Is Malnutrition Overdiagnosed in Older Hospitalized Patients? Association Between the Soluble Interleukin-2 Receptor and Serum Markers of Malnutrition

Rosenthal, Amy J.; Sanders, Karen M.; McMurtry, Cynthia T.; Jacobs, Mary Ann; Thompson, Dakota; Gheorghiu, David; Little, Kathy L.; Adler, Robert A.

doi:10.1093/gerona/53a.2.m81

Cited by 34 publications

(24 citation statements)

References 23 publications

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“…When serum albumin decreased by 1 g=l, the odds of being classified as malnourished increased 1.1 times in both tools. Serum albumin as an indicator of malnutrition is criticized (Rosenthal et al, 1998), but the results show that serum albumin was significantly associated with the classifications. Severe hypoalbuminaemia is shown to be a strong predictor of mortality (Ferguson et al, 1993).…”

Section: Discussionmentioning

confidence: 96%

“…It is well known that serum proteins (Fleck, 1988;Boosalis et al, 1989;Rosenthal et al, 1998) and anthropomerty (Gibson, 1990;de Onis & Habicht, 1996;Thuluvath & Triger, 1995) are affected by other factors in addition to nutritional status. To minimize these influences on the objective assessment, two or more parameters below reference values were used, including one anthropometrical parameter and one serum protein measurement.…”

Section: Discussionmentioning

confidence: 99%

“…However, the measurement of both anthropometric and biochemical values has its shortcomings (Charney, 1995) and the presence of only one parameter has, in some circumstances, low specificity (Jeejeebhoy et al, 1990). Anthropometry, which is the core-measurement (de Onis & Habicht, 1996;Lansey et al, 1993), is affected by for example, fluid retention and serum proteins by, for example, the function of the liver (Thuluvath & Triger, 1995), inflammation (Rosenthal et al, 1998) and chronic stress (Fleck, 1988;Boosalis et al, 1989). When malnutrition has been estimated using a combination of at least one anthropometrical and one biochemical variable, the sensitivity increases (Symreng et al, 1983;Lansey et al, 1993).…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of nutritional assessment techniques in elderly people newly admitted to municipal care

2002

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Objectives: To evaluate the Subjective Global Assessment (SGA) and the Mini Nutritional Assessment (MNA) with regard to validity using a combination of anthropometric and serum-protein measurements as standard criteria to assess protein-energy malnutrition (PEM). Design: Cross-sectional study with consecutive selection of residents aged ! 65 y. Setting: A municipality in the south of Sweden. Subjects: During a year, starting in October 1996, 148 females and 113 males, aged ! 65 -104 y of age, newly admitted to special types of housing for the elderly, were included in the study. Results: According to SGA, 53% were assessed as malnourished or moderately malnourished on admission. The corresponding figure from MNA was 79% malnourished or at risk of malnutrition. Both tools indicated that anthropometric values and serum proteins were significantly lower in residents classified as being malnourished (P < 0.05). Sensitivity in detecting PEM was in SGA 0.93 and in MNA 0.96 and specificity was 0.61 and 0.26, respectively. Using regression analysis, weight index and serum albumin were the best objective nutritional parameters in predicting the SGA-and MNA classifications. Item 'muscle wasting' in SGA and 'self-experienced health status' in MNA showed most predictive power concerning the odds of being assessed as malnourished. Conclusions: SGA was shown to be the more useful tool in detecting residents with established malnutrition and MNA in detecting residents who need preventive nutritional measures.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of nutritional assessment techniques in elderly people newly admitted to municipal care

2002

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“…The protein malnutrition observed in the enrolled patients is also a common finding in the elderly [2,3,17]. In aged patients, serum albumin has been proposed as an indicator of skeletal muscles [18] and as a prognostic index of morbidity [19,20].…”

Section: Discussionmentioning

confidence: 99%

Nutritional Markers, Acute Phase Reactants and Tissue Inhibitor of Matrix Metalloproteinase 1 in Elderly Patients with Pressure Sores

et al. 2002

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Background: Loss of collagen and elastin is observed in the elderly. In geriatric inpatients, chronic protein malnutrition could induce susceptibility to additional morbidity such as pressure sores. Objective: The purpose of this study was to explore the relationship between nutritional and inflammatory status and the production of tissue inhibitor of matrix metalloproteinase 1 (TIMP-1). Methods: Chronically ill elderly inpatients, without or with pressure sores, were enrolled. Nutritional protein markers, acute phase reactants, and TIMP-1 were determined, and changes in these biological parameters were compared. Results: Chronic inflammatory process and protein malnutrition were observed in all enrolled patients. The severity of these two pathophysiological processes was independent of the occurrence of pressure sores. The serum prealbumin and albumin levels were lower in patients with pressure sores than in those without. In addition, the general increase in the TIMP-1 level was independent of the occurrence of pressure sores. The TIMP-1 level was mainly related to the prognostic inflammatory and nutritional index. Conclusions: The general increase in acute-phase reactants observed in the elderly could be related to the intercurrent diseases. The generally low serum albumin level, lowest in patients with pressure sores, may be considered evidence of protein malnutrition and hypercatabolism. Regarding the morbidity, the increase in TIMP-1 levels could be explained as an adaptive process to prevent intrinsic protein expenditure of extracellular matrices.

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“…Les protéines à demivie courte sont les plus sensibles car leurs taux plasmatiques varient rapidement lors du déficit nutritionnel. Au cours des états d'agression, les taux des protéines nutritionnelles diminuent de façon inversement proportionnelle à l'élévation des cytokines plasmatiques ce qui oblige à connaître l'état inflammatoire d'un malade pour pouvoir interpréter son état nutritionnel[32].Dépistag ge de la dénutrition chez l'adulte hospitalisé en CS ou SSR…”

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Outils et procédures de dépistage de la dénutrition et de son risque en milieu hospitalier

Hasselmann

Alix

2003

Nutrition Clinique et Métabolisme

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Is Malnutrition Overdiagnosed in Older Hospitalized Patients? Association Between the Soluble Interleukin-2 Receptor and Serum Markers of Malnutrition

Cited by 34 publications

References 23 publications

Evaluation of nutritional assessment techniques in elderly people newly admitted to municipal care

Evaluation of nutritional assessment techniques in elderly people newly admitted to municipal care

Nutritional Markers, Acute Phase Reactants and Tissue Inhibitor of Matrix Metalloproteinase 1 in Elderly Patients with Pressure Sores

Outils et procédures de dépistage de la dénutrition et de son risque en milieu hospitalier

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