Metabolism and catabolism in hip fracture patients: Nutritional and anabolic intervention—a review

Hedström, Margareta; Ljungqvist, Olle; Cederholm, Tommy

doi:10.1080/17453670610012926

Cited by 68 publications

(42 citation statements)

References 47 publications

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“…One is inflammation, which increases muscle loss and the second factor is insulin resistance, which causes hyperinsulinemia. The latter causes and stimulates muscle protein depletion [26]. This hypercatabolic state is perpetuated after discharge from hospital andoften together with a deficient intake -contributes to weight loss, mainly at the expense of muscle tissue, with fat tissue remaining stable [76].…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of malnutrition in these patients varies widely among the papers reviewed, reaching 50% in several of them [26,54,74,75]. Two of the long term consequences of an insufficient calorie and protein intake are loss of strength and osteoporosis, which leads to fractures due to increase in falls and a reduction of bone resistance to impact [74].…”

Section: Discussionmentioning

confidence: 99%

“…Albumin serum concentration is also affected by kidney illnesses and by alterations in patients' state of hydration [26].…”

Section: In Hospitalized Elderlymentioning

confidence: 99%

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Serum albumin and health in older people: Review and meta analysis

Cabrerizo¹,

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Serum albumin and health in older people: Review and meta analysis

Cabrerizo¹,

et al. 2015

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“…An overall improvement of visceral and somatic proteins may be more important than the single factor to ensure that patients with HF have better body stability and performance of daily tasks. The quantification of ECW could indicate whether an excess of water retention still existed and could contribute to lower albumin concentrations [96]. …”

Section: Limitationsmentioning

confidence: 99%

Despite Inflammation, Supplemented Essential Amino Acids May Improve Circulating Levels of Albumin and Haemoglobin in Patients after Hip Fractures

Aquilani

Zuccarelli²,

Condino

et al. 2017

Nutrients

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Essential amino acids (EAAs) are nutritional substrates that promote body protein synthesis; thus we hypothesised that their supplementation may improve circulating albumin (Alb) and haemoglobin (Hb) in rehabilitative elderly patients following hip fractures (HF). Out of the 145 HF patients originally enrolled in our study, 112 completed the protocol. These subjects were divided into two randomised groups, each containing 56 patients. For a period of two months, one group (age 81.4 ± 8.1 years; male/female 27/29) received a placebo, and the other (age 83.1 ± 7.5 years; male/female 25/31) received 4 + 4 g/day oral EAAs. At admission, the prevalence of both hypoAlb (<3.5 g/dL) and hypoHb (<13 g/dL male, <12 g/dL female) was similar in the placebo group (64.3% hypoAlb, 66% hypoHb) and the treated group of patients (73.2% hypoAlb, 67.8% hypoHb). At discharge, however, the prevalence of hypoAlb had reduced more in EAAs than in placebo subjects (31.7% in EAAs vs. 77.8% in placebo; p < 0.001). There was a 34.2% reduction of anaemia in hypoHb in EAA subjects and 18.9% in placebo subjects, but the difference was not statistically significant. Oral supplementation of EAAs improves hypoAlb and, to a lesser extent, Hb in elderly rehabilitative subjects with hip fractures. Anaemia was reduced in more than one third of patients, which, despite not being statistically significant, may be clinically relevant.

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“…In this regard, up to half of elderly patients with hip fractures are already malnourished on admission to hospital and protein energy malnutrition appears to be more common in older patients with hip fractures than age-matched controls [17,18]. In addition to the effects of preexisting undernutrition, lean body mass may be further depleted by the inflammatory response to injury, which leads to a catabolic state characterized by nitrogen loss and insulin resistance [18]. This is evident immediately after the injury and may continue for up to 3 months after surgery.…”

Section: Optimizing Energy Delivery After Hip Surgery In Geriatricmentioning

confidence: 99%

Food for Thought: The Effects of Nutritional Support on Outcomes in Hospitalized Elderly Patients and the Critically Ill

Cohen

Tehilla

Anbar

et al. 2014

Advances in Critical Care

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The provision of adequate nutritional support appears to be essential for critically ill patients and other groups of patients at high risk for having malnutrition. In this review paper we describe our recent research regarding the amount of energy to be provided, how this should be assessed, and the beneficial effects of specialized nutritional support. We have shown that repeated measurements of energy expenditure using indirect calorimetry capture the dynamic energy changes characteristic of hospitalized patients. The provision of energy according to these measurements was associated with lower hospital mortality in critically ill patients when compared to patients receiving a fixed energy intake. A similar study performed in geriatric patients revealed a significant reduction in the number of infections when energy was provided according to repeated measurements. We have also shown that a diet enriched with eicosapentaenoic acid and gamma-linolenic acid improved oxygenation and lung dynamics and decreased ventilation duration in ICU patients with acute lung injury and ARDS. A similarly enriched diet together with micronutrients resulted in significantly less progression of existing pressure ulcers in ICU patients compared to an isonitrogenous, nutrient-sufficient formula. This may be related to an increase in the percentage of positive lymphocyte and granulocyte adhesion molecules.

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Metabolism and catabolism in hip fracture patients: Nutritional and anabolic intervention—a review

Cited by 68 publications

References 47 publications

Serum albumin and health in older people: Review and meta analysis

Serum albumin and health in older people: Review and meta analysis

Despite Inflammation, Supplemented Essential Amino Acids May Improve Circulating Levels of Albumin and Haemoglobin in Patients after Hip Fractures

Food for Thought: The Effects of Nutritional Support on Outcomes in Hospitalized Elderly Patients and the Critically Ill

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