Efficacy of Corrected Rapid Turnover Protein Increment Index (CRII) for Early Detection of Improvement of Nutrition Status in Patients with Malnutrition

Abstract

Serum prealbumin level is useful for assessment of changes in nutritional status but it is markedly affected by the inflammation. In this study, we examined the efficacy of the corrected rapid turnover protein increment index (CRII) for prealbumin, which is calculated as [prealbumin level/C-reactive protein (CRP) level on the assessment day]/[prealbumin level/CRP level on the day of starting nutritional care], for prediction of improvement of nutritional status in patients with malnutrition. The subjects were 50 hospitalized patients with low albuminemia, who were receiving nutritional care. Serum concentrations of albumin, prealbumin and CRP were measured every week for 5 weeks. We defined patients whose serum albumin level was elevated by more than 0.2 g/dl after 5 weeks as those showing improved nutritional status. There was a significant difference in the prealbumin level between improved and unimproved patients at 5 weeks after the start of nutritional support. On the other hand, the prealbumin CRII value showed a significant difference between the groups at 1 and 2 weeks after the start of nutritional support. In conclusion, assessment of prealbumin CRII is useful for early prediction of improved nutritional status in patients with malnutrition.

Leptin is better than any other biological parameter for monitoring the efficacy of renutrition in hospitalized malnourished elderly patients

“…The purpose of this study was to determine which biological parameter(s) could best monitor efficacy of renutrition, itself considered successful when a patient gained at least 5% of weight. The biological marker most frequently used for this purpose is serum transthyretin concentration, which reacts quickly to any change in nutritional status and nitrogen accretion, 8,26 although its specificity has long been a subject of debate 4–7 . In reality, serum transthyretin and serum albumin are influenced by haemoconcentration and inflammation 4–6 .…”

“…The biological marker most frequently used for this purpose is serum transthyretin concentration, which reacts quickly to any change in nutritional status and nitrogen accretion, 8,26 although its specificity has long been a subject of debate. [4][5][6][7] In reality, serum transthyretin and serum albumin are influenced by haemoconcentration and inflammation. [4][5][6] This is well illustrated in our study which, despite a relatively small number of patients, found that changes in transthyretin concentrations were highly negatively correlated with changes in CRP levels and highly positively correlated with changes in albumin concentrations, but were not associated with successful renutrition.…”

“…There are plenty of studies describing biological markers for follow‐up of renutrition. The marker most frequently used for this purpose is serum transthyretin, although its specificity has been a matter of debate for many years 4–7 . Transthyretin offers the advantage of a short half‐life at only 48 h and its concentration therefore reacts quickly to any change in nutritional status 8 .…”

“…Transthyretin offers the advantage of a short half‐life at only 48 h and its concentration therefore reacts quickly to any change in nutritional status 8 . However, as the concentration of transthyretin, like albumin, is influenced by haemoconcentration and inflammation, 4–6 these parameters may not be appropriate as indicators of nutritional status in elderly populations, who often suffer from heart failure (oedema) or chronic disease with inflammatory or/and septic complications 9,10 . Other biological parameters are sometimes used, such as insulin‐like growth factor‐1 (IGF‐1), which has essentially anabolic activity, associated with IGF‐binding proteins (IGFBPs) 11,12 .…”

“…The marker most frequently used for this purpose is serum transthyretin, although its specificity has been a matter of debate for many years. [4][5][6][7] Transthyretin offers the advantage of a short half-life at only 48 h and its concentration therefore reacts quickly to any change in nutritional status. 8 However, as the concentration of transthyretin, like albumin, is influenced by haemoconcentration and inflammation, 4-6 these parameters may not be appropriate as indicators of nutritional status in elderly populations, who often suffer from heart failure (oedema) or chronic disease with inflammatory or/and septic complications.…”