https://scholars.lib.ntu.edu.tw/handle/123456789/551015
標題: | Parenteral glutamine supplementation improves serum albumin values in surgical cancer patients | 作者: | JIN-MING WU Ho T.-W. I-RUE LAI CHIUNG-NIEN CHEN MING-TSAN LIN |
公開日期: | 2021 | 出版社: | Churchill Livingstone | 卷: | 40 | 期: | 2 | 起(迄)頁: | 645-650 | 來源出版物: | Clinical Nutrition | 摘要: | Introduction: Patients with gastric adenocarcinoma (GA) often develop malnutrition, which deteriorates after cancer surgery and negatively affects surgical outcomes. Despite being an abundant and versatile amino acid involved in the immune system and metabolic functions, glutamine levels are significantly depleted among patients who are critically ill or hypercatabolic. Therefore, this study aimed to investigate whether parenteral glutamine supplementation may improve nutritional status and surgical outcomes. Methods: This retrospective, single-center cohort study included patients with GA who underwent gastrectomy between January 2007 and June 2019. Patients were classified into either the non-glutamine or glutamine group. Propensity score matching was used to minimize the bias in patient demographics. Furthermore, the average parenteral glutamine dose from the day of surgery to postoperative day four was calculated in g/kg/day. Surgical outcomes (length of hospitalization, major complication, and mortality) and changes in lymphocyte count and serum albumin levels 7 days post-surgery were assessed in both matched groups using adjusted models. Results: A total of 1950 patients were reviewed, among whom 522 (26.8%) received parenteral glutamine supplementation (glutamine dose ranging from 0.05 to 0.49 g/kg/day). Among the included patients, 57.2% were males, and the median age was 64.9 years. After matching, there were 478 cases in each group. No differences in surgical outcomes and changes in lymphocyte count were observed between both matched groups. The glutamine group exhibited a smaller decrease in serum albumin levels compared to the non-glutamine group (−0.6 vs. −1.1 g/dL; P < 0.001). The adjusted matched model showed that glutamine dose contributed significantly toward increasing serum albumin levels (coefficient = 0.08 per 0.1 g/day/kg increment in glutamine; 95% confidence interval: 0.04 to 0.10; P < 0.001). Conclusions: Perioperative parenteral glutamine supplementation had a positive dose-dependent impact on the recovery of serum albumin levels among patients with GA undergoing gastrectomy, implying that glutamine supplementation improved postoperative nutritional suppression and ameliorated stress-associated inflammation. Although glutamine supplementation was not associated with surgical outcomes, further studies should be conducted to evaluate the clinical significance of serum albumin restoration. © 2020 The Authors |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85088583001&doi=10.1016%2fj.clnu.2020.06.015&partnerID=40&md5=d7beca65a5b78d5ab31cec25cef0fb8d https://scholars.lib.ntu.edu.tw/handle/123456789/551015 |
ISSN: | 0261-5614 | DOI: | 10.1016/j.clnu.2020.06.015 | SDG/關鍵字: | glutamine; serum albumin; glutamine; serum albumin; adult; albumin blood level; Article; cancer patient; cohort analysis; diet supplementation; female; gastrectomy; hospital mortality; human; lymphocyte count; major clinical study; male; nutritional status; parenteral nutrition; perioperative period; postoperative complication; postoperative period; retrospective study; surgical patient; adenocarcinoma; aged; blood; complication; dietary supplement; malnutrition; metabolism; middle aged; parenteral nutrition; procedures; propensity score; stomach tumor; treatment outcome; Adenocarcinoma; Aged; Dietary Supplements; Female; Gastrectomy; Glutamine; Humans; Male; Malnutrition; Middle Aged; Nutritional Status; Parenteral Nutrition; Perioperative Care; Postoperative Period; Propensity Score; Retrospective Studies; Serum Albumin; Stomach Neoplasms; Treatment Outcome |
顯示於: | 解剖學暨細胞生物學科所 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。