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脂溶性维生素作为营养状况的生物标志物及其与多发伤患者并发症的关系。

Fat-soluble vitamins as biomarkers of nutritional status and their relation with complications in polytrauma patients.

作者信息

Verheul Esmee A H, Horzum Ebru, Dijkink Suzan, Krijnen Pieta, Hoogendoorn Jochem M, Arbous Sesmu M, Peters Ron, Schipper Inger B

机构信息

Department of Trauma Surgery, Leiden University Medical Centre, Leiden, The Netherlands.

Department of General Surgery, Haaglanden Medical Centre, The Hague, The Netherlands.

出版信息

Nutr Health. 2025 Sep;31(3):1067-1075. doi: 10.1177/02601060241273640. Epub 2024 Aug 19.

Abstract

Background and AimsThis exploratory observational prospective study aimed to evaluate fat-soluble vitamin plasma levels during hospital admission and its relation with the development of malnutrition and complications in polytrauma patients, considering the protocolized multivitamin supplementation during intensive care unit (ICU) admission.MethodsIn 49 well-nourished polytrauma (injury severity score ≥ 16) patients admitted to the ICU of two level-1 trauma centers, vitamin A, D, and E levels were assessed weekly during hospital stay. All patients received multivitamin supplementation during ICU stay. Linear mixed-effect models were used to assess a trend in vitamin levels over time during hospital stay. Mixed-effects logistic regression analysis was performed to relate vitamin concentrations with malnutrition, defined as a subjective global assessment score ≤5, and complications.ResultsVitamin A levels increased 0.17 µmol/L per week (95% confidence interval 0.12-0.22, p < 0.001), vitamin D levels increased 1.49 nmol/L per week (95% confidence interval 0.64-2.33, p < 0.01), vitamin E levels increased 1.17 µmol/L per week (95% confidence interval 0.61-1.73, p < 0.001) during hospital stay (29 ± 17 days). Vitamin levels were not related to malnutrition or complications during hospital stay.ConclusionVitamin A, D, and E levels increased due to supplementation during hospital admission. Plasma levels of vitamins A, D, and E do not seem to be useful as biomarkers for the nutritional status of polytrauma patients during hospital stay. No correlation with complications could be demonstrated.

摘要

背景与目的

本探索性观察性前瞻性研究旨在评估多创伤患者住院期间脂溶性维生素的血浆水平及其与营养不良和并发症发生发展的关系,同时考虑在重症监护病房(ICU)住院期间按方案补充多种维生素。

方法

在两家一级创伤中心的ICU收治的49例营养状况良好的多创伤患者(损伤严重程度评分≥16)中,住院期间每周评估维生素A、D和E水平。所有患者在ICU住院期间均接受多种维生素补充。采用线性混合效应模型评估住院期间维生素水平随时间的变化趋势。进行混合效应逻辑回归分析,以确定维生素浓度与营养不良(定义为主观全面评估评分≤5)及并发症之间的关系。

结果

住院期间(29±17天),维生素A水平每周升高0.17µmol/L(95%置信区间0.12 - 0.22,p<0.001),维生素D水平每周升高1.49 nmol/L(95%置信区间0.64 - 2.33,p<0.01),维生素E水平每周升高1.17µmol/L(95%置信区间0.61 - 1.73,p<0.001)。住院期间维生素水平与营养不良或并发症无关。

结论

住院期间因补充维生素,维生素A、D和E水平升高。维生素A、D和E的血浆水平似乎无助于作为多创伤患者住院期间营养状况的生物标志物。未发现与并发症存在相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33aa/12423471/0a9477f84485/10.1177_02601060241273640-fig1.jpg

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