Oral intake and plasma citrulline predict quality of life in patients with intestinal failure

Nutrition. Nov-Dec 2020;79-80:110855. doi: 10.1016/j.nut.2020.110855. Epub 2020 May 15.

Abstract

Objective: Chronic intestinal failure (cIF) is a rare medical condition usually treated by long-term parenteral nutrition (PN). Owing to disease-associated symptoms and treatment-specific complications, patients with cIF commonly present with reduced quality of life (QoL) compared with healthy controls. The aim of this study was to identify factors associated with QoL in patients with cIF.

Methods: Ninety adult patients with cIF receiving PN were included in an observational study between 2014 and 2017. QoL based on the novel Short Bowel Syndrome-Quality of Life (SBS-QoL) scale and the Short-Form 36 (SF-36) health survey and nutritional status, liver function, and standard blood chemistry were assessed in every study patient. Univariate and multivariable regressions were conducted to determine independent predictors of QoL.

Results: Oral food intake and plasma citrulline were the two independent variables associated with the SBS-QoL subscale 1 (R2 = 0.240) and subscale 2 (R2 = 0.235). Oral intake (β = -43.909, P = 0.015) and citrulline (β = -0.952, P = 0.003) were also significantly associated with the SBS-QoL sum scale (R2 = 0.209). The results of SF-36 health survey were significantly associated with both SBS-QoL subscale 1 (P <0.001) and subscale 2 (P <0.001) and the SBS-QoL sum scale (P <0.001).

Conclusions: Citrulline and oral intake are predictors of QoL in patients with cIF. Although citrulline appears to be good screening tool, oral food ingestion should be considered as key goal in patients with cIF.

Keywords: Intestinal failure; Quality of life; Short bowel syndrome (SBS) health survey.