{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:50:25Z","timestamp":1791521425829,"version":"4.3.4"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Heart failure (HF) is characterized by marked clinical heterogeneity, while conventional left ventricular ejection fraction (LVEF)-based classification may not fully capture systemic inflammatory, nutritional, hematologic, and cardiorenal abnormalities. We aimed to identify laboratory-derived inflammatory\u2013nutritional exploratory phenogroups in hospitalized patients with HF and evaluate their associations with functional limitation and 30-day same-center all-cause unplanned readmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective cohort included 1,588 hospitalized patients with HF, of whom 1,455 with complete data for 15 prespecified clustering variables were included in the primary analysis. K-means, Gaussian mixture models, and DBSCAN were compared, and K-means with K\u202f=\u202f3 was selected based on internal separation, stability, cluster size, and clinical interpretability, with K\u202f=\u202f2 used as a sensitivity analysis. Severe functional limitation was defined as NYHA class III\u2013IV, and 30-day same-center all-cause unplanned readmission was evaluated as the short-term clinical outcome. Multivariable logistic regression with HC3 robust standard errors was used to assess these associations, with multiple-imputation and median-imputation sensitivity analyses conducted in the full cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three phenogroups were identified: an inflammatory\u2013cardiorenal\u2013nutritional vulnerability phenotype, an anemia\u2013immune dysregulation phenotype, and a relatively preserved laboratory phenotype. LVEF was similar across groups, whereas severe functional limitation and 30-day same-center all-cause unplanned readmission differed significantly. After enhanced adjustment, compared with Cluster 3, the odds ratios for severe functional limitation were 3.814 and 5.594 for Clusters 1 and 2, respectively, and the corresponding odds ratios for 30-day same-center all-cause unplanned readmission were 1.966 and 2.616. Higher quartiles of both ALI and PNI were associated with lower odds of severe functional limitation; higher ALI quartiles and the highest PNI quartile were associated with lower odds of 30-day same-center all-cause unplanned readmission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Routine admission laboratory measurements identified three exploratory HF phenogroups with distinct inflammatory, nutritional, hematologic, and cardiorenal profiles. After adjustment for continuous LVEF and NT-proBNP, the two vulnerable phenogroups remained associated with severe functional limitation and 30-day same-center all-cause unplanned readmission, with directionally consistent findings in the full-cohort and K\u202f=\u202f2 sensitivity analyses. ALI and PNI reflect laboratory-derived inflammatory\u2013nutritional vulnerability but cannot replace formal nutritional assessment or establish incremental predictive value. These findings remain exploratory and require validation in prospective multicenter cohorts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1985953","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T04:26:30Z","timestamp":1791519990000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Laboratory-derived inflammatory\u2013nutritional exploratory phenogroups and their associations with functional limitation and 30-day same-center all-cause unplanned readmission in patients with heart failure"],"prefix":"10.3389","volume":"13","author":[{"given":"Yilian","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Beijing Anzhen Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The First Medical Center of Chinese PLA","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongbin","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Third Medical Center of Chinese PLA","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiyu","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Beijing Anzhen Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingzhu","family":"Nan","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Beijing Anzhen Hospital, Capital Medical University","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1093\/ehjqcco\/qcae110","article-title":"Global burden of heart failure and its underlying causes in 204 countries and territories, 1990-2021","volume":"11","author":"Chen","year":"2025","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"578698","DOI":"10.2147\/VHRM.S578698","article-title":"Clinical advances in heart failure with preserved ejection fraction: a systematic review of therapeutic and mechanistic evidence","volume":"22","author":"Parizad","year":"2026","journal-title":"Vasc Health Risk Manag"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"785","DOI":"10.1007\/s10741-024-10397-8","article-title":"Budget impact analyses for treatment of heart failure. 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