Journal
BRITISH JOURNAL OF NUTRITION
Volume 106, Issue 6, Pages 906-912Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0007114511001097
Keywords
Refeeding syndrome; Insulin-like growth factor 1; Leptin
Categories
Funding
- Department of Health [DHCS/05/05] Funding Source: Medline
- National Institute for Health Research [DHCS/05/05] Funding Source: researchfish
Ask authors/readers for more resources
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 X 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.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available