Markers of the Nutritional Status in Acutely Ill Elderly Patients

Finucane, Paul; Rudra, Tapash; Hsu, Ronald; Tomlinson, K.; Hutton, R.D. Cheryl W.; Pathy, M. S.

doi:10.1159/000212971

Cited by 17 publications

(6 citation statements)

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“…In acutely ill elderly patients, previous authors (Finucane et al, 1988) found no correlation between transferrin and some indirect indexes of body composition as arm muscle area and triceps skinfold thickness. They concluded that plasma transferrin is not a useful marker of the nutritional status.…”

Section: Discussionmentioning

confidence: 82%

“…Probably other factors, beside malnutrition, could influence transferrin values. It is already known that transferrin levels increases in iron deficiency anemia and decreases in hepatic cirrhosis, iron overload and acute and chronic infections (Finucane et al, 1988).…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, prealbumin and RPB increase in renal failure. Transferrin is influenced by many conditions common in old age beside malnutrition, while it raises in iron deficiency anemia (Finucane et al, 1988).…”

Section: Introductionmentioning

confidence: 99%

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Role of visceral proteins in detecting malnutrition in the elderly

et al. 2005

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Objective: In the clinical practice, visceral proteins are used as indirect markers of protein energy malnutrition (PEM), but their reliability could be reduced with advancing age. The aim of this work is to investigate the reliability of albumin, prealbumin, retinol-binding protein (RBP) and transferrin in evaluating nutritional status in old patients and their relationship with fat-free mass (FFM). Design: Cross-sectional study. Setting: Padua, Italy. Subjects: In 44 underweight (body mass indexo20 kg/m 2 ) (66-97 years) and 69 normal weight or overweight elderly subjects (62-98 years), albumin, prealbumin, transferrin and RBP were determined in the plasma. Body composition and particularly FFM was obtained by dual X-ray absorptiometry. FFM was also expressed as FFM index (FFMI) calculated as FFM divided by height squared. Subjects affected by acute illnesses and inflammatory states were excluded. Results: Albumin, prealbumin and RBP mean values were significantly lower in underweight subjects. No differences between two groups were found for transferrin. Albumin prealbumin and RBP resulted under the normal range in 55, 25 and 54% of underweight subjects, respectively. Transferrin's values were low in about 40% of underweight and normal weight subjects, respectively. In all subjects, FFMI shows a significant correlation with albumin (r: 0.52), prealbumin (r: 0.64) and RBP (r: 0.57). No correlation between FFMI and transferrin was found. Conclusions: Visceral proteins, except for transferrin, seem to be useful indexes in detecting malnutrition in the elderly; low values still in the normal range should also be carefully evaluated because they could suggest a poor nutritional status.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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Role of visceral proteins in detecting malnutrition in the elderly

et al. 2005

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“…Using the same reference ranges, low protein con centrations were present in 10-26%, and un satisfactory vitamin values in 10-37% of our patients. Other studies investigating protein concentrations in geriatric patients showed even higher proportions of low concentra tions or lower mean values, especially for albumin [4,5,12,14,18]. In institutionalized elderly, wide ranges of values have been re ported [46,47,52,53], Similarly, reports on vitamin values are conflicting.…”

Section: Nutritional Statusmentioning

confidence: 99%

Malnutrition in Geriatric Patients: Diagnostic and Prognostic Significance of Nutritional Parameters

Volkert¹,

Kruse²,

Oster³

et al. 1992

Ann Nutr Metab

105

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Nutritional status was assessed in 300 geriatric patients aged 75 years or more using clinical, anthropometric, biochemical and immunologic methods. Relations between different assessment methods and their prognostic significance with regard to 18-month mortality were examined. For biochemical variables 10% (prealbumin, vitamin B₆) to 37% (vitamins A and C) were below conventional limits. In 44% of the patients lymphocytes were diminished. 44% were anergic. Judgement of nutritional status by clinical impression resulted in 22% being deemed undernourished. Clinical diagnosis of undernutrition was associated with low anthropometric measurements (p < 0.05 for all parameters) and a high prevalence of low biochemical values (p < 0.05 for albumin, prealbumin, transferrin, vitamin A, vitamin B₁). The mean values of all anthropometric variables, plasma proteins, vitamins A and C were significantly lower in patients who died within the following 18 months compared to survivors. The greatest prognostic significance was related to the clinical diagnosis of malnutrition. We conclude that clinical assessment is useful for the evaluation of nutritional status in geriatric patients and the best of numerous nutritional parameters to estimate risk of long-term mortality.

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“…erheblich einschränkt. [16][17][18]. Da seine Serumkonzentration im Alter um 0,8 g/l pro Altersdekade abnimmt, gilt Albumin als der beste Marker zur Abschätzung des "biologischen Alters" [19].…”

Section: Serumproteineunclassified

Grenzen und Bedeutung der Labordiagnostik bei Mangelernährung im Alter

Lapin

2006

Wien Med Wochenschr

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Despite the widespread interest in malnutrition in the elderly, the utility of laboratory tests is limited. This is because their diagnostic significance can be impaired by undercurrent diseases, pre-analytical effects and unsatisfactory standardization. This survey summarizes the most important parameters of malnutrition. Thus, "nitrogen balance" is considered the golden standard of nutrition status, while the diagnostic significance of serum proteins depends on their biological half-time. Albumin is seen as the most reliable malnutrition marker, but cholinesterase and cholesterol-decrease must also be mentioned. The so-called "low-T3-phenomenon" which is caused by the production of "reverse T3", seems to be the unique parameter for the "catabolic" state of metabolism. Of special interest are also prognostic markers of mortality, such as orosomucoid. Cytokines, other signal peptides, trace elements and vitamins are from the diagnostic point of view of rather limited significance. In sum, the diagnosis and monitoring of malnutrition in the elderly represents an important challenge for laboratory medicine.

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Markers of the Nutritional Status in Acutely Ill Elderly Patients

Cited by 17 publications

References 1 publication

Role of visceral proteins in detecting malnutrition in the elderly

Role of visceral proteins in detecting malnutrition in the elderly

Malnutrition in Geriatric Patients: Diagnostic and Prognostic Significance of Nutritional Parameters

Grenzen und Bedeutung der Labordiagnostik bei Mangelernährung im Alter

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