- Nutrition
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Associations between systemic inflammation and intestinal permeability with Onodera's prognostic nutritional index in critically ill patients
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Seyed Hossein Ardehali, Ghazaleh Eslamian, Shirin Malek
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Acute Crit Care. 2021;36(4):361-368. Published online November 26, 2021
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DOI: https://doi.org/10.4266/acc.2021.00178
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Abstract
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- Background
Malnutrition is a potentially costly problem in critically ill patients admitted to the intensive care unit (ICU). The aim of this study is to evaluate the relationships between the Onodera’s prognostic nutritional index (OPNI) and intestinal permeability and between OPNI and systemic inflammation in critically ill patients.
Methods This was a cross-sectional study conducted in the general ICU of a university-affiliated hospital. A total of 162 ICU-hospitalized adult patients admitted between May 2018 and December 2019, was included in the study sample. The OPNI was calculated at admission and categorized as ≤40 or >40. We assessed plasma endotoxin and zonulin concentrations as markers of intestinal permeability as well as serum interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) as markers of systemic inflammation upon admission under stringent conditions. The relationships between these markers and OPNI were assessed after adjusting for potential confounders through estimation of a binary logistic regression model.
Results Median (interquartile range) hs-CRP, IL-6 zonulin, and endotoxin were significantly greater in the low OPNI subgroup than in the high OPNI subgroup (all P<0.05). Multivariate analyses showed significant association between serum IL-6 (odds ratio [OR], 0.88; 95% confidence interval [CI], 0.64–0.96), serum hs-CRP (OR, 0.77; 95% CI, 0.53–0.92), plasma endotoxin (OR, 0.81; 95% CI, 0.72–0.93), and plasma zonulin (OR, 0.83; 95% CI, 0.75–0.98) levels with OPNI in the overall population.
Conclusions Our results provide evidence that higher plasma endotoxin, zonulin, IL-6, and hs-CRP levels are associated with progressively lower OPNI in mixed ICU populations, particularly in surgical ICU patients.
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Citations
Citations to this article as recorded by
- Association of malnutrition status with 30-day mortality in patients with sepsis using objective nutritional indices: a multicenter retrospective study
Moon Seong Baek, Young Suk Kwon, Sang Soo Kang, Daechul Shim, Youngsang Yoon, Jong Ho Kim Acute and Critical Care.2024; 39(1): 127. CrossRef - Practical parameters that can be used for nutritional assessment in patients hospitalized in the intensive care unit with the diagnosis of chronic obstructive pulmonary disease
Ramazan Baldemir, Mustafa Özgür Cirik Medicine.2022; 101(24): e29433. CrossRef - Nutritional Status, Body Composition, and Inflammation Profile in Older Patients with Advanced Chronic Kidney Disease Stage 4–5: A Case-Control Study
Mar Ruperto, Guillermina Barril Nutrients.2022; 14(17): 3650. CrossRef
- Infection
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Association of vitamin D deficiency with COVID-19 severity and mortality in Iranian people: a prospective observational study
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Alireza Fatemi, Seyed Hossein Ardehali, Ghazaleh Eslamian, Morvarid Noormohammadi, Shirin Malek
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Acute Crit Care. 2021;36(4):300-307. Published online November 29, 2021
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DOI: https://doi.org/10.4266/acc.2021.00605
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6,190
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129
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Abstract
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- Background
As the coronavirus disease 2019 (COVID-19) pandemic continues to escalate, it is important to identify the prognostic factors related to increased mortality and disease severity. To assess the possible associations of vitamin D level with disease severity and survival, we studied 248 hospitalized COVID-19 patients in a single center in a prospective observational study from October 2020 to May 2021 in Tehran, Iran.
Methods Patients who had a record of their 25-hydroxyvitamin D level measured in the previous year before testing positive with COVID-19 were included. Serum 25-hydroxyvitamin D level was measured upon admission in COVID-19 patients. The associations between clinical outcomes of patients and 25-hydroxyvitamin D level were assessed by adjusting for potential confounders and estimating a multivariate logistic regression model.
Results The median (interquartile range) age of patients was 60 years (44–74 years), and 53% were male. The median serum 25-hydroxyvitamin D level prior to admission decreased with increasing COVID-19 severity (P=0.009). Similar findings were obtained when comparing median serum 25-hydroxyvitamin D on admission between moderate and severe patients (P=0.014). A univariate logistic regression model showed that vitamin D deficiency prior to COVID-19 was associated with a significant increase in the odds of mortality (odds ratio, 2.01; P=0.041). The Multivariate Cox model showed that vitamin D deficiency on admission was associated with a significant increase in risk for mortality (hazard ratio, 2.35; P=0.019).
Conclusions Based on our results, it is likely that deficient vitamin D status is associated with increased mortality in COVID-19 patients. Thus, evaluating vitamin D level in COVID-19 patients is warranted.
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Citations
Citations to this article as recorded by
- The close association of micronutrients with COVID-19
Aimin Zhang, Yue Yin, Jiashu Tian, Xialin Wang, Zhihong Yue, Lin Pei, Li Liu, Li Qin, Mei Jia, Hui Wang, Qingwei Ma, Wei-bo Gao, Lin-Lin Cao Heliyon.2024; 10(7): e28629. CrossRef - The bounds of meta-analytics and an alternative method
Ramalingam Shanmugam, Mohammad Tabatabai, Derek Wilus, Karan P Singh Epidemiology and Health.2024; : e2024016. CrossRef - Systematic Mendelian randomization study of the effect of gut microbiome and plasma metabolome on severe COVID-19
Han Yan, Si Zhao, Han-Xue Huang, Pan Xie, Xin-He Cai, Yun-Dan Qu, Wei Zhang, Jian-Quan Luo, Longbo Zhang, Xi Li Frontiers in Immunology.2023;[Epub] CrossRef - Risk Factors Associated with Severity and Death from COVID-19 in Iran: A Systematic Review and Meta-Analysis Study
Ahmad Mehri, Sahar Sotoodeh Ghorbani, Kosar Farhadi-Babadi, Elham Rahimi, Zahra Barati, Niloufar Taherpour, Neda Izadi, Fatemeh Shahbazi, Yaser Mokhayeri, Arash Seifi, Saeid Fallah, Rezvan Feyzi, Koorosh Etemed, Seyed Saeed Hashemi Nazari Journal of Intensive Care Medicine.2023; 38(9): 825. CrossRef - Vitamin D: A Role Also in Long COVID-19?
Luigi Barrea, Ludovica Verde, William B. Grant, Evelyn Frias-Toral, Gerardo Sarno, Claudia Vetrani, Florencia Ceriani, Eloisa Garcia-Velasquez, José Contreras-Briceño, Silvia Savastano, Annamaria Colao, Giovanna Muscogiuri Nutrients.2022; 14(8): 1625. CrossRef
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