scholarly journals Serum albumin and transferrin in protein-energy malnutrition: Their use in the assessment of marginal undernutrition and the prognosis of severe undernutrition

1976 ◽  
Vol 36 (2) ◽  
pp. 255-263 ◽  
Author(s):  
P. J. Reeds ◽  
A. A. O. Laditan
Keyword(s):  
Serum Albumin ◽  
Protein Energy Malnutrition ◽  
Severe Malnutrition ◽  
Serum Transferrin ◽  
Malnourished Children ◽  
Protein Energy ◽  
The Mean ◽  
Index Of Severity ◽  
Mean Concentration ◽  
Made In

1. Deficits in weight- and length-for-age, and serum albumin and transferrin concentrations were determined for children who were either marginally undernourished (twenty-five children) or suffering from either marasmus (thirty-two children) or kwashiorkor (twenty-six children) defined according to the Wellcome Classification (Waterlow, 1972). The measurements were also made in eight children with kwashiorkor after the loss of oedema, and in sixteen children who were recovering from either marasmus or kwashiorkor.2. The mean concentration of serum albumin was similar for children from the ‘under-nourished’ group and from the group with marasmus, but was significantly reduced in those with kwashiorkor.3. The concentration of serum transferrin was significantly reduced in both the group of children with marasmus and those with kwashiorkor. The serum transferrin concentration was significantly lower in children with kwashiorkor when compared with the level in those with marasmus.4. Seventeen children (seven with kwashiorkor and ten with marasmus) died. These children were neither lighter nor shorter than the severely malnourished children who survived. The concentration of serum albumin was not lower in the children who died than in those who survived.5. In contrast to the results for serum albumin concentrations, the children who died had significantly lower levels of serum transferrin than those who survived.6. There was a significant linear relationship between serum transferrin concentrations and the deficits in length-for-age (P < 0·05) and weight-for-length (P < 0·001) in the marginally undernourished children. The deficit in weight-for-length was also linearly related to the serum transferrin concentrations (P < 0·001) in children recovering from severe malnutrition.7. It is suggested that the measurement of serum transferrin concentrations provides an index of severity in severely malnourished children, and should prove useful in field assessments of nutritional status.

scholarly journals Plasma concentrations of N-acetylneuraminic acid in severe malnutrition

1985 ◽  
Vol 53 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Jacqueline M. Hibbert ◽  
Alan A. Jackson ◽  
Sally M. Grantham-Mcgregor
Keyword(s):  
Brain Function ◽  
Brain Activity ◽  
Protein Energy Malnutrition ◽  
Plasma Concentrations ◽  
Nutritional State ◽  
Severe Malnutrition ◽  
Acetylneuraminic Acid ◽  
Malnourished Children ◽  
Protein Energy ◽  
Before And After

1. In rat studies, circulating concentrations of N-acetylneuraminic acid (NANA) have been shown to be an indicator of NANA concentrations in the brain and functional brain activity, in relation to nutritional state and stimulation. Abnormal behaviour can be improved with exogenous NANA. In the present study, the plasma NANA concentration has been measured in children with severe malnutrition and compared with that in controls.2. NANA was measured colorimetrically in the plasma of twenty-three severely malnourished children (mean age 11.43 (SD 6.05) months) before and after recovery, and in thirty-four controls (mean age 14.28 (SD 7.32) months). In thirteen of the malnourished children, NANA was measured after infections had been treated with a course of antibiotics.3. Mean plasma NANA concentration was significantly higher in protein-energy malnutrition (PEM)(2.89 (SD 0,58)μmol/ml; n 23) compared with controls (2.13(SD 0.37)μmol/ml; n 34, P < 0.001). The levels remained high in PEM after infections had been treated (2.87(SD 0.43) μmol/ml, n 13) but returned to control levels at recovery from PEM (2.14(SD 0.24)μmol/ml).4. In contrast to the findings in rats, in malnourished children plasma NANA concentrations were not reduced and did not relate directly to nutritional state or, by inference, brain function. These findings do not provide any support for the use of exogenous NANA supplements to improve brain function in humans.

