Concomitant apolipoprotein A-IV and citrulline plasma changes during short-term parenteral nutrition in surgical patients

Autor: Carmen Través, J. López-Hellin, M. Dolores López-Tejero, Juan Antonio Baena-Fustegueras, Elena García-Arumí
Rok vydání: 2010
Předmět:
Zdroj: e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism. 5:e219-e224
ISSN: 1751-4991
DOI: 10.1016/j.eclnm.2010.07.004
Popis: Summary Background & aims Apolipoprotein A-IV (apo A-IV) and citrulline are non-invasive biomarkers that can be used to monitor nutritional and intestinal changes in patients receiving parenteral nutrition (PN). Yet, while the role of citrulline has been well established, further research is needed to understand apo A-IV’s utility. Methods Twenty-eight patients who underwent gastrointestinal surgery by laparotomy, either a subtotal gastrectomy or a hemicolectomy, and were placed on short-term PN, were selected and assigned on a Parenteral-Oral (4-day PN and 4-day oral, 8 patients) or a Parenteral-Only (7-day PN, 20 patients) nutritional regime. They were delivered PN solutions (PN1 to PN4) containing varying amounts of amino acids, fat and carbohydrates. Results Pre-operative apo A-IV and citrulline values were within those of a western population. On day 4 in the Parenteral-Oral regime, apo A-IV and citrulline levels were 70% and 60% lower than pre-operative levels, respectively. When enteral feeding was resumed, citrulline rose faster than apo A-IV and was close to pre-operative values on day 8. In the Parenteral-Only regime the PN solution composition had no influence on the parameters. While Apo A-IV levels decreased with time, citrulline started increasing on day 2. Conclusions Both biomarkers can be used complementarily to monitor intestinal function. While apo A-IV may be more sensitive than citrulline in measuring the impact of a lack of oral intake, citrulline reacts faster to the onset of enteral nutrition.
Databáze: OpenAIRE
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