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Gut permeability, intestinal morphology, and nutritional depletion
R R van der Hulst1, M F von Meyenfeldt, B K van Kreel
1Department of Surgery, University of Limburg, Maastricht, The Netherlands.
Nutrition (Burbank, Los Angeles County, Calif.)
|January 23, 1998
Summary
Nutritional depletion worsens gut integrity, increasing intestinal permeability and reducing villous height. This suggests the intestinal barrier is a key factor in postoperative complications linked to poor nutrition.
Area of Science:
- Gastroenterology and Nutrition Science
- Surgical Pathophysiology
Background:
- Nutritional depletion is a known risk factor for postoperative complications.
- The intestinal barrier's role in this process is not fully understood.
- Gut integrity may be compromised in malnourished patients.
Purpose of the Study:
- To investigate the relationship between nutritional depletion and gut integrity.
- To assess intestinal morphology in depleted versus non-depleted patients.
Main Methods:
- Evaluated 26 patients for nutritional depletion using percentage ideal body weight (PIB) and percentage ideal fat-free mass (PIFFM).
- Assessed gut integrity via lactulose/mannitol (L/M) test.
- Analyzed duodenal biopsies for villous height, crypt depth, IgA plasma cells, intraepithelial lymphocytes (IELs), and proliferation index.
Main Results:
- Depleted patients showed an increased L/M ratio, indicating higher intestinal permeability.
- Villous height was significantly decreased in depleted patients.
- No significant differences were observed in immune cell counts or proliferation index.
- A positive correlation was found between IgA plasma cells and the L/M ratio.
Conclusions:
- Nutritional depletion is associated with impaired gut integrity and reduced villous height.
- Increased intestinal permeability is a key feature of nutritional depletion.
- These findings highlight the importance of the intestinal barrier in the context of nutritional status and surgical outcomes.