Analyses of laboratory data and establishment of reference values and intervals for healthy elderly people

Kubota, Keiichi; Kadomura, Tomohisa; Ohta, Keiichiro; Kanemaru, Kazunori; Okuda, Hisashi; Kobayashi, Masashi; Ishii, Chiako; Fujiwara, Yoshinori; Nishioka, Takazumi; Ohmae, Yumi; Ohmae, Toshimichi; Kitajima, Masaki

doi:10.1007/s12603-011-0355-3

Cited by 30 publications

(18 citation statements)

References 17 publications

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“…Moreover, a multivariate regression demonstrated that hemoglobin improvement can predict lower health-care costs. Hemoglobin has been proposed as a valuable marker of nutritional status [ 32 ]. Serum levels of hemoglobin are a biochemical indicator routinely used by clinicians to monitor nutritional status in chronically critically ill patients [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Health-Care Costs, Glycemic Control and Nutritional Status in Malnourished Older Diabetics Treated with a Hypercaloric Diabetes-Specific Enteral Nutritional Formula

et al. 2016

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Diabetes-specific formulas are an effective alternative for providing nutrients and maintaining glycemic control. This study assesses the effect of treatment with an oral enteral nutrition with a hypercaloric diabetes-specific formula (HDSF) for one year, on health-care resources use, health-care costs, glucose control and nutritional status, in 93 type-2 diabetes mellitus (T2DM) malnourished patients. Changes in health-care resources use and health-care costs were collected the year before and during the year of intervention. Glucose status and nutritional laboratory parameters were analyzed at baseline and one-year after the administration of HDSF. The administration of HDSF was significantly associated with a reduced use of health-care resources, fewer hospital admissions (54.7%; p < 0.001), days spent at hospital (64.1%; p < 0.001) and emergency visits (57.7%; p < 0.001). Health-care costs were reduced by 65.6% (p < 0.001) during the intervention. Glycemic control (short- and long-term) and the need of pharmacological treatment did not change, while some nutritional parameters were improved at one year (albumin: +10.6%, p < 0.001; hemoglobin: +6.4%, p = 0.026). In conclusion, using HDSF in malnourished older type-2 diabetic patients may allow increasing energy intake while maintaining glucose control and improving nutritional parameters. The use of health-care resources and costs were significantly reduced during the nutritional intervention.

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Section: Discussionmentioning

confidence: 99%

Health-Care Costs, Glycemic Control and Nutritional Status in Malnourished Older Diabetics Treated with a Hypercaloric Diabetes-Specific Enteral Nutritional Formula

et al. 2016

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“…Blood biomarker concentrations often vary with age, sex, race, diet, metabolism, and disease status [ 12 ]. The applicability of traditional cut-off values previously set for the general population is questionable for determining malnutrition in older people [ 13 ]. Reliance on the conventional threshold values may result in misdiagnosis of malnutrition.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Blood Biomarkers Associated with Risk of Malnutrition in Older Adults: A Systematic Review and Meta-Analysis

et al. 2017

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Malnutrition is a common yet under-recognized problem in hospitalized patients. The aim of this paper was to systematically review and evaluate malnutrition biomarkers among order adults. Eligible studies were identified through Cochrane, PubMed and the ProQuest Dialog. A meta-regression was performed on concentrations of biomarkers according to malnutrition risks classified by validated nutrition assessment tools. A total of 111 studies were included, representing 52,911 participants (55% female, 72 ± 17 years old) from various clinical settings (hospital, community, care homes). The estimated BMI (p < 0.001) and concentrations of albumin (p < 0.001), hemoglobin (p < 0.001), total cholesterol (p < 0.001), prealbumin (p < 0.001) and total protein (p < 0.05) among subjects at high malnutrition risk by MNA were significantly lower than those without a risk. Similar results were observed for malnutrition identified by SGA and NRS-2002. A sensitivity analysis by including patients with acute illness showed that albumin and prealbumin concentrations were dramatically reduced, indicating that they must be carefully interpreted in acute care settings. This review showed that BMI, hemoglobin, and total cholesterol are useful biomarkers of malnutrition in older adults. The reference ranges and cut-offs may need to be updated to avoid underdiagnosis of malnutrition.

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“…M any circulating biomarkers change with age independently of disease. 1 Characterizing age-adjusted distributions of these biomarkers in healthy older adults would therefore be important to increase specificity of diagnosis, inform treatment and prevention, and limit unnecessary procedures and treatments. Despite the fact that people aged 85 and older are the fastest growing age segment of the population, 2 characterization of many circulating biomarkers for this age group are incomplete, and changes at extreme old ages are predicted from mathematical models.…”

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confidence: 99%

Age and Sex Distributions of Age‐Related Biomarker Values in Healthy Older Adults from the Long Life Family Study

Sebastiani

Thyagarajan

Sun

et al. 2016

J American Geriatrics Society

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Background and Objectives Many laboratory tests have normal ranges that change with age. While people older than 85 years of age are the fastest growing age group, distributions for such tests at extreme old ages are unknown. Design Cross-sectional cohort study. Settings International cohort study. Participants Participants of the Long Life Family Study (LLFS, n=~5,000, age range 25 to 110 years, median age 67, 45% males). Measurements Serum biomarkers were selected based on association with aging-related diseases and included: complete blood count, lipids (triglycerides, HDL-c, LDL-c and total cholesterol), 25-OH vitamin D2 and D3, and vitamin D epi-isomer, diabetes related biomarkers (adiponectin, insulin, insulin-like growth factor 1 (IGF1), glucose, hemoglobin A1C, soluble receptor for advanced glycation end-product (sRAGE)), kidney disease related biomarkers (albumin, creatinine, cystatin), endocrine biomarkers (dehydroepiandrosterone (DHEA), and sex-hormone binding globulin (SHBG), testosterone) markers of inflammation (interleukin 6 (IL6), high-sensitive C-reactive protein, NT-proBNP), ferritin, and transferrin. Results Out of 38 measured biomarkers, 34 were significantly correlated with age. Summary statistics were generated for all biomarkers according to sex and 5-year age increments, spanning 50 to 100+ years, after exclusion of participants with diseases and treatments that were associated with biomarkers. We also generated a biomarker dataset that will be useful for other investigators seeking to compare biomarker levels across studies. Conclusion Levels of several biomarkers change with older age in healthy individuals. The descriptive statistics that we have identified herein will be useful in future studies and, if replicated in additional studies, might become useful also in clinical practice. The availability of the reference dataset will facilitate appropriate calibration of biomarkers measured in different laboratories.

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Analyses of laboratory data and establishment of reference values and intervals for healthy elderly people

Cited by 30 publications

References 17 publications

Health-Care Costs, Glycemic Control and Nutritional Status in Malnourished Older Diabetics Treated with a Hypercaloric Diabetes-Specific Enteral Nutritional Formula

Health-Care Costs, Glycemic Control and Nutritional Status in Malnourished Older Diabetics Treated with a Hypercaloric Diabetes-Specific Enteral Nutritional Formula

Evaluation of Blood Biomarkers Associated with Risk of Malnutrition in Older Adults: A Systematic Review and Meta-Analysis

Age and Sex Distributions of Age‐Related Biomarker Values in Healthy Older Adults from the Long Life Family Study

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