Nutritional status and laboratory parameters among internal medicine inpatients

Demir, MV; Tamer, Ali; Cinemre, Hakan; Uslan, Mustafa İhsan; Yaylacı, Selçuk; Erkorkmaz, Ünal

doi:10.4103/1119-3077.158145

“…The fairly stable (compared with 1- and 2-way circuits) FFA levels were associated with a significant increase in human albumin concentration—this may be due to the fact that any excess FFA in the 3-way 35%AT and 25%AT conditions was bound to albumin, and hence not detectable in the media. These results are coherent with in-vivo findings, as several studies on humans report a positive correlation between elevated serum albumin levels, nutritional status and body mass index (BMI), likely associated with albumin’s role as a carrier of FFAs [ 40 , 41 ].…”

Section: Discussionsupporting

confidence: 85%

Systemic and vascular inflammation in an in-vitro model of central obesity

Ahluwalia

¹

,

Misto

²

,

Vozzi

³

et al. 2018

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Metabolic disorders due to over-nutrition are a major global health problem, often associated with obesity and related morbidities. Obesity is peculiar to humans, as it is associated with lifestyle and diet, and so difficult to reproduce in animal models. Here we describe a model of human central adiposity based on a 3-tissue system consisting of a series of interconnected fluidic modules. Given the causal link between obesity and systemic inflammation, we focused primarily on pro-inflammatory markers, examining the similarities and differences between the 3-tissue model and evidence from human studies in the literature. When challenged with high levels of adiposity, the in-vitro system manifests cardiovascular stress through expression of E-selectin and von Willebrand factor as well as systemic inflammation (expressing IL-6 and MCP-1) as observed in humans. Interestingly, most of the responses are dependent on the synergic interaction between adiposity and the presence of multiple tissue types. The set-up has the potential to reduce animal experiments in obesity research and may help unravel specific cellular mechanisms which underlie tissue response to nutritional overload.

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“…The fairly stable (compared with 1and 2-way circuits) FFA levels were associated with a significant increase in human albumin concentrationthis may be due to the fact that any excess FFA in the 3-way 35%AT and 25%AT conditions was bound to albumin, and hence not detectable in the media. These results are coherent with in-vivo findings, as several studies on humans report a positive correlation between elevated serum albumin levels, nutritional status and body mass index (BMI), likely associated with albumin's role as a carrier of FFAs [37,38]. Adipose tissue is an important source of inflammatory cytokine production and obesity is regarded as a state of chronic, low-grade inflammation [3].…”

Section: Discussionsupporting

confidence: 69%

Systemic and vascular inflammation in an in-vitro model of central obesity

Ahluwalia

¹

,

Misto

²

,

Vozzi

³

et al. 2017

Preprint

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Metabolic disorders due to over-nutrition are a major global health problem, often associated with obesity and related morbidities. Obesity is peculiar to humans, as it is associated with lifestyle and diet, and so difficult to reproduce in animal models.Here we describe a model of human central adiposity based on a 3-tissue system consisting of a series of interconnected fluidic modules. Given the causal link between obesity and systemic inflammation, we focused primarily on pro-inflammatory markers, examining the similarities and differences between the 3-tissue model and evidence from human studies in the literature. When challenged with high levels of adiposity, the in-vitro system manifests cardiovascular stress through expression of E-selectin and von Willebrand factor as well as systemic inflammation (expressing IL-6 and MCP-1) as observed in humans. Interestingly, most of the responses are dependent on the synergic interaction between adiposity and the presence of multiple tissue types. The set-up has the potential to reduce animal experiments in obesity research and may help unravel specific cellular mechanisms which underlie tissue response to nutritional overload. Keywords: Obesity, multi-organ model, endogenous metabolism, inflammation IntroductionOverweight and obesity are major risk factors for a number of chronic diseases, including diabetes [1], cardiovascular diseases and cancer [2]. Since the turn of the century, the number of obese adults has increased to over 300 million. Obese individuals often have excess central visceral adiposity, a condition that contributes to a chronic increase in circulating free fatty acids and metabolites, such as glycerol and triglycerides. These metabolites in turn activate various signaling cascades that interfere with insulin signaling and β-cell function, further contributing to gluco/lipotoxicity [3]. A great deal of research has been dedicated to delineate the etiopathogenic mechanisms of obesity and diabetes using animal models. The most widely employed models of obesity are rodents, either mutant or genetically engineered mice or rats in which adiposity is induced by prolonged feeding on high fat diets [4,5]. As succinctly put by Wang et al, "despite the extensive use of these rodent models, many mechanistic details of human metabolism remain poorly understood and treatment options for humans are limited and largely unsatisfactory" [6]. Indeed, we now know much about the details of rodent metabolism, but still lack a detailed understanding of the mechanisms underlying human glucose homeostasis and response to chronic over-nutrition as well as human obesity related comorbidities and responses to interventions [7]. Besides the evident differences between human and rodent lifespan, diet, and basic biology, animal models are not amenable to dissociation of metabolite dynamics in different tissues and

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“…A majority of the studies represented a cross-sectional design since assessment of nutrition status and analysis of biomarkers were generally carried out within 48 hours of admission for inpatients or at baseline for non-hospitalized subjects. Several studies considered gender or age as confounding variables and presented biomarker levels separately for men and women [ 22 , 23 , 24 , 25 ] or for age greater than 65 or not [ 26 ]. Correlation coefficients for men and women respectively were reported in 3 studies [ 23 , 27 , 28 ].…”

Section: Resultsmentioning

confidence: 99%

“…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

Zhang

¹

,

Pereira

²

,

Luo

³

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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Nutritional status and laboratory parameters among internal medicine inpatients

Abstract: Malnutrition risk is high among internal medicine inpatients and risk seems to be higher among older patients. Nutritional screening of geriatric patients, close follow-up and providing earlier health care would contribute rehabilitation of chronic diseases and decrease re-admissions.

Cited by 13 publications

References 15 publications

Systemic and vascular inflammation in an in-vitro model of central obesity

Systemic and vascular inflammation in an in-vitro model of central obesity

Systemic and vascular inflammation in an in-vitro model of central obesity

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

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