Limited utility of adipokine levels in the diagnosis of malnutrition in the elderly

Akın, Sibel; Tufan, Fatih; Bulut, Leyla; Genç, Sema Yılmaz; Bahat, Gülistan; Saka, Bülent; Erten, Nilgün; Karan, Mehmet Akif

doi:10.1007/s40520-013-0158-y

Cited by 4 publications

(5 citation statements)

References 27 publications

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“…Leptin secretion is proportional to the adipocyte mass [ 37 ] and to malnutrition results in hypoleptinemia. Accordingly, a low leptin level has often (but not always) been associated with a low BMI and a low MNA score in adults with malnutrition [ 3 , 4 , 5 , 6 , 7 ], as was the case in our study population. In contrast to a previous study of adults having undergone colorectal cancer surgery, we did not find that a low BMI was associated with HAI [ 38 ].…”

Section: Discussionsupporting

confidence: 57%

“…The median (range) age was 84.8 (75–101) years, and 168 (72.4%) of the 232 participants were female ( Table 1 ). The median (IQR) CIRS-G and ADL scores were 11 [ 9 , 10 , 11 , 12 , 13 , 14 ] and 8 [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ], respectively. According to the MNA, 50 participants (21.6%) showed malnutrition and 125 (53.9%) were at risk of malnutrition.…”

Section: Resultsmentioning

confidence: 99%

“…Serum leptin levels are correlated with fat mass [ 2 ], and are thus higher in women than in men. Some studies [ 3 , 4 , 5 , 6 ] (but not others [ 7 ]) have observed an association between low leptin levels and malnutrition in patients with severe chronic diseases (such as kidney failure and cirrhosis), independently of the level of inflammation or the fluid balance. Furthermore, a growing body of evidence suggests that leptin can also regulate immune function [ 8 ] (especially T lymphocyte function [ 9 , 10 ]) and may be involved in the response to infection [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Serum Leptin Levels, Nutritional Status, and the Risk of Healthcare-Associated Infections in Hospitalized Older Adults

et al. 2022

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We aimed to determine whether serum leptin levels are predictive of the occurrence of healthcare-associated infections (HAIs) in hospitalized older patients. In a prospective cohort, 232 patients had available data for leptin and were monitored for HAIs for 3 months. Admission data included comorbidities, invasive procedures, the Mini Nutritional Assessment (MNA), BMI, leptin, albumin and C-reactive protein levels, and CD4 and CD8 T-cell counts. Multivariate logistic regression modelling was used to identify predictors of HAIs. Of the 232 patients (median age: 84.8; females: 72.4%), 89 (38.4%) experienced HAIs. The leptin level was associated with the BMI (p < 0.0001) and MNA (p < 0.0001) categories. Women who experienced HAIs had significantly lower leptin levels than those who did not (5.9 μg/L (2.6–17.7) and 11.8 (4.6–26.3), respectively; p = 0.01; odds ratio (OR) (95% confidence interval): 0.67 (0.49–0.90)); no such association was observed for men. In a multivariate analysis of the women, a lower leptin level was significantly associated with HAIs (OR = 0.70 (0.49–0.97)), independently of comorbidities, invasive medical procedures, and immune status. However, leptin was not significantly associated with HAIs after adjustments for malnutrition (p = 0.26) or albuminemia (p = 0.15)—suggesting that in older women, the association between serum leptin levels and subsequent HAIs is mediated by nutritional status.

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Section: Discussionsupporting

confidence: 57%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Serum Leptin Levels, Nutritional Status, and the Risk of Healthcare-Associated Infections in Hospitalized Older Adults

et al. 2022

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“…Correlation coefficients for men and women respectively were reported in 3 studies [ 23 , 27 , 28 ]. A number of studies also presented regression associations [ 26 , 29 , 30 , 31 , 32 , 33 , 34 ] or correlation coefficients [ 35 , 36 , 37 , 38 , 39 ] adjusted for potential confounding variables, including age, gender, BMI, and morbidities. However, no study has presented confounder-adjusted biomarker level estimates.…”

Section: Resultsmentioning

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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“…Recently, adipokines, substances produced specifically by adipocytes, whose synthesis and secretion are regulated by nutritional status, have become a target of interest in studies involving older adults [ 14 , 15 , 16 , 17 ]. Leptin, acting on the central nervous system, regulates food intake.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Selected Parameters of Oxidative Stress and Adipokine Levels in Hospitalized Older Patients with Diverse Nutritional Status

et al. 2023

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Malnutrition is classified as one of the Giant Geriatric Syndromes. It carries serious consequences, such as sarcopenia or depression, which lead to functional disability. The main objective of this study was to identify parameters of oxidative stress and adipokines, which may be potential biomarkers of malnutrition in hospitalized older patients. During the study, selected parameters were determined in 137 senile patients, taking into account their nutritional status determined according to the Mini Nutritional Assessment (MNA), as well as an additional tool, namely the Geriatric Nutritional Risk Index (GNRI). Leptin and resistin were determined as the parameters with statistically significant differences between the patients classified according to the MNA. This phenomenon was confirmed using the GNRI classification. However, additional parameters for which differences were observed include the oxidized low-density lipoprotein level and activity of glutathione peroxidase. In conclusion, the determination of the mentioned markers in hospitalized senile patients as an adjunct to the routine assessment of nutritional status might be suggested to identify the early risk of malnutrition so that a personalized nutritional therapy can be implemented as early as possible.

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Limited utility of adipokine levels in the diagnosis of malnutrition in the elderly

Abstract: Adipokine levels do not seem to give relevant information in nutritional state assessment.

Cited by 4 publications

References 27 publications

Serum Leptin Levels, Nutritional Status, and the Risk of Healthcare-Associated Infections in Hospitalized Older Adults

Serum Leptin Levels, Nutritional Status, and the Risk of Healthcare-Associated Infections in Hospitalized Older Adults

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

Evaluation of Selected Parameters of Oxidative Stress and Adipokine Levels in Hospitalized Older Patients with Diverse Nutritional Status

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