Nematy Mohsen, O'Flynn Jacqui E, Wandrag Liesl, Brynes Audrey E, Brett Stephen J, Patterson Michael, Ghatei Mohammad A, Bloom Stephen R, Frost Gary S
Nutrition and Dietetic Research Group, Imperial College, Hammersmith Hospitals NHS Trust, Du Cane Road, London W12 0HS, UK.
Crit Care. 2006 Feb;10(1):R10. doi: 10.1186/cc3957.
The nutritional status of patients in the intensive care unit (ICU) appears to decline not only during their stay in the ICU but also after discharge from the ICU. Recent evidence suggests that gut released peptides, such as ghrelin and peptide YY (PYY) regulate the initiation and termination of meals and could play a role in the altered eating behaviour of sick patients. The aim of this study was to assess the patterns of ghrelin and PYY levels during the stay of ICU patients in hospital.
Sixteen ICU patients (60 +/- 4.7 years, body mass index (BMI) 28.1 +/- 1.7 kg/m2 (mean +/- standard error of the mean)) underwent fasting blood sample collections on days 1, 3, 5, 14, 21 and 28 of their stay at Hammersmith and Charing Cross Hospitals. Changes in appetite and biochemical and anthropometric markers of nutritional status were recorded. A comparison was made to a group of 36 healthy volunteers matched for age and BMI (54.3 +/- 2.9 years, p = 0.3; BMI 25.8 +/- 0.8 kg/m2 p = 0.2).
Compared to healthy subjects, ICU patients exhibited a significantly lower level of ghrelin (day one 297.8 +/- 76.3 versus 827.2 +/- 78.7 pmol/l, p < 0.001) during their stay in the ICU. This tended to rise to the normal level during the last three weeks of hospital stay. Conversely, ICU patients showed a significantly higher level of PYY (day one 31.5 +/- 9.6 versus 11.3 +/- 1.0 pmol/l, p < 0.05) throughout their stay in the ICU and on the ward, with a downward trend to the normal level during the last three weeks of stay.
Results from our study show high levels of PYY and low levels of ghrelin in ICU patients compared to healthy controls. There appears to be a relationship between the level of these gut hormones and nutritional intake.
重症监护病房（ICU）患者的营养状况似乎不仅在其入住ICU期间会下降，而且在从ICU出院后也会下降。最近的证据表明，肠道释放的肽，如胃饥饿素和肽YY（PYY），可调节进餐的开始和结束，并可能在患病患者饮食行为改变中起作用。本研究的目的是评估ICU患者住院期间胃饥饿素和PYY水平的变化模式。
16例ICU患者（年龄60±4.7岁，体重指数（BMI）28.1±1.7kg/m²（平均值±平均标准误差））在入住哈默史密斯医院和查令十字医院的第1、3、5、14、21和28天进行空腹血样采集。记录食欲以及营养状况的生化和人体测量指标的变化。与一组年龄和BMI匹配的36名健康志愿者（年龄54.3±2.9岁，p = 0.3；BMI 25.8±0.8kg/m²，p = 0.2）进行比较。
与健康受试者相比，ICU患者在入住ICU期间胃饥饿素水平显著较低（第1天297.8±76.3对827.2±78.7pmol/l，p < 0.001）。在住院的最后三周，该水平趋于上升至正常水平。相反，ICU患者在整个入住ICU期间及在病房时PYY水平显著较高（第1天31.5±9.6对11.3±1.0pmol/l，p < 0.05），在住院的最后三周呈下降趋势至正常水平。
我们的研究结果显示，与健康对照组相比，ICU患者的PYY水平较高，胃饥饿素水平较低。这些肠道激素的水平与营养摄入之间似乎存在关联。
