0.9 AWI;fPaPROTEIf B-~&I /apoB/ AS A. POSSIBLE LABORATORY IND& OF NUTRITIONAL STATE.BLBobilewic~_,T.Korta,K.Stgpieri,K.Zieniewicz,~.Pertkiewicz.Postgradu- ate ?dedicalCentre,Institute of Surgery Medical Academy,Warsaw,Poland. Diagnostic value of particular serum proteins used for nutritional assess- ment is still under discussion.Our attention was focused on apoB - carrier protein of LDLcholesterol,with relatively short half live/3 days/,in phy- siological condition serum apoB is correlated with cholesterol 1evelfCw. To demonstrate to what extent serum apoB can be affected by nutritional state,apoB,CH,albumin/alb/and Creactive protein/CRP/were measured in:104 normolipemic subjects with normal alb,25 malnourished patients with alb <30&,60patients on total parenteral nutritiodTPN/ grouped according to their alb,8 patients fasting for 2-6days for different reasons. Results:In all groups ap$B was diminished,reaching+the lowest values iv malnour+shed patients/67-18 compare to control 124-29mg/dl/,CH was 139-40 and 185-29mg/dl,apoB/CH ratio 0,51 and 0,68 respectively.Parenteral feeding in malnourished patients resulted in rise of apoB up to 95mg/dl.In the same range of alb in TPN patients apoB was higher and CH lower than in malnourished.ApoB/CI ratio during TPN varied from 0.81 to 0,71,On 2-4th day in fasting patients apoB decreased without changes in alb.No correla- tion was found between apoB and CRP. Conclusion:Zerum apoB may be considered as an independent laboratory index of nutritional state,especially useful to follow up the response of malnourished patients to parenteral feeding. 0.10 INDIVIDUALISED PRESCRIBING OF PARENTERAL NUTRITION ALLOWS WEIGHT MAINTENANCE OR WEIGHT GAIN AS REQUIRED. MJ GLYNN, J Powell-Tuck, A Fleck, Gastrointestinal Unit and Department of Chemical Pathology, Charing Cross Hospital, London UK and Department of Human Nutrition, London Hospital Medical College, London UK. In spite of wide use in a variety of patients little is known of the overall results of parenteral nutrition (PN) prescribed throughout a general hospital. As part of a multidisciplinary nutrition team we supplied all adult PN in this general teaching hospital, usually restricting it to patients with true GI failure, but also including chemotherapy patients who tolerated nasogastric feeding poorly. During the 40 months up to 30.4.86, PN was provided for 199 adults (123 men, 76 women, median age 571. Nutrient input was individualised using a standard computer program (Colley et al. BMJ 1985:290:1403) to calculate energy requirements (mean supplied 4lkcallkgid). The program allowed choice between weight maintenance for those of ideal weight or above (99 patients), or weight gain (100 pts) for whom an extra 30Okcal was added to the estimate, to give an expected gain of 0.5-0.6kg/wk. Initial nitrogen (N) input was between lgN/lOOkcal and lgN/200kcal dependent on the degree of sepsis, and adjusted weekly according to the urine N output. The median feeding period was 2 weeks with a total of 605 patient-weeks (80 patients fed for 1 week only, 32 for 2wks, 33 for 3wks and 54 for more than 3 weeks). Diagnoses included postoperative ileus (79 patients), oesophageal surgery (31 pts), enterocutaneous fistula (27), chemotherapy (25), medical intensive care (20), liver failure (12) and inflammatory bowel disease (5 patients). Wht:] weight maintenance was wanted average weight change was -0.37kg/wk. When weight gain was specified, it was achieved at a rate of 0.46kg/wk (P<O.OOOl - 't' test). Corresponding mean daily nitrogen balance was -0.2gN/d and +1.9gN/d. Individualising a presciption for parenteral nutrition dsing this standard computer program allows weight gain of about O.Skg/wk to be achieved when desired. 15

Apolipoprotein B-100 /apoB/ as A. possible laboratory index of nutritional state

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Page 1: Apolipoprotein B-100 /apoB/ as A. possible laboratory index of nutritional state

Diagnostic value of particular serum proteins used for nutritional assess-

ment is still under discussion.Our attention was focused on apoB - carrier protein of LDLcholesterol,with relatively short half live/3 days/,in phy-

siological condition serum apoB is correlated with cholesterol 1evelfCw.

To demonstrate to what extent serum apoB can be affected by nutritional state,apoB,CH,albumin/alb/and Creactive protein/CRP/were measured in:104 normolipemic subjects with normal alb,25 malnourished patients with alb <30&,60patients on total parenteral nutritiodTPN/ grouped according to their alb,8 patients fasting for 2-6days for different reasons.

Results:In all groups ap$B was diminished,reaching+the lowest values iv malnour+shed patients/67-18 compare to control 124-29mg/dl/,CH was 139-40 and 185-29mg/dl,apoB/CH ratio 0,51 and 0,68 respectively.Parenteral feeding in malnourished patients resulted in rise of apoB up to 95mg/dl.In the same range of alb in TPN patients apoB was higher and CH lower than in malnourished.ApoB/CI ratio during TPN varied from 0.81 to 0,71,On 2-4th day in fasting patients apoB decreased without changes in alb.No correla- tion was found between apoB and CRP.

Conclusion:Zerum apoB may be considered as an independent laboratory index of nutritional state,especially useful to follow up the response of malnourished patients to parenteral feeding.

0.10 INDIVIDUALISED PRESCRIBING OF PARENTERAL NUTRITION ALLOWS WEIGHT MAINTENANCE OR WEIGHT

GAIN AS REQUIRED. MJ GLYNN, J Powell-Tuck, A Fleck, Gastrointestinal Unit and Department of Chemical Pathology, Charing Cross Hospital, London UK and Department of Human Nutrition, London Hospital Medical College, London UK.

In spite of wide use in a variety of patients little is known of the overall results of parenteral nutrition (PN) prescribed throughout a general hospital. As part of a multidisciplinary nutrition team we supplied all adult PN in this general teaching hospital, usually restricting it to patients with true GI failure, but also including chemotherapy patients who tolerated nasogastric feeding poorly.

During the 40 months up to 30.4.86, PN was provided for 199 adults (123 men, 76 women, median age 571. Nutrient input was individualised using a standard computer program (Colley et al. BMJ 1985:290:1403) to calculate energy requirements (mean supplied 4lkcallkgid). The program allowed choice between weight maintenance for those of ideal weight or above (99 patients), or weight gain (100 pts) for whom an extra 30Okcal was added to the estimate, to give an expected gain of 0.5-0.6kg/wk. Initial nitrogen (N) input was between lgN/lOOkcal and lgN/200kcal dependent on the degree of sepsis, and adjusted weekly according to the urine N output. The median feeding period was 2 weeks with a total of 605 patient-weeks (80 patients fed for 1 week only, 32 for 2wks, 33 for 3wks and 54 for more than 3 weeks). Diagnoses included postoperative ileus (79 patients), oesophageal surgery (31 pts), enterocutaneous fistula (27), chemotherapy (25), medical intensive care (20), liver failure (12) and inflammatory bowel disease (5 patients).

Wht:] weight maintenance was wanted average weight change was -0.37kg/wk. When weight gain was specified, it was achieved at a rate of 0.46kg/wk (P<O.OOOl - 't' test). Corresponding mean daily nitrogen balance was -0.2gN/d and +1.9gN/d.

Individualising a presciption for parenteral nutrition dsing this standard computer program allows weight gain of about O.Skg/wk to be achieved when desired.