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Fibronectin. A new nutritional parameter.

T K McKone, A T Davis, R E Dean

    The American Surgeon
    |June 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

    Nutritionally depleted patients benefit from parenteral nutrition, as indicated by rising plasma fibronectin levels. Increased fibronectin post-nutrition correlates with survival in hospitalized patients.

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    Area of Science:

    • Biochemistry
    • Clinical Nutrition
    • Surgical Patient Management

    Background:

    • Malnutrition significantly increases surgical patient morbidity and mortality.
    • Plasma fibronectin levels reflect reticuloendothelial function and decrease in critical conditions like burns, shock, trauma, and sepsis.
    • A failure to increase fibronectin post-stress is linked to poor patient outcomes.

    Purpose of the Study:

    • To evaluate the utility of plasma fibronectin as a marker for assessing nutritional status in hospitalized patients with nutritional depletion.
    • To investigate the changes in fibronectin, albumin, and transferrin levels during total parenteral nutrition (TPN).

    Main Methods:

    • Eight nutritionally depleted patients receiving total parenteral nutrition (TPN) were studied.
    • Plasma levels of fibronectin, albumin, and transferrin were measured before and at various intervals during TPN.

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  • Statistical analysis was performed to assess changes in these protein levels.

    • Main Results:

    • Pre-TPN transferrin and albumin levels were below normal ranges and did not significantly change during TPN.
    • Mean fibronectin levels significantly increased (P < 0.005) within 1-4 days of TPN initiation, rising from 236.4 to 341.9 microgram/ml.
    • Six of eight patients who showed at least a 30% increase in fibronectin survived, while the two non-survivors had minimal fibronectin level increases.

    Conclusions:

    • Plasma fibronectin is a sensitive indicator of nutritional repletion in hospitalized patients.
    • An increase in fibronectin levels during TPN is associated with improved survival rates.
    • Fibronectin may serve as a valuable prognostic marker in nutritionally compromised surgical patients.