title: Effect of glutamine enriched nutrition support on surgical patients with gastrointestinal tumor: a meta-analysis of randomized controlled trials.
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.
authors.forename: Kai
authors.initials: K
authors.lastname: Kang
authors.affiliation: Department of Nutrition, East Hospital, Tong Ji University School of Medicine, Shanghai 200120, China.
authors.forename: Xiao-Liang
authors.initials: XL
authors.lastname: Shu
authors.forename: Yong-Sheng
authors.initials: YS
authors.lastname: Zhang
authors.forename: Xian-Li
authors.initials: XL
authors.lastname: Liu
authors.forename: Jian
authors.initials: J
authors.lastname: Zhao
mesh_terms: D004750:Enteral Nutrition; D005770:Gastrointestinal Neoplasms / Q000601:surgery*; D005973:Glutamine / Q000627:therapeutic use*; D006801:Humans; D010288:Parenteral Nutrition; D011183:Postoperative Complications / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic
chemical_list: D005973:Glutamine