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Effect of glutamine enriched nutrition support on surgical patients with gastrointestinal tumor: a meta-analysis of randomized controlled trials.

Kang K, Shu XL, Zhang YS, Liu XL, Zhao J - Chin. Med. J. (2015)

Bottom Line: Thirteen RCTs, involving 1034 patients, were included in the meta-analysis.Meanwhile, it was more significant in decreasing the incidence of infectious complications (RR: 0.67; 95% CI: 0.50-0.90; P < 0.05) and shortening the length of hospital stay (MD: -1.72; 95% CI: -3.31--0.13; P < 0.05).Glutamine enriched nutrition support was superior in improving immune function, reducing the incidence of infectious complications and shortening the length of hospital stay, playing an important role in the rehabilitation of surgical GI cancer patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Nutrition, East Hospital, Tong Ji University School of Medicine, Shanghai 200120, China.

ABSTRACT

Background: Associations between glutamine (Gln) enriched nutrition support and surgical patients with gastrointestinal (GI) tumor remain controversy. The purpose of this meta-analysis was to assess the effect of Gln enriched nutrition support on surgical patients with GI tumor in term of relevant biochemical indices, immune indices, and clinical outcomes.

Methods: Six databases were systematically searched to find eligible randomized controlled trials (RCTs) from 1966 to May 2014. When estimated the analysis indexes, the relative risk (RR) was used as the effect size of the categorical variable, while the weighted mean difference (MD) was used as the effect size of a continuous variable. Meta-analysis was conducted with Rev Man 5.2.

Results: Thirteen RCTs, involving 1034 patients, were included in the meta-analysis. The analysis showed that Gln enriched nutrition support was more effective in increasing serum albumin (MD: 0.10; 95% confidence interval [CI]: 0.02-0.18; P < 0.05), serum prealbumin (MD: 1.98; 95% CI: 1.40-2.55; P < 0.05) and serum transferring (MD: 0.35; 95% CI: 0.12-0.57; P < 0.05), concentration of IgG (MD: 1.26; 95% CI: 0.90-1.63; P < 0.05), IgM (MD: 0.18; 95% CI: 0.11-0.25; P < 0.05), IgA (MD: 0.22; 95% CI: 0.10-0.33; P < 0.05), CD3 + (MD: 3.71; 95% CI: 2.57-4.85; P < 0.05) and CD4/CD8 ratio (MD: 0.27; 95% CI: 0.12-0.42; P < 0.05). Meanwhile, it was more significant in decreasing the incidence of infectious complications (RR: 0.67; 95% CI: 0.50-0.90; P < 0.05) and shortening the length of hospital stay (MD: -1.72; 95% CI: -3.31--0.13; P < 0.05).

Conclusions: Glutamine enriched nutrition support was superior in improving immune function, reducing the incidence of infectious complications and shortening the length of hospital stay, playing an important role in the rehabilitation of surgical GI cancer patients.

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Related in: MedlinePlus

Funnel plot of studies mentioned change of relevant biochemical indices between glutamine and control group. Dotted lines are pseudo 95% confidence intervals. The asymmetry funnel plot suggested possible publication bias existed, which was associated with the significant heterogeneity of studies mentioned change of serum transferrin.
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Figure 3: Funnel plot of studies mentioned change of relevant biochemical indices between glutamine and control group. Dotted lines are pseudo 95% confidence intervals. The asymmetry funnel plot suggested possible publication bias existed, which was associated with the significant heterogeneity of studies mentioned change of serum transferrin.

Mentions: There were five studies[1718232426] with 274 subjects that mentioned the change of serum transferring (g/L) between the Gln and control group, but the heterogeneity among them was significant (I2 = 76%; P < 0.05; Chi-square = 16.45). Thus, we performed a subgroup analysis according to different countries and regions. I2 between subgroups was 0% (P = 0.36; Chi-square = 0.85), but the total heterogeneity was still large. In this case, we used a random-effects model to analyze the data. There was significantly increase of serum transferring in Gln group (MD: 0.35; 95% CI: 0.12–0.57; P < 0.05) [Figure 2d]. Moreover, the symmetry funnel plot suggested scarcely any publication bias existed between studies mentioned change of serum transferring [Figure 3].


