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Body composition changes in cachectic patients receiving home parenteral nutrition
Laura E Matarese1, Ezra Steiger, Douglas L Seidner
1Department of General Surgery, The Cleveland Clinic Foundation, Ohio 44195, USA. matarel@ccf.org
JPEN. Journal of Parenteral and Enteral Nutrition
|October 31, 2002
Summary
Malnourished patients on home parenteral nutrition (HPN) gain primarily fat, not lean tissue, during initial repletion. Nutritional status improves, indicated by weight gain and better transferrin levels.
Area of Science:
- Clinical Nutrition
- Body Composition Analysis
- Parenteral Nutrition
Background:
- Malnourished patients often require home parenteral nutrition (HPN) for nutritional repletion.
- Understanding initial body compositional changes is crucial for optimizing HPN therapy.
Purpose of the Study:
- To evaluate the initial body compositional changes in malnourished patients receiving HPN.
- To assess changes in fat mass, lean soft tissue, and bone mineral content.
Main Methods:
- Prospective study of eight patients over 3 months.
- Body composition assessed using dual-energy X-ray absorptiometry (DXA).
- Comprehensive nutrition assessment including anthropometrics and visceral proteins.
Main Results:
- Significant increase in total body fat (p < .001) and bone mineral content (p = .047).
- Lean soft tissue remained unchanged; body weight and BMI increased significantly (p = .006, p = .005).
- Improvements observed in triceps skinfold (p < .001) and serum transferrin (p = .043).
Conclusions:
- Initial weight gain in HPN patients is predominantly fat.
- Bone mineral content increases, while lean soft tissue is maintained.
- HPN therapy leads to improved overall nutritional status in malnourished patients.