| Leptin and insulin growth factor 1: diagnostic markers of the refeeding syndrome and mortality. | |
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MedLine Citation:
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PMID: 21554807 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Refeeding syndrome is difficult to diagnose since the guidelines for identifying those at risk are largely based on subjective clinical parameters and there are no predictive biochemical markers. We examined the suitability of insulin-like growth factor 1 (IGF1) and leptin as markers to identify patients at risk of the refeeding syndrome before initiation of parenteral nutrition (PN). A total of thirty-five consecutive patients referred for commencement of PN were included. Serum leptin and IGF1 were measured before starting PN. Electrolytes, liver and renal function tests were conducted before and daily for 1 week after initiating PN. The primary outcome was a decrease in phosphate 12-36 h after initiating PN. 'Refeeding index' (RI) was defined as leptin × IGF1 divided by 2800 to produce a ratio of 1·0 in patients who are well nourished. RI had better sensitivity (78 %; 95 % CI 40, 97 %) and specificity (78 %; 95 % CI 40, 97 %) with a likelihood ratio of 3·4, at a cut-off value of 0·19 for predicting a ≥ 30 % decrease in phosphate concentration within 12-36 h after starting PN, compared with IGF1 or leptin alone. However, IGF1 was a better predictor of mortality than either leptin or the RI. The present study is the first to derive and test the 'RI', and find that it is a sensitive and specific predictor of the refeeding syndrome in hospitalised patients before starting PN. |
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Authors:
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Manal O Elnenaei; Jamshid Alaghband-Zadeh; Roy Sherwood; Mahmoud A Awara; Caje Moniz; Carel W le Roux |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-5-4 |
Journal Detail:
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Title: The British journal of nutrition Volume: - ISSN: 1475-2662 ISO Abbreviation: - Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-5-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372547 Medline TA: Br J Nutr Country: - |
Other Details:
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Languages: ENG Pagination: 1-7 Citation Subset: - |
Affiliation:
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Clinical Biochemistry, King's College Hospital, Denmark Hill, London SE5 9RS, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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