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Efficacy of Glutamine-Enriched Nutrition Support for Patients With Severe Acute Pancreatitis: A Meta-Analysis.

Abstract

BACKGROUND

Plasma glutamine (Gln) level has been negatively correlated with the severity of severe acute pancreatitis (SAP). Although Gln is widely used today, the results of individual randomized controlled trials of Gln-enriched nutrition support for patients with SAP are conflicting.

METHODS

PubMed, EMBASE, HighWire, Cochrane Central Register of Controlled Trials, Wanfang, China Journals Full-Text Database, and the Chinese Biomedical Literature Database were searched. Literature published before June 2014 was searched. Randomized controlled trials investigating the comparison of conventional and Gln-enriched nutrition support were included; a random effect model using Rev Man 5.2 software was chosen to complete this meta-analysis. The count data were analyzed using the risk ratio (RR) and 95% confidence interval (CI), and the measurement data were analyzed using the standard mean difference or weighted mean difference and 95% CI. Heterogeneity analyses were conducted by I(2) test; publication bias analyses were conducted by Begg test.

RESULTS

Ten studies were eventually chosen for analysis, including 218 patients who received conventional methods (control group) and 215 patients who received Gln-enriched nutrition support (experimental group). Compared with the control group, Gln is helpful in elevating the albumin level, decreasing C-reaction protein (standard mean difference = 1.01, -1.89; 95% CI: 0.50 to 1.51, -3.23 to -0.56; P < .05), decreasing the incidence of infectious complication and mortality (RR = 0.62, 0.36; 95% CI: 0.46 to 0.83, 0.16 to 0.83; P < .05), and shortening the hospital stay length (weighted mean difference [WMD] = -3.89; 95% CI: -4.98 to -2.81; P < .05) without increasing expenses (WMD = -0.16; 95% CI: -1.34 to 1.02; P > .05). Intravenous infusion manifested more advantages by decreasing the incidence of infectious complications and mortality.

CONCLUSIONS

Gln-enriched nutrition support is superior to conventional methods for SAP, and intravenous infusion may be a better choice for drug administration.

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  • Authors+Show Affiliations

    ,

    Department of General Surgery, Wuhan Clinical College of Southern Medical University (Wuhan General Hospital of Guangzhou Military Command),Wuhan, Hubei Province, China.

    ,

    Department of General Surgery, Wuhan Clinical College of Southern Medical University (Wuhan General Hospital of Guangzhou Military Command),Wuhan, Hubei Province, China. ptwklqp111@163.com.

    ,

    Department of General Surgery, Wuhan Clinical College of Southern Medical University (Wuhan General Hospital of Guangzhou Military Command),Wuhan, Hubei Province, China.

    Department of General Surgery, Wuhan Clinical College of Southern Medical University (Wuhan General Hospital of Guangzhou Military Command),Wuhan, Hubei Province, China.

    Source

    MeSH

    Acute Disease
    C-Reactive Protein
    China
    Communicable Diseases
    Databases, Factual
    Glutamine
    Hospitalization
    Humans
    Length of Stay
    Pancreatitis
    Parenteral Nutrition
    Randomized Controlled Trials as Topic
    Serum Albumin

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Review

    Language

    eng

    PubMed ID

    25655622

    Citation

    Yong, Li, et al. "Efficacy of Glutamine-Enriched Nutrition Support for Patients With Severe Acute Pancreatitis: a Meta-Analysis." JPEN. Journal of Parenteral and Enteral Nutrition, vol. 40, no. 1, 2016, pp. 83-94.
    Yong L, Lu QP, Liu SH, et al. Efficacy of Glutamine-Enriched Nutrition Support for Patients With Severe Acute Pancreatitis: A Meta-Analysis. JPEN J Parenter Enteral Nutr. 2016;40(1):83-94.
    Yong, L., Lu, Q. P., Liu, S. H., & Fan, H. (2016). Efficacy of Glutamine-Enriched Nutrition Support for Patients With Severe Acute Pancreatitis: A Meta-Analysis. JPEN. Journal of Parenteral and Enteral Nutrition, 40(1), pp. 83-94. doi:10.1177/0148607115570391.
    Yong L, et al. Efficacy of Glutamine-Enriched Nutrition Support for Patients With Severe Acute Pancreatitis: a Meta-Analysis. JPEN J Parenter Enteral Nutr. 2016;40(1):83-94. PubMed PMID: 25655622.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Efficacy of Glutamine-Enriched Nutrition Support for Patients With Severe Acute Pancreatitis: A Meta-Analysis. AU - Yong,Li, AU - Lu,Qi-Ping, AU - Liu,Sheng-Hui, AU - Fan,Hu, Y1 - 2015/02/05/ PY - 2014/07/22/received PY - 2014/10/12/accepted PY - 2015/2/7/entrez PY - 2015/2/7/pubmed PY - 2016/9/24/medline KW - glutamine KW - severe acute pancreatitis SP - 83 EP - 94 JF - JPEN. Journal of parenteral and enteral nutrition JO - JPEN J Parenter Enteral Nutr VL - 40 IS - 1 N2 - BACKGROUND: Plasma glutamine (Gln) level has been negatively correlated with the severity of severe acute pancreatitis (SAP). Although Gln is widely used today, the results of individual randomized controlled trials of Gln-enriched nutrition support for patients with SAP are conflicting. METHODS: PubMed, EMBASE, HighWire, Cochrane Central Register of Controlled Trials, Wanfang, China Journals Full-Text Database, and the Chinese Biomedical Literature Database were searched. Literature published before June 2014 was searched. Randomized controlled trials investigating the comparison of conventional and Gln-enriched nutrition support were included; a random effect model using Rev Man 5.2 software was chosen to complete this meta-analysis. The count data were analyzed using the risk ratio (RR) and 95% confidence interval (CI), and the measurement data were analyzed using the standard mean difference or weighted mean difference and 95% CI. Heterogeneity analyses were conducted by I(2) test; publication bias analyses were conducted by Begg test. RESULTS: Ten studies were eventually chosen for analysis, including 218 patients who received conventional methods (control group) and 215 patients who received Gln-enriched nutrition support (experimental group). Compared with the control group, Gln is helpful in elevating the albumin level, decreasing C-reaction protein (standard mean difference = 1.01, -1.89; 95% CI: 0.50 to 1.51, -3.23 to -0.56; P < .05), decreasing the incidence of infectious complication and mortality (RR = 0.62, 0.36; 95% CI: 0.46 to 0.83, 0.16 to 0.83; P < .05), and shortening the hospital stay length (weighted mean difference [WMD] = -3.89; 95% CI: -4.98 to -2.81; P < .05) without increasing expenses (WMD = -0.16; 95% CI: -1.34 to 1.02; P > .05). Intravenous infusion manifested more advantages by decreasing the incidence of infectious complications and mortality. CONCLUSIONS: Gln-enriched nutrition support is superior to conventional methods for SAP, and intravenous infusion may be a better choice for drug administration. SN - 1941-2444 UR - https://www.unboundmedicine.com/medline/citation/25655622/full_citation L2 - https://doi.org/10.1177/0148607115570391 DB - PRIME DP - Unbound Medicine ER -