KMID : 1144420210360040361
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Acute and Critical Care 2021 Volume.36 No. 4 p.361 ~ p.368
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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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Ardehali Seyed Hossein
Eslamian Ghazaleh Malek Shirin
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Abstract
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Background: Malnutrition is a serious condition in critically ill patients. 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 intensive care unit (ICU) of a university-affiliated hospital. A total of 162 patients admitted between May 2018 and December 2019, was included in the study. The OPNI was calculated at admission and categorized as ¡Â40 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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KEYWORD
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C-reactive protein, endotoxin, intensive care unit, interleukin-6, zonulin, Onodera
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