Effect of enteral nutrition treatment on metabolism and serum adiponectin level in elderly patients with metabolic syndrome / 中华老年医学杂志

ABSTRACT

Objective To observe the effect of enteral nutrition therapy on metabolic status and adiponectin levels in elderly patients with metabolic syndrome (MS) complicated with nonalcoholic fatty liver disease (NAFLD).Methods 92 elderly hospitalized patients with mild to moderate non-alcoholic fatty liver disease underwent enteral nutrition (EN,n=46) and total parenteral nutrition (TPN,n=46) for 2 months.Body mass index,triceps skin-fold thickness,waist hip ratio,serum high-molecular weight (HMW) form of adiponectin,fasting blood glucose,postprandial 2-hour blood glucose,glycosylated hemoglobin,plasma insulin,alanine aminotransferase,aspartate aminotransferase,γ-glutamyltransferase,total bilirubin,direct bilirubin,total cholesterol,triglyceride,low density lipoprotein cholesterol,high density lipoprotein cholesterol,the blood pressure and liver ultrasound test were detected.The insulin resistance (HOMA-IR) was used to assess insulin resistance.Results In pre-versus post-treatment,serum level of HMW adiponectin [(6.8 ± 4.0) μg/L vs.(7.1 ± 3.9) μg/L,P ＞ 0.05 in enteral nutrition],and [(6.8 ± 3.5) μg/L vs.(5.0 ± 1.1)μg/L(P＜0.05)] in parenteral nutrition were found.The significantly decreased body mass index in the obese patients (P＜0.05),significantly improved values of 2-hour blood glucose,glycated hemoglobin,liver function,triglycerides,low-density lipoprotein cholesterol levels (all P＜0.05),and no obvious change in HOMA-IR were found after two months of enteral nutrition treatment.There were no significant changes in indicators mentioned above in TPN group after 2 months of treatment.Conclusions Enteral nutrition therapy can improve the glucose metabolism,lipid metabolism,the non-alcoholic fatty liver disease and body mass index,affect the level of adiponectin in the elderly patients with MS and NAFLD.It is vital to body metabolism.