Kürşat GÜNDOĞAN, Ender DOĞAN, Nurhayat Tuğra ÖZER, Gülşah GÜNEŞ ŞAHİN, Serap ŞAHİN, Murat SUNGUR, İsmail Hakkı AKBUDAK, Sabahattin MUHTAROĞLU, Muhammet GÜVEN, Thomas R. ZIEGLER

The association between the route of nutrition and serum levels of adipokines in critical illness: a pilot study

Background/aim: Adipokines play an important role in the regulation of metabolism. In critical illness, they alter serum levels and are suspected to worsen clinical outcomes. But the effect of the route of nutrition on adipokines is not known. The purpose of this study was to evaluate the association between the route of nutrition and adipokine levels in critically ill patients. Materials and methods: This prospective study was performed in an intensive care unit ICU . Patients admitted to the ICU for least 72 h and receiving either enteral nutrition EN via tube feeding or parenteral nutrition PN were enrolled. Serum was obtained at baseline, 24 h, and 72 h for concentrations of leptin, adiponectin, resistin, glucagon-like peptide 1 GLP-1 , insulin-like growth factors 1 IGF-1 , and ghrelin. Results: A total of 26 patients were included in the study. Thirteen patients received EN and 13 patients received PN. In the PN group, leptin level significantly increased P = 0.037 , adiponectin and ghrelin significantly decreased during follow up P = 0.037, P = 0.008, respectively . There was no significant change between all adipokines in the EN group and resistin, IGF-1 and GLP-1 in the PN group during follow up. Resistin levels were markedly lower in the EN group at both 24 h P = 0.015 and 72 h P = 0.006 while GLP-1 levels were higher in the EN group at baseline, 24 h, and 72 h P = 0.018, P = 0.005, and P = 0.003, respectively . There were no differences in leptin, adiponectin, IGF-1, and ghrelin levels over time. Conclusion: The delivery of EN in critical illness was associated with decreased resistin levels and increased GLP-1 levels. Thus, the route of nutrition may impact the clinical outcome in critical illness due to adipokines.

Keywords:

Adipokine, critical illness, enteral nutrition, parenteral nutrition,

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