title: Nutritional assessment using stable isotope ratios of carbon and nitrogen in the scalp hair of geriatric patients who received enteral and parenteral nutrition formulas.
abstract: The δ13C and δ15N values in the scalp hair of geriatric patients in Japan who received the enteral or parenteral nutrition formula were measured to assess nutritional status.
  
  
  
  The relations among δ13C, δ15N, calorie intake, BMI, albumin concentration, total cholesterol (T-CHO) and geriatric nutritional risk index (GNRI) in the patients were investigated. Furthermore, the enrichment of δ13C and δ15N from the nutrients to the hair was investigated.
  
  
  
  The δ13C values in the hair of patients who received enteral nutrition decreased with decreases in the calories received, while the δ15N values increased, suggesting malnutrition in some patients with a low calorie intake due to a negative nitrogen balance. The distribution of patients with a low calorie intake (below 20 kcal/kg/day) when δ13C was plotted against δ15N differed from that of control subjects, but the distribution of patients with a high calorie intake (above 20 kcal/kg/day) was similar to that of control subjects. No significant differences were observed in BMI, albumin concentration, T-CHO or GNRI between the low and high calorie groups. The enrichment of δ13C and δ15N from the enteral nutrients to the hair were inversely correlated with the δ13C and δ15N in the enteral nutrients. The enrichment levels of δ13C and δ15N tended to be higher and lower, respectively, in the high calorie group. On the other hand, the δ13C and δ15N values in the hair of patients who received parenteral nutrition were higher and lower than those in the control subjects and in the patients who received enteral nutrition, respectively, reflecting the higher δ13C and lower δ15N contents of the parenteral nutrients.
  
  
  
  The δ13C and δ15N values in the hair of patients who received enteral nutrition may be effective indicators for evaluating the long-term nutritional status of geriatric patients. A calorie intake of 20 kcal/kg/day may be a cut-off value for malnutrition in Japanese geriatric patients receiving enteral nutrition. However, caution is necessary when dealing with patients switching from parental nutrition as parenteral nutrition resulted in different changes in δ13C and δ15N. The enrichment levels of δ13C and δ15N from the enteral nutrients to the hair may be inversely correlated with the δ13C and δ15N values of enteral nutrients and vary according to the calorie intake.
authors.affiliation: Sapporo Higashi-Tokushukai Hospital, N33-E14, Higashi-ku, Sapporo, Hokkaido 065-0033, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Hayasaka
authors.affiliation: Sapporo Minami-Seishu Hospital, 1-2-20, Satozuka, Kiyota-Ku, Sapporo, Hokkaido 004-0801, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Ogasawara
authors.affiliation: Hokusei Hospital, W3-2-10, Sinkawa, Kita-Ku, Sapporo, Hokkaido 001-0933, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Hotta
authors.affiliation: Hijirigaoka Hospital, 214-22, Funaoka, Date, Hokkaido 052-0014, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tsukagoshi
authors.affiliation: School of Pharmaceutical Science, Health Sciences University of Hokkaido, 1757 Kanazawa, Ishikari-Tobetsu, Hokkaido 061-0293, Japan.
authors.forename: O
authors.initials: O
authors.lastname: Kimura
authors.affiliation: Naganuma Municipal Hospital, 2-2-1 Chuo, Naganuma, Yubari, Hokkaido 069-1332, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Kura
authors.affiliation: Hokusei Hospital, W3-2-10, Sinkawa, Kita-Ku, Sapporo, Hokkaido 001-0933, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Tarumi
authors.affiliation: Rumoi City Hospital, 2-16 Shinonome, Rumoi, Hokkaido 077-8511, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Muramatsu
authors.affiliation: School of Pharmaceutical Science, Health Sciences University of Hokkaido, 1757 Kanazawa, Ishikari-Tobetsu, Hokkaido 061-0293, Japan. Electronic address: endotty@hoku-iryo-u.ac.jp.
authors.forename: T
authors.initials: T
authors.lastname: Endo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D015992:Body Mass Index; D002247:Carbon Isotopes / Q000032:analysis*; D004750:Enteral Nutrition; D005260:Female; D015577:Geriatric Assessment; D006197:Hair / Q000737:chemistry*; D006801:Humans; D007564:Japan; D008297:Male; D009587:Nitrogen Isotopes / Q000032:analysis*; D015596:Nutrition Assessment; D009751:Nutritional Requirements; D009752:Nutritional Status; D010288:Parenteral Nutrition; D012535:Scalp
chemical_list: D002247:Carbon Isotopes; D009587:Nitrogen Isotopes
keywords: Calorie; Enteral nutrition; Parenteral nutrition; Scalp hair; Stable isotope ratio of carbon; Stable isotope ratio of nitrogen