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Original Article
- Nutrition
- Associations between systemic inflammation and intestinal permeability with Onodera's prognostic nutritional index in critically ill patients
- Seyed Hossein Ardehali, Ghazaleh Eslamian, Shirin Malek
- Acute Crit Care. 2021;36(4):361-368. Published online November 26, 2021
- DOI: https://doi.org/10.4266/acc.2021.00178
- 3,744 View
- 97 Download
- 2 Web of Science
- 3 Crossref
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Abstract
PDF - 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. -
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
- Association of malnutrition status with 30-day mortality in patients with sepsis using objective nutritional indices: a multicenter retrospective study
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