Objectives: Protein energy malnutrition and inflammation are among the causes of morbidity in patients with metabolic stress. Because of the adipogenic and somatotrophic effects of insulin, insulin like growth factor-1(IGF-1) and insulin like growth factor binding protein-3 (IGFBP-3) interacts with leptin. Regarding the studies, the levels of leptin, IGF-1 and IGFBP-3 have shown increases compared to the basal levels in long term parenteral nutrition (TPN). It is challenging to show the regulation of leptin in short term nutrition. The effects of two different nutrition solutions on levels of leptin, IGF-1 and IGFBP-3 in patients with metabolic stress are aimed to be evaluated in this study.

Materials and Methods: Nineteen patients in need of enteral nutrition were divided into two groups. Patients in group 1 and group 2 were fed as follows, group 1: (n=9) standard polymeric product (53.2% carbohydrates, 30.1% lipid and 16.7% protein) and group 2: (n=10) polymeric product with high lipid ratio (28% carbohydrates, 55.2% lipid and 16.7% protein). Blood samples were collected twice; one before nutrition (basal) and the other one 48 hours after the start of nutrition. The levels of leptin, IGF-1 and IGFBP-3 were determined by ELISA.

Results: The leptin levels increased in the first group, and decreased in the second group, however the changes were not statistically significant. There was a statistically significant increase in the tryglicerid levels and a decrease in the HDL- cholesterol levels of the group fed by a high carbohydrate diet at the 48th hour (p<0.05). This difference could not be detected in the 2nd group. There was a decrease of apolipoprotein-A1 (Apo A1) levels in the 1st group similar to HDL- cholesterol levels. Leptin, IGF-1 and IGFBP-3 levels were stabile short term after the high carbohydrate diet.

Conclusion: We thought that ous results may be explained by the stimulation of insulin secretion secondary to rapid compensation of the energy lack by carbohydrates. The tendency of decrease in leptin, IGF-1 and IGFBP-3 levels with the diet with polimeric products, indicates that the energy lack is not decreased during short term feeding.