CHANGES IN PROTEIN REPLETION MARKERS IN U NDERNOURISHED PATIENTS RECEIVING ENTERAL NUTRITION

Aim To study the relationship between the changes in protein reaction indicators and calorie and mitrogen balance in undernourished patients receiving enteral nutrition. Patients and methods: Fourteen patients (11 female, age range 55-85 years old) with an initial serum albumin b elow 3.5 g/dl or serum transferrin below 200 mg/dl, which received ent eral nutrition, were studied. On days one and ten of nutritional suppo rt, indirect calorimetry, nitrogen balance and serum levels of albumin , transferrin, pre-albumin and total lymphocyte count were measured. R esults: Initial resting energy expenditure was 25.1+/-5 Kcal/kg/day (1 15.4+/-20% of that predicted by Harris Benedict equations) and urinary urea nitrogen 5.4+/-3.7 g/day. Initial and final nitrogen balances we re 66.9+/-71 and 81.4+/-105.9 mg N/kg/day and mean energy balance thro ughout the study was +9.0+/-7.2 Kcal/kg/day. During the ten days of nu tritional support, albumin improved significantly in 0.35+/-0.43 g/dl (15.2+/-19.8%). Transferrin, pre-albumin and total lymphocyte count di d not change significantly. The changes in these last parameters did n ot correlate with nitrogen or calorie balance. Conclusions: Probably o ther factors, besides nutritional balances, influence serum protein le vels and these may not change despite an adequate nutritional repletio n.