Abstract
BACKGROUND: Muscle mass depletion caused by hypercatabolism and inappropriate nutritional support in patients with intestinal failure (IF) is associated with poor clinical outcomes and reduced quality of life. This retrospective study evaluated the correlation between nutritional support factors (type and composition) and muscle mass. METHODS: In this cohort study, two hundreds and twenty-three eligible patients with type I or II IF were included at a clinical nutrition center between September 2013 and September 2017. Muscle mass was measured via Bioelectrical Impedance Analysis. Statistical analyses included paired-samples T test, Pearson's or Spearman's rank correlation, univariate and multivariate regressions. RESULTS: The mean age was 46.1 ± 18.6 years, the mean nutritional risk screening -2002 score was 3.5 ± 0.8, and the median hospitalization duration was 19.5 days. Multivariate linear regression analysis revealed that Δsoft lean mass (ΔSLM) and Δskeletal muscle mass (ΔSMM) were significantly correlated with calories delivered via parenteral nutrition (PN) (β = 0.051, 95%CI [0.014, 0.008], p < 0.05 and β = 0.041, 95%CI [0.010, 0.072], p < 0.05). Among the PN composition variables, daily glucose intake via PN showed a significant correlation with ΔSLM (β = 0.350, 95%CI [0.091, 0.609], p < 0.01) and ΔSMM (β = 0.254, 95%CI [0.027, 0.481], p < 0.01). Subgroup analysis revealed that daily glucose intake via PN was associated with ΔSMM, especially at ≥1.2 g/kg/day of amino acid intake (r = 0.328, p < 0.01). CONCLUSIONS: Adequate calories and amino acids supplementation delivered via parenteral nutrition play an important role in promoting muscle mass maintenance in patients with type I or II intestinal failure, who were under metabolically unstable or enteral nutrition intolerance condition.