenia in the elderly. PLoS One. 2017;12(9):e0185206. doi: 10.1371/journal.pone.0185206
16. Pedroso JA, Zampieri TT, Donato J. Reviewing the effects of L-leucine supplementation in the regulation of food intake, energy balance, and glucose homeostasis. Nutrients. 2015;7(5):3914‒3937. doi: 10.3390/nu7053914
17. Zhang P, Liang X, Shan T, et al. mTOR is necessary for proper satellite cell activity and skeletal muscle regeneration. Biochem Biophys Res Commun. 2015;463(1-2):102‒108. doi: 10.1016/j.bbrc.2015.05.032
18. Kim HK, Suzuki T, Saito K, et al. Effects of exercise and amino acid supplementation on body composition and physical function in community-dwelling elderly Japanese sarcopenic women: a randomized controlled trial. J Am Geriatr Soc. 2012;60(1):16‒23. doi: 10.1111/j.1532-5415.2011.03776.x EDN: YCHUUL
19. Jin CL, Ye JL, Yang J, et al. mTORC1 mediates lysine-induced satellite cell activation to promote skeletal muscle growth. Cells. 2019;8(12):1549. doi: 10.3390/cells8121549
20. Bologna C, Pone E. Clinical study on the efficacy and safety of arginine administered orally in association with other active ingredients for the prevention and treatment of sarcopenia in patients with COVID-19-related pneumonia, hospitalized in a sub-intensive care unit. Healthcare (Basel). 2022;10(1):162. doi: 10.3390/healthcare10010162 EDN: USDOYB
21. Liu G, Kim WK. The functional roles of methionine and arginine in intestinal and bone health of poultry: review. Animals (Basel). 2023;13(18):2949. doi: 10.3390/ani13182949 EDN: OYIZPY
22. Ferreira AG, Scherer EB, da Cunha AA, et al. Hyperprolinemia induces DNA, protein and lipid damage in blood of rats: antioxidant protection. Int J Biochem Cell Biol. 2014;54:20‒25. doi: 10.1016/j.biocel.2014.05.027
23. Delwing D, Delwing D, Sanna RJ, et al. Proline promotes decrease in glutamate uptake in slices of cerebral cortex and hippocampus of rats. Life Sci. 2007;81(25-26):1645–1650. doi: 10.1016/j.lfs.2007.09.031
24. Suidasari S, Stautemas J, Uragami S, et al. Carnosine content in skeletal muscle is dependent on vitamin B6 status in rats. Front Nutr. 2016;2:39. doi: 10.3389/fnut.2015.00039 EDN: CMHHGA
25. Kumar A, Kumar Y, Sevak JK, et al. Metabolomic analysis of primary human skeletal muscle cells during myogenic progression. Sci Rep. 2020;10(1):11824. doi: 10.1038/s41598-020-68796-4 EDN: CUDPPA
26. Pelosi M, De Rossi M, Barberi L, Musarò A. IL-6 impairs myogenic differentiation by downmodulation of p90RSK/eEF2 and mTOR/p70S6K axes, without affecting AKT activity. Biomed Res Int. 2014;2014:206026. doi: 10.1155/2014/206026
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For citations:
Valiullina S.A., Ponina I.V., Novoselov I.N., Akhadov T.A., Matytsina E.E., Bozhko O.V., Burakov A.A. Modern Laboratory Methods for Assessing Risks of Malnutrition and Sarcopenia in Patients with Severe Traumatic Injuries. M.Ya. Studenikin Russian Pediatric Journal. 2026;1(3):199-204. (In Russ.) https://doi.org/10.46563/2026-1-3-2036
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