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2019/01/11

MANUSCRIPT ACCEPTED: The article entitled "Identification of serological markers for pre- and postoperative fasting periods." will be published in Clinical Nutrition ESPEN.
In this pilot study, we identified pre- and postoperative metabolic markers of patients undergoing elective surgery of the upper or lower gastrointestinal tract. Our data provide the first description of reliable fasting biomarkers, suitable to identify patients in prolonged fasting conditions - and thus catabolic states. Applying our findings in clinical practice will be beneficial for targeted nutrition support to alleviate catabolic states, especially as the recommendations on pre- and postoperative fasting periods are often not achieved in clinical practice. This is of particular importance for an optimzed postoperative recovery. It could further be applied to patients of other disciplines in order identify prolonged fasting periods and to counteract mal- and undernutrition.
Preoperative fasting times were positively correlated with plasma levels of
valine, leucine, serine, α-amino butyric acid, free fatty acids, 3-hydroxy butyric acid and significantly negative correlated with chloride and glutamic acid. Postoperative fasting times were correlated with erythrocytes, leukocytes and plasma levels of albumin, CRP, HDL, asparagine and 3-methylhistidine. The multivariate regression analysis revealed glutamic acid and valine as significant independent predictors of preoperative fasting periods. The regression model showed best performance (sensitivity of 90.91% and specificity of 92.31%) to detect patients fasted for ≥20h.

Figure 2. Correlations between preoperative fasting time and plasma levels of glutamic acid and valine. (A) Glutamic acid (filled circles) correlated negatively (r=-0.45, p=0.031) and valine positively (r=0.463, p=0.023) with fasting time. (B) The final regression model for predictive calculation of fasting times, including plasma levels of glutamic acid and valine (concentration in µmol/L).

 
 
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