Boccardi Virginia, Cari Luigi, Naghavi Alhosseini Mahdieh, Bastiani Patrizia, Scamosci Michela, Caironi Giulia, Aprea Giulia, Mancinetti Francesca, Cecchetti Roberta, Ruggiero Carmelinda, Nocentini Giuseppe, Mecocci Patrizia
Division of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, Santa Maria della Misericordia Hospital, 06020 Perugia, Italy.
Department of Clinical Pathology, Santa Maria della Misericordia Hospital, 06020 Perugia, Italy.
Nutrients. 2024 Dec 5;16(23):4211. doi: 10.3390/nu16234211.
Malnutrition is common in acutely ill geriatric patients, worsening immune function and clinical outcomes. Immunonutrition, containing nutrients like omega-3 fatty acids, arginin and glutamine, may improve recovery in this population. This study aimed to evaluate the impact of immunonutrition on clinical outcomes, inflammatory markers, and immune responses in frail, hospitalized older adults.
This is a retrospective observational study. In total, 36 subjects, during hospitalization, received either an immunonutrition formula or isoproteic and isocaloric enteral nutrition. The primary outcome was the length of hospital stay (LOS), with secondary outcomes focused on inflammatory cytokines and immune parameters within a week of hospitalization.
Patients were primarily oldest-old, with a mean age of 88.6 years ± 4.9 (range 79-96). The immunonutrition group had a significantly shorter LOS (11.37 ± 4.87 vs. 16.82 ± 10.83 days, = 0.05) and showed increases in key cytokines (G-CSF, INF-α2, IL-12p70, IL-15, IL-2, and IL-3, < 0.05) enhanced immune function. A decrease in T cells and an increased B/T cell ratio was also observed. No significant differences in infection rates or 90-day survival were found.
Enteral immunonutrition improved clinical outcomes by reducing LOS and modulating immune responses in frail patients, suggesting potential benefits in recovery. Further studies are needed to confirm these findings.
营养不良在急性病老年患者中很常见,会使免疫功能和临床结局恶化。含有ω-3脂肪酸、精氨酸和谷氨酰胺等营养素的免疫营养可能会改善该人群的康复情况。本研究旨在评估免疫营养对体弱的住院老年人的临床结局、炎症标志物和免疫反应的影响。
这是一项回顾性观察研究。共有36名受试者在住院期间接受了免疫营养配方或等蛋白、等热量的肠内营养。主要结局是住院时间(LOS),次要结局集中在住院一周内的炎症细胞因子和免疫参数。
患者主要为高龄老人,平均年龄为88.6岁±4.9(范围79 - 96岁)。免疫营养组的住院时间显著缩短(11.37±4.87天对16.82±10.83天,P = 0.05),关键细胞因子(G-CSF、INF-α2、IL-12p70、IL-15、IL-2和IL-3)增加(P < 0.05),免疫功能增强。还观察到T细胞减少和B/T细胞比值增加。感染率或90天生存率无显著差异。
肠内免疫营养通过缩短住院时间和调节体弱患者的免疫反应改善了临床结局,提示在康复方面有潜在益处。需要进一步研究来证实这些发现。