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Research ArticleOpen Access

Non-Protein Calorie: Nitrogen Ratio (NPC/N) as an Indicator of Nitrogen Balance in Clinical Settings

Volume 6 - Issue 1

Teruyoshi Amagai*1, Mari Hasegawa1, Moeko Kitagawa2 and Seiji Haji3

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    • 1Department of Food Sciences and Nutrition, Mukogawa Women’s University, Japan
    • 2Department of Clinical Nutrition, Kitano Hospital, Japan
    • 3Department of Surgery, Takarazuka Iso Hospital, Japan

    *Corresponding author:Teruyoshi Amagai, Department of Food Sciences and Nutrition, Japan

Received: June 19, 2018;   Published: June 25, 2018

DOI: 10.26717/BJSTR.2018.06.001297

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Background: An energy and protein provisions to patients in clinical settings, with not only acute but non-acute illnesses, have been reported an essential to prevent body mass wasting if they are provided sufficiently. A malnutrition observed in acute and chronic illnesses is more or less resulted from an inflammation.

Methods: We set three clinical questions to analyze:

a) To which extents is protein provision sufficient to prevent adverse events in nutritional management,

b) Is there any relevant indicator to prevent muscle loss,

c) If it exists, is there any explanation to make clear the mechanism hidden behind it?


a) 1.2-1.5 gram protein per kg of preadmission body weight was defined optimal target.

b) There was a significant relation between total protein loss and calorie: N ratio. Additionally, non-protein calorie: N (NPC/N) ratio were also proposed as indicators of N balance in the literatures.

c) The hormonal and metabolic reactions to starvation and stress were studied to ensure the mechanism hidden behind these sequences.

Conclusions: From the review of the literatures, we would propose NPC/N ratio as a clinically feasible indicator of nitrogen balance to prevent muscle loss or adverse events to prevent in patients with acute and non-acute illnesses.

Keywords: Non-Protein Calorie; Nitrogen Ratio; NPC/N; Nutrition Management

Abstract| Introduction| Methods| Results| Conclusion| References|