Nutrition and chronic diseases II 151

patients with clinically stable bronchiectasis and theirrelation with respiratory parameters.Methods: We assessed anthropometric parameters, adietary questionnaire, hand grip dynamometry, levels ofleptin, adiponectin, IL-6, TNFa, TNF soluble receptorsTNFr1 and TNFr2, and ultrasensitive PCR (usPCR), as wellas respiratory parameters.Results: 93 adult patients. Fat-free mass depletion werepresent in 36% of the patients, with no differencesaccording to the aetiology of the bronchiectasis. The IL-6correlated negatively with the FEV1 (%), the Bhalla scoreof the TCAR, albumin and anthropometric parametersand positively with exacerbations and bronchorrea. Thepatients with worse respiratory disease severity, malnu-trition and diabetes had significantly higher levels of IL-6.The adiponectin correlated negatively with the fat-freemass and hand grip dynamometry and positively withexacerbations. The leptin correlated positively with thefree-fat mass, Bhalla, FEV1 and negatively with exacerba-tions. The other markers had a similar behaviour to IL-6.Conclusion: Patients with bronchiectasis present a highpercentage of fat-free mass depletion, independently ofthe aetiology of the disease. The levels of inflammatorycytokines (especially IL-6) may be useful markers ofdisease severity. The levels of adiponectin were higherin patients with fat-free mass depletion.

Disclosure of Interest: None Declared

PP096-MONA RARE COMPLICATION OF SHORT BOWEL SYNDROME:D-LACTIC ACIDOSISM.J. Tapia1, R. Fernandez1, C. Maldonado1, C. Bautista1,D. Fernandez-Arias1, G. Olveira1,2. 1Endocrinologyand Nutrition, Hospital Universitario Carlos Haya,Malaga, 2Ciberdem, Ciber de Diabetes y EnfermedadesMetabolicas (Instituto de Salud Carlos III), Malaga, Spain

Rationale: The short bowel syndrome appears for thereduction of intestinal absorptive surface due to func-tional or anatomical loss of part of the small bowel.We present a rare but important complication of thissyndrome: D-lactic acidosis or D-lactate encephalopathy.Methods: A 35 year old woman presented with sporadicself-limiting (5 6 hours) episodes of dizziness with gaitinestability, loss of strength in hands, blurred vision,irritability and slurred speech. Five years previously thepatient had small intestinal resections leaving 40 cm ofjejunum, secondary to acute intestinal ischemia.Results: A neurological examination, magnetic resonanceimaging and electroencephalogram were performed (nor-mal results). Using venous blood gas analysis, coincidingwith an episode, we observed a high anion gap metabolicacidosis: pH 7.3 (7.33 7.45), pCO2 24.2 mmHg (35 50),HCO3 11.6 mmol/L (20 27), anion GAP 21.4 mEq/L(8 12). Lactate level was normal. Given the clinicaland laboratory data, the suspected diagnosis is D-lacticacidosis. It is due to a change in intestinal flora secondaryto an overgrowth of lactic acid bacteria that produceD-lactate. D-lactic acidosis was confirmed on the basisof a plasma D-lactate level of 498mmol/L (normal <19).The treatment was a lower carbohydrate diet and use ofmetronidazole and oral bicarbonate if symptoms.

Conclusion: D-lactic acidosis should be looked for in casesof metabolic acidosis in which the identity of acidosisis not apparent, neurological manifestations withoutfocality and the patient has short bowel syndromeor patients who have had jejunoileal bypass surgery.Appropiate treatment usually results in resolution ofneurologic symptoms and prevents or reduces furtherrecurrences.Disclosure of Interest: None Declared

PP097-MONORAL NUTRITIONAL SUPPLEMENT (ONS) IMPROVEDNUTRITIONAL STATUS IN MALNOURISHED PATIENTSRECEIVING HIP FRACTURE SURGERYM. Luo1, G. Golybev2, I. Klyukvin3, L. Reznik4,G. Kuropatkin5, A.C. Voss1. 1Abbott Nutrition,Abbott Laboratories, Columbus, United States; 2CityClinical Hospital #1, named after N.A. Semashko,Rostov-na-Dony, 3Scientific Research Institute EmergencyCare n.a. N.V. Sklifosovskogo, Moscow, 4ClinicalMedico-Surgical Center Ministries of Healthcare ofOmsk Region, Omsk, 5Samara Regional Clinical Hospital,Samara, Russian Federation

Rationale: Malnutrition is a key predictor of recovery andclinical outcomes in orthopedic surgical patients. Thisstudy evaluated the effect of an ONS on nutritional statusand clinical course in patients undergoing hip fracturesurgery in Russia Federation.Methods: In this multicenter, prospective, randomizedstudy, moderately malnourished elderly patients who hadsurgery within 14 days (D) of fracture and had screeningserum albumin levels �38 g/L were enrolled. Subjectsin the experimental group received a nutritionallycomplete, calorically-dense, high protein ONS (Ensure2)three times a day (100 mL between meals and 200 mLas evening snack) from study entry to 28 d after oraldiet resumed postoperatively. Each 200 mL ONS provided389 Kcal, 17 g protein, 18 g fat and 40 g CHO. Controlsubjects received standard hospital food only. Weight,serum albumin, prealbumin, and total protein weremeasured at Baseline, D14 and/or D28. Suture status andfunctional recovery were evaluated on D14 and D28. LeastSquares Mean (LSM)±SEM are reported.Results: Data from 46 out of 127 enrolled subjectswere analyzed per protocol evaluable criteria and GCP.Baseline characteristics were similar between the ONS(n = 22) and control group (n = 24). On D28, albumin levelimproved in the ONS group (3.8±1.4 g/L) compared tothe control group (0.4±1.3 g/L, p = 0.054). Significantlyhigher increase in prealbumin was also observed in theONS group (6.3±1.3 mg/dL) vs control (2±1.2 mg/dL,p = 0.007). Weight was increased 2.4±0.8 kg in ONS groupbut decreased 0.9±0.7 kg in controls (p = 0.01). Chair-to-bed transfer domain from Modified Barthel Index wasbetter in the ONS group on D14 (p = 0.10).Conclusion: Supplementation of the calorically-dense,high protein ONS for at least 28 days significantlyimproved nutritional status in moderately malnourishedpatients undergoing hip fracture surgery.Disclosure of Interest: M. Luo Other: Employee, G. Golybev:None Declared, I. Klyukvin: None Declared, L. Reznik: None De-clared, G. Kuropatkin: None Declared, A. Voss Other: Employee