BODY-COMPOSITION CHANGES MEASURED BY DUAL-ENERGY X-RAY ABSORPTIOMETRYIN PATIENTS RECEIVING HOME PARENTERAL-NUTRITION

Background: To monitor changes in body composition in patients receivi ng home parenteral nutrition (HPN) and to ascertain whether changes we re related to the amount of energy supplied by HPN, we studied prospec tively patients with gut failure maintained on HPN. Methods: Patients were subjected to repeated measurement of body composition by dual-ene rgy X-ray absorptiometry (DXA), the second investigation being perform ed after a mean period of 20 (range, 11-26) months. Thirty-two patient s were included, one patient was excluded, and five patients died duri ng the study period. At inclusion, the patients had received HPN for a mean period of 30 (range, 6-216) months. The indication for HPN was i nflammatory bowel disease (n = 16), abdominal cancers (n = 5), and scl eroderma and others (n = 11). The fat-free mass (FFM), fat mass (FM), and total body mineral content (TBMC) were measured by DXA. Results: M ean body mass index decreased from 21.18 to 20.96 kg/m(2) (P = 0.36). The mean FFM showed a small, insignificant increase to 37.68 kg (P = 0 .71). Mean TBMC was unchanged at 2.28 kg, and mean FM decreased from 1 9.25 to 18.17 kg (P = 0.055). During the study period the mean daily e nergy supply by HPN was reduced from kcal 1195 to kcal 959 (P = 0.004) . There was a direct positive correlation between the individual chang es in HPN energy supply and body weight and FFM (r = 0.437, r = 0.410, P < 0.05). Conclusion: The body composition of HPN patients was stabl e, with no change in mean FFM, FM, or TBMC. Individual changes in body weight and FFM correlated with change in HPN energy supply.