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

Abstract

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.

Measurement of serial serum total and acylated ghrelin levels in critically ill patients: A prospective and observational pilot study

“…24 Gündoğan et al looked at the difference in ghrelin levels for 3 consecutive days in ICU patients receiving EN and parenteral nutrition (PN), and ghrelin levels were found to be significantly lower in the group receiving PN. 25 Kerem et al performed an experimental study on 30 rats to examine the levels of ghrelin and leptin in pancreatitis of different severity and the relationship between these hormones to blood glucose level and proinflammatory cytokines. 6 Serum leptin and ghrelin levels were increased in the first 48 h of acute edema pancreatitis (AEP) and acute necrotizing pancreatitis (ANP).…”

The need for biomarkers to determine response to enteral nutrition during and after critical illness: an update

“…nutritional status [50]. In 13 patients receiving PN the leptin levels rose, while in 13 patients on EN the resistin levels were low and the GLP-1 was elevated.…”

“…There is a natural interest in their possible interactions with nutritional support and prognosis in critical care. In a study of 26 ICU patients, numerous adipokines were studied alongside documentation of nutritional status [50]. In 13 patients receiving PN the leptin levels rose, while in 13 patients on EN the resistin levels were low and the GLP-1 was elevated.…”