Should Albumin and Prealbumin Be Used as Indicators for Malnutrition?

Marcason, Wendy

doi:10.1016/j.jand.2017.04.018

Cited by 51 publications

(38 citation statements)

References 3 publications

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“…Because low BMI is included in the existing RD diagnosis, we would expect it to perform reasonably well. However, serum albumin level is not included in the RD diagnosis and was only included due to its previous use by other investigators . Like those investigators, we do not recommend using low serum albumin level as an indicator of malnutrition in hospitalized patients because serum albumin level is an acute phase reactant and plasma levels are decreased in a number of disease states unrelated to nutrition status such as injury, inflammation, sepsis, fluid shifts and anasarca, and synthetic liver dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…However, serum albumin level is not included in the RD diagnosis and was only included due to its previous use by other investigators. 21,22 Like those investigators, we do not recommend using low serum albumin level as an indicator of malnutrition in hospitalized patients because serum albumin level is an acute phase reactant and plasma levels are decreased in a number of disease states unrelated to nutrition status such as injury, inflammation, sepsis, fluid shifts and anasarca, and synthetic liver dysfunction. MMS aims to inform the development of an objective screening protocol by providing a quantitative assessment of muscle and fat, independent of factors such as BMI and serum albumin level, to better characterize body changes caused by malnutrition.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Morphomic Malnutrition Score: A Standardized Screening Tool for Severe Malnutrition in Adults

Lee

Raymond

Derstine

et al. 2018

J Parenter Enteral Nutr

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Morphomic Malnutrition Score: A Standardized Screening Tool for Severe Malnutrition in Adults

Lee

Raymond

Derstine

et al. 2018

J Parenter Enteral Nutr

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“…Some have concluded that this is antiquated thinking and ignores the fact that albumin is a negative acute phase reactant and that cancer can be considered as an inflammatory condition [3,4], and this may in part explain the prognostic value of albumin in patients with cancer. Also, serum albumin concentrations do not change in response to short-term changes in nutrient intake and in states of malnutrition [5][6][7].…”

Section: Introductionmentioning

confidence: 95%

Hypoalbuminemia Reflects Nutritional Risk, Body Composition and Systemic Inflammation and Is Independently Associated with Survival in Patients with Colorectal Cancer

Almasaudi

Dolan

Edwards

et al. 2020

Cancers

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It has long been recognized that albumin has prognostic value in patients with cancer. However, although the Global Leadership Initiative on Malnutrition GLIM criteria (based on five diagnostic criteria, three phenotypic criteria and two etiologic criteria) recognize inflammation as an important etiologic factor in malnutrition, there are limited data regarding the association between albumin, nutritional risk, body composition and systemic inflammation, and whether albumin is associated with mortality independent of these parameters. The aim of this study was to examine the relationship between albumin, nutritional risk, body composition, systemic inflammation, and outcomes in patients with colorectal cancer (CRC). A retrospective cohort study (n = 795) was carried out in which patients were divided into normal and hypoalbuminaemic groups (albumin <35 g/L) in the presence and absence of a systemic inflammatory response C-reactive protein (CRP >10 and <10 mg/L, respectively). Post-operative complications, severity of complications and mortality were considered as outcome measures. Categorical variables were analyzed using Chi-square test χ 2or linear-by-linear association. Survival data were analyzed using univariate and multivariate Cox regression. In the presence of a systemic inflammatory response, hypoalbuminemia was directly associated with Malnutrition Universal Screening Tool MUST (p < 0.001) and inversely associated with Body Mass Index BMI (p < 0.001), subcutaneous adiposity (p < 0.01), visceral obesity (p < 0.01), skeletal muscle index (p < 0.001) and skeletal muscle density (p < 0.001). There was no significant association between hypoalbuminemia and either the presence of complications or their severity. In the absence of a systemic inflammatory response (n = 589), hypoalbuminemia was directly associated with MUST (p < 0.05) and inversely associated with BMI (p < 0.01), subcutaneous adiposity (p < 0.05), visceral adiposity (p < 0.05), skeletal muscle index (p < 0.01) and skeletal muscle density (p < 0.001). Hypoalbuminemia was, independently of inflammatory markers, associated with poorer cancer-specific and overall survival (both p < 0.001). The results suggest that hypoalbuminemia in patients with CRC reflects both increased nutritional risk and greater systemic inflammatory response and was independently associated with poorer survival in patients with CRC.

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“…Albumin is an acute phase reactant that can be decreased in infections (Wierdak et al 2018). The association of albumin with the nutritional status is controversial and apparently varies among patient populations (Fuhrman et al 2004;Kuzuya et al 2007;Baron et al 2010;Gama-Axelsson et al 2012;Fruchtenicht et al 2015;Academy of Nutrition and Dietetics 2016;Bharadwaj et al 2016;Marcason 2017). Other laboratory parameters were also disturbed in SCAP patients (such as platelets, liver function, and natriuretic peptide), but whether they are causes or consequences of SCAP is unknown.…”

Section: Discussionmentioning

confidence: 99%

Anemia and Low Albumin Levels Are Associated with Severe Community-Acquired Pneumonia in Pregnancy: A Case-Control Study

Mai

et al. 2019

Tohoku J. Exp. Med.

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Community-acquired pneumonia (CAP) is the most common form of pneumonia in pregnancy and may lead to severe adverse maternal and fetal outcomes. Severe CAP (SCAP) is defined as the need for invasive mechanical ventilation and with septic shock with the need for vasopressors. This study aimed to analyze the clinical characteristics and factors associated with SCAP in pregnancy. The present study was a case-control study of pregnant women hospitalized between September 2012 and September 2017 at nine tertiary hospitals in China. Among 358,424 pregnant women, we found 35 SCAP cases and 393 common CAP cases. The 35 SCAP cases were matched 1:4 with common CAP cases (n = 140), based on patient age and gestational weeks. Infection indicators, hemoglobin, platelets, coagulation function, liver, and kidney function markers, myocardial enzyme, arterial oxygen pressure/fraction inspired oxygen (PO 2 / FiO 2), and partial echocardiographic results were different between the two groups at admission (all P < 0.05). The univariable analyses indicated significant differences for hemoglobin, BMI, irregular obstetric examination, albumin, and white blood cells (all P < 0.05) between the common CAP and SCAP groups. The multivariable logistic regression analysis showed that hemoglobin (OR = 0.87, 95% CI: 0.77-0.97, P = 0.01), BMI (OR = 0.42, 95% CI: 0.22-0.81, P = 0.01), and serum albumin (OR = 0.37, 95% CI: 0.19-0.69, P = 0.002) were independently associated with SCAP. Anemia and low serum albumin are possibly associated with SCAP in pregnancy. The results indicate that anemia and albumin levels should be examined and properly treated in pregnant women with CAP.

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Should Albumin and Prealbumin Be Used as Indicators for Malnutrition?

Cited by 51 publications

References 3 publications

Morphomic Malnutrition Score: A Standardized Screening Tool for Severe Malnutrition in Adults

Morphomic Malnutrition Score: A Standardized Screening Tool for Severe Malnutrition in Adults

Hypoalbuminemia Reflects Nutritional Risk, Body Composition and Systemic Inflammation and Is Independently Associated with Survival in Patients with Colorectal Cancer

Anemia and Low Albumin Levels Are Associated with Severe Community-Acquired Pneumonia in Pregnancy: A Case-Control Study

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