Effect of glutamine enriched nutrition support on surgical patients with gastrointestinal tumor: a meta-analysis of randomized controlled trials.

Kang K, Shu XL, Zhang YS, Liu XL, Zhao J - Chin. Med. J. (2015)

Funnel plot of studies mentioned change of relevant biochemical indices between glutamine and control group. Dotted lines are pseudo 95% confidence intervals. The asymmetry funnel plot suggested possible publication bias existed, which was associated with the significant heterogeneity of studies mentioned change of serum transferrin.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4837846&req=5

Figure 3: Funnel plot of studies mentioned change of relevant biochemical indices between glutamine and control group. Dotted lines are pseudo 95% confidence intervals. The asymmetry funnel plot suggested possible publication bias existed, which was associated with the significant heterogeneity of studies mentioned change of serum transferrin.
Mentions: There were five studies[1718232426] with 274 subjects that mentioned the change of serum transferring (g/L) between the Gln and control group, but the heterogeneity among them was significant (I2 = 76%; P < 0.05; Chi-square = 16.45). Thus, we performed a subgroup analysis according to different countries and regions. I2 between subgroups was 0% (P = 0.36; Chi-square = 0.85), but the total heterogeneity was still large. In this case, we used a random-effects model to analyze the data. There was significantly increase of serum transferring in Gln group (MD: 0.35; 95% CI: 0.12–0.57; P < 0.05) [Figure 2d]. Moreover, the symmetry funnel plot suggested scarcely any publication bias existed between studies mentioned change of serum transferring [Figure 3].

Bottom Line: Thirteen RCTs, involving 1034 patients, were included in the meta-analysis.Meanwhile, it was more significant in decreasing the incidence of infectious complications (RR: 0.67; 95% CI: 0.50-0.90; P < 0.05) and shortening the length of hospital stay (MD: -1.72; 95% CI: -3.31--0.13; P < 0.05).Glutamine enriched nutrition support was superior in improving immune function, reducing the incidence of infectious complications and shortening the length of hospital stay, playing an important role in the rehabilitation of surgical GI cancer patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Nutrition, East Hospital, Tong Ji University School of Medicine, Shanghai 200120, China.

ABSTRACT

Background: Associations between glutamine (Gln) enriched nutrition support and surgical patients with gastrointestinal (GI) tumor remain controversy. The purpose of this meta-analysis was to assess the effect of Gln enriched nutrition support on surgical patients with GI tumor in term of relevant biochemical indices, immune indices, and clinical outcomes.

Methods: Six databases were systematically searched to find eligible randomized controlled trials (RCTs) from 1966 to May 2014. When estimated the analysis indexes, the relative risk (RR) was used as the effect size of the categorical variable, while the weighted mean difference (MD) was used as the effect size of a continuous variable. Meta-analysis was conducted with Rev Man 5.2.

Results: Thirteen RCTs, involving 1034 patients, were included in the meta-analysis. The analysis showed that Gln enriched nutrition support was more effective in increasing serum albumin (MD: 0.10; 95% confidence interval [CI]: 0.02-0.18; P < 0.05), serum prealbumin (MD: 1.98; 95% CI: 1.40-2.55; P < 0.05) and serum transferring (MD: 0.35; 95% CI: 0.12-0.57; P < 0.05), concentration of IgG (MD: 1.26; 95% CI: 0.90-1.63; P < 0.05), IgM (MD: 0.18; 95% CI: 0.11-0.25; P < 0.05), IgA (MD: 0.22; 95% CI: 0.10-0.33; P < 0.05), CD3 + (MD: 3.71; 95% CI: 2.57-4.85; P < 0.05) and CD4/CD8 ratio (MD: 0.27; 95% CI: 0.12-0.42; P < 0.05). Meanwhile, it was more significant in decreasing the incidence of infectious complications (RR: 0.67; 95% CI: 0.50-0.90; P < 0.05) and shortening the length of hospital stay (MD: -1.72; 95% CI: -3.31--0.13; P < 0.05).

Conclusions: Glutamine enriched nutrition support was superior in improving immune function, reducing the incidence of infectious complications and shortening the length of hospital stay, playing an important role in the rehabilitation of surgical GI cancer patients.

Show MeSH
Related in: MedlinePlus