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Nutritional parameters in patients with severe catabolism due to trauma or sepsis

  • G Gallioli1,
  • G Pittoni2,
  • M Zanello3,
  • S Colombo1,
  • M Picarone4,
  • N Toppan2,
  • L Gianotti5,
  • F Broglio5,
  • MG Papini6,
  • MF Boghen6,
  • G Miola6 and
  • E Ghigo6
Critical Care19971(Suppl 1):P100

Published: 1 March 1997


Public HealthAlbuminSignificant VariationEmergency MedicineTransferrin

Our previous studies indicate that in critically ill patients ICF-I levels are reduced to a greater extent in septic (S) than in trauma (T) subjects. However, it is well known that IGF-I levels depend on nutrition as well as on somatotrope secretion. Aim of the present study was to verify the levels of IGF-I and other nutritional parameters such as albumin (A), prealbumin (PRE-A), transferrin (TRA) and retinol-binding-globulin (RBG) in septic patients [n = 11, age (mean ± SEM) 56.1 ± 2.7 years, BMI 25.2 ± 0.9 kg/m2] and in trauma patients (n = 13, age 42.4 ± 4.1 years, BMI 25.0 ± 0.8 kg/m2) after ICU admission. Both groups were characterized by similar scores of catabolism (SAPSII and MOF score) and underwent similar artificial nutrition. Nutritional parameters were evaluated on day 1, 3, 5 and 7 after ICU admission. Both in S and in T, IGF-I, A, PRE-A, TRA and RBG levels on day 1 of ICU admission were lower than the normal range. Basal IGF-I levels in S were lower than those in T (82.9 ± 13.0 versus 127.0 ± 16.4 μg/1, P < 0.05). IGF-I levels increased on day 7 to a lower (P < 0.05) extent in S (110.3 ± 9.5, P < 0.05 versus day 1) than in T (211.4 ± 25.5, P < 0.01 versus day 1). Basal A and RBG levels in S (3.0 ± 0.2 g/dl and 2.8 ± 0.9 mg/dl) were similar to those in T (3.2 ± 0.1 g/dl and 3.1 ± 0.3 mg/dl); in both groups A levels did not show variations up to day 7 while RBG showed a trend toward increase (P < 0.05 in S). Basal PRE-A and TRA levels in S (10.9 ± 2.5 mg/dl and 108.8 ± 10.7 mg/dl) were lower (P < 0.01) than those in T (17.8 ± 1.4 mg/dl and 168.7 ± 8.3 mg/dl). PRE-A and TRA levels did not show significant variations up to day 7 persisting lower (P < 0.05) in S than in T.

In conclusion, our results further demonstrate that, in spite of similar score of catabolism, in critically ill patients the reduction of IGF-I, PRE-A and TRA levels is more marked in septic than in trauma patients. These findings indicate that the influence of nutrition and/or somatotrope function on ICF-I synthesis and release varies among different catabolic states.

Authors’ Affiliations

Division of Anesthesiology, University of Milano, Milano, Italy
University of Padova, Padova, Italy
Osp Bellaria, Bologna, Italy
Osp Mantova, Mantova, Italy
Division of Endocrinology, Department of Internal Medicine, University Torino, Italy
Pharmacia & Upjohn Medical Department, Milano 6, Italy


© BioMed Central Ltd 2001