Insulin-like growth factor-1 as a nutritional monitoring factor in patients with chronic intestinal failure
Insulin-like growth factor-1 as a nutritional monitoring factor in patients with chronic intestinal failure
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胰岛素样生长因子-1作为慢性肠衰竭患者的营养监测因子
DOI：
10.1016/j.clnu.2018.07.031
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发表时间：
2019-08-01
影响因子：
6.3
通讯作者：
Li, Jieshou
中科院分区：
文献类型：
--
作者：
Wang, Xinying;Tian, Feng;Li, Jieshou
背景和目标：营养监测在优化慢性肠功能衰竭（CIF）患者长期补充营养的营养支持中起着重要作用。然而，与最初的营养评估不同，没有建议制定营养监测指数的指导方针。为探讨胰岛素样生长因子-1（IGF-1）作为营养监测指标在CIF患者中的适用性，对197例CIF患者的血清营养指标（包括IGF-1水平）与营养评价、营养监测及瘦体重的相关性进行回顾性分析。197例入组患者的平均年龄为47.22 ± 18.87岁，平均BMI为16.83 ± 3.31。平均NRS-2002评分为3.49 +/- 0.83;此外，76.3%的患者营养不良。平均住院时间（LOS）为18.5天。IGF-1与体重指数、血红蛋白、白蛋白、前白蛋白、视黄醇结合蛋白（RBP）、转铁蛋白、血肌酐（Scr）、胆固醇呈正相关（均P < 0.05）。在入院后3周内进行的检测显示，在营养支持期间，仅观察到IGF-1、RBP和Scr的每周变化有显著差异（p < 0.05）。多元线性回归分析显示，IGF-1和体重指数是影响去脂体重、骨骼肌质量和体蛋白质量的独立因素（均P < 0.05）。这可能是由于其半衰期较短，灵敏度较高，与瘦体重的相关性较好。ClinicalTrials.gov编号，NCT 03277014。(C)2018爱思唯尔有限公司和欧洲临床营养与代谢学会。All rights reserved.
Background & aims: Nutritional monitoring plays an important role in optimizing nutritional support in patients with chronic intestinal failure (CIF) receiving long-term supplementation. Unlike initial nutritional assessment, however, there are no recommended guidelines for establishing a nutritional monitoring index. This study is to evaluate the suitability of insulin-like growth factor-1 (IGF-1) as a nutritional monitoring factor in CIF patients.Methods: We retrospectively analyzed the correlation between serum nutritional indicators, including IGF-1 levels, and nutritional assessment, nutritional monitoring, and lean body mass in 197 patients with CIF.Results: The mean age of the 197 enrolled patients was 47.22 +/- 18.87 years old and; the mean BMI was 16.83 +/- 3.31. The mean NRS-2002 score was 3.49 +/- 0.83; and moreover, 76.3% of the patients were malnourished. The median length of hospital stay in hospital (LOS) was 18.5 days. IGF-1 was positively correlated with body mass index, hemoglobin, albumin, pre-albumin, retinol-binding protein (RBP), transferrin, serum creatinine (Scr) and cholesterol (p < 0.05 for all). Testing performed over 3 weeks post-admission showed that significantly different weekly changes were observed only in IGF-1, RBP, and Scr during the period of nutritional support (p < 0.05 for each). Multivariate linear regression analysis showed that IGF-1 and body mass index were independent factors influencing fat-free mass, skeletal muscle mass, and body protein mass (p < 0.05 for each).Conclusions: IGF-1 is suitable for monitoring short-term changes in the nutritional status in CIF patients. This may be attributed to its shorter half-life, greater sensitivity, and better correlation with lean body mass. ClinicalTrials.gov number, NCT03277014. (C) 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.