GUT PERMEABILITY, INTESTINAL MORPHOLOGY, AND NUTRITIONAL DEPLETION

Nutritional depletion increases the risk for postoperative complicatio ns. The intestinal barrier may be important in the underlying pathophy siologic mechanism. In this study, 26 patients were evaluated to deter mine whether nutritional depletion was related to gut integrity and in testinal morphology. Nutritional depletion was estimated by calculatin g percentage ideal body weight (PIB) or percentage ideal fat free mass (PIFFM). To assess gut integrity, a lactulose/mannitol (L/M) test was performed. Duodenal biopsies were taken, and villous height, crypt de pth, number of IgA-producing plasma cells, intraepithelial lymphocytes (IELs), and proliferating index were determined. The L/M ratio was in creased, and villous height was decreased in depleted patients. Deplet ion was not associated with differences in the number of immune cells or proliferating index. The number of IgA-producing plasma cells was p ositively correlated with the LIM ratio. This study shows that nutriti onal depletion is associated with increased intestinal permeability an d a decrease in villous height. (C) Elsevier Science Inc. 1998