Muscle Loss Clinical Trial
Official title:
The Correlation Between Nutritional Support Regimens and Muscle Mass in Patients With Chronic Intestinal Failure
Patients who are suffer from CIF often develop muscle wasting because of hypercatabolism.The relationship between different nutrition support formulas and lean body mass is still unclear. The purpose of this study is to investigate the relationship between nutrition support and muscle mass and attempt to find the nutrients which will benefit lean body mass in patients with CIF.
Chronic intestinal failure (CIF) is defined as the malabsorption and nutrients deficiency
mainly caused by severe gastrointestinal benign diseases such as intestinal fistula, short
bowel, and mechanical obstruction and some malignant diseases such as end-stage
intra-abdominal or pelvic cancers . CIF is one of the rarest of organ failures all over the
world and patients suffer from CIF often requires a prolonged time to recover .
Hypercatabolism caused by diseases stress, inflammation and reduced nutrient intake indicates
that patients with CIF need long-term nutritional support .
Patients who are suffer from CIF often develop muscle wasting because of hypercatabolism.
Moreover, studies showed that low muscle mass and muscle wasting during critical illness are
associated with poor clinical outcomes and hampered rehabilitation. Except Resistance
training, sufficient nutrients supplement also play important roles in maintaining the
skeletal muscle mass. Guidelines recommended that nutritional support regimens in patients
should be individualized and adjusted over time based on formal nutritional assessment .
However, almost all guidelines only recommended the total energy and protein requirements
based on the results of basal metabolic rate (BMR) and nitrogen balance rather than the lean
body mass . The relationship between different nutrition support formulas and lean body mass
is still unclear.
The purpose of this study is to investigate the relationship between nutrition support and
muscle mass and attempt to find the nutrients which will benefit lean body mass in patients
with CIF.
All adult CIF patients (age ≥18 years) receiving nutrition support were included. The
exclusion criteria were hepatic insufficiency (alanine transaminase/aspartate transaminase
ratio 200% above normal range or bilirubin >3 mg/dL), renal insufficiency (serum creatinine
[Scr] >1.5 mg/dL), acute or life-threatening diseases (e.g., shock, collapse, stroke, coma of
unknown etiology, or recent cardiac infarction), and pregnant or breast-feeding women. The
study was approved by the ethics committee of Jinling Hospital, Medical School of Nanjing
University.
The lean body mass include soft lean mass (SLM), skeletal muscle mass (SMM) and fat free mass
(FFM) which were measured and recorded by body composition analyzer (InBody S10, Biospace) at
the time of admission and discharge respectively.The deviation of lean body mass was
calculated by the difference between admission and discharge, and then symbolized as ∆SLM,
∆SMM and ∆FFM. Basic and nutritional information of CIF patients was measured weekly after
hospital admission, including age, sex, BMI, NRS-2002 score, SGA grade, etiology of
malnutrition, daily energy & protein intake via EN & PN.
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