LB011 - GASTRIC INHIBITORY POLYPEPTIDE (GIP) AS A POTENTIAL BIOMARKER OF NUTRITIONAL RESILIENCE IN ACUTE ILLNESS: A SECONDARY ANALYSIS OF THE RANDOMIZED CLINICAL TRIAL EFFORT

LB011

GASTRIC INHIBITORY POLYPEPTIDE (GIP) AS A POTENTIAL BIOMARKER OF NUTRITIONAL RESILIENCE IN ACUTE ILLNESS: A SECONDARY ANALYSIS OF THE RANDOMIZED CLINICAL TRIAL EFFORT

M. Weibel^1,2,*, A. Lava^1,2, C. Wunderle¹, P. Tribolet^1,3,4, P. Schütz^1,2

¹Medical University Department, Division of General Internal and Emergency Medicine, Division of Endocrinology, Diabetes and Metabolism, Aarau, ²Medical Faculty of the University of Basel, Basel, ³Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland, ⁴4Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria

Rationale: Gastric inhibitory polypeptide (GIP) is an incretin hormone that suppresses appetite. While GIP receptor agonists have facilitated obesity management, the prognostic and therapeutic relevance of endogenous GIP in disease-related malnutrition remains unclear.

Methods: In this secondary analysis of the Effect of early nutritional support on Frailty, Functional Outcomes, and Recovery of malnourished medical inpatients Trial (EFFORT), we examined the associations between fasting GIP concentrations at hospital admission and clinical as well as nutritional outcomes. The primary outcome was 30-day all-cause mortality.

Results: Among 997 patients with complete clinical and biochemistry data, 498 exhibited elevated GIP concentration (>130 pg/mL). Higher fasting GIP levels were independently associated with reduced 30-day mortality (adjusted HR 0.49, [95% CI 0.26–0.85], p=0.013), after adjustment for randomization group, sex, age, nutritional status, underlying diagnoses, comorbidities, inflammation and study site. A similar trend was observed for long-term mortality. Moreover, patients with high GIP concentrations tended to derive greater benefit from individualized nutritional therapy than those with lower levels (HR 0.31 vs 0.87, interaction term p=0.084).

Conclusion: In malnourished medical inpatients, elevated fasting GIP concentrations were independently associated with improved short-term survival and appeared to predict a greater response to individualized nutritional therapy. A low GIP level may indicate an unfavorable metabolic adaptation during acute illness.

Disclosure of Interest: M. Weibel: None declared, A. Lava: None declared, C. Wunderle Other: Relationship with Nestlé Health Science, Nutricia Danone, BBraun, Baxter, Abbott Nutrition that includes: lecture fee, P. Tribolet Other: Relationship with Nestlé Health Science and Abbott Nutrition that includes: lecture fee, P. Schütz Grant / Research Support from: Relationship with Roche, Thermo Fisher, bioMérieux, Nestlé Health Science and Abbott Nutrition that includes: funding grants