scholarly journals Low serum albumin and total lymphocyte count as predictors of 30 day hospital readmission in patients 65 years of age or older

2015 ◽  
Author(s):  
Robert Robinson
Keyword(s):  
Risk Factor ◽  
Serum Albumin ◽  
Hospital Readmission ◽  
Lymphocyte Count ◽  
Protein Energy Malnutrition ◽  
Total Lymphocyte Count ◽  
Total Lymphocyte ◽  
Protein Energy ◽  
Patients At Risk ◽  
Low Serum

Introduction: Hospital readmission within 30 days of discharge is a target for health care cost savings through the medicare Value Based Purchasing initiative. Because of this focus, hospitals and health systems are investing considerable resources into the identification of patients at risk of hospital readmission and designing interventions to reduce the rate of hospital readmission. Malnutrition is a known risk factor for hospital readmission. Materials and Methods: All medical patients 65 years of age or older discharged from Memorial Medical Center from January 1, 2012 to March 31, 2012 who had a determination of serum albumin level and total lymphocyte count on hospital admission were studied retrospectively. Admission serum albumin levels and total lymphocyte counts were used to classify the nutritional status of all patients in the study. Patients with a serum albumin less than 3.5 grams/dL and/or a TLC less than 1,500 cells per mm3 were classified as having protein energy malnutrition. The primary outcome investigated in this study was hospital readmission for any reason within 30 days of discharge. Results: The study population included 1,683 hospital discharges with an average age of 79 years. The majority of the patients were female (55.9%) and had a DRG weight of 1.22 (0.68). 219 patients (13%) were readmitted within 30 days of hospital discharge. Protein energy malnutrition was common in this population. Low albumin was found in 973 (58%) patients and a low TLC was found in 1,152 (68%) patients. Low albumin and low TLC was found in 709 (42%) of patients. Kaplan-Meier analysis shows any laboratory evidence of PEM is a significant (p < 0.001) predictor of hospital readmission. Low serum albumin (p < 0.001) and TLC (p = 0.018) show similar trends. Cox proportional-hazards regression analysis showed low serum albumin (Hazard Ratio 3.27, 95% CI: 2.30-4.63) and higher DRG weight (Hazard Ratio 1.19, 95% CI: 1.03-1.38) to be significant independent predictors of hospital readmission within 30 days. Discussion: This study investigated the relationship of PEM to the rate of hospital readmission within 30 days of discharge in patients 65 years of age or older. These results indicate that laboratory markers of PEM can identify patients at risk of hospital readmission within 30 days of discharge. This risk determination is simple and identifies a potentially modifiable risk factor for readmission: protein energy malnutrition.

scholarly journals Evaluation of children with protein energy malnutrition and level of malaria parasitemia in Kwara State, Nigeria

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Aishat Oluwatoyin Saka ◽  
Mohammed Jamiu Saka ◽  
Lateefat Olayinka Sa’adu
Keyword(s):  
Protein Energy Malnutrition ◽  
Venous Blood ◽  
Relevant Information ◽  
Blood Film ◽  
Childhood Mortality ◽  
Sub Saharan Africa ◽  
Insecticide Treated Nets ◽  
Malnourished Children ◽  
Malaria Parasitemia ◽  
Protein Energy

Malaria and Protein-Energy-Malnutrition (PEM) are two major causes of childhood mortality in sub-Saharan Africa. Malaria can predispose a child to PEM and the reverse may also be true. Recent studies have presented inconsistent findings about nutritional status and the occurrence of malaria among the children. The goal of this study was to evaluate the association between PEM and malaria parasitemia if any. A case control study in which 90 children diagnosed for PEM (aged 6-59 months), and another well-nourished 90 children age and sex-matched controls were evaluated for malaria parasitemia. A semi-structured proforma was used to obtain relevant information on the children’s sociodemographic characteristics, nutritional indices amongst others. Venous blood sample was collected and thick and thin blood film were prepared and viewed under the microscope. Malaria parasitemia was present in 82 (91.1%) of malnourished group and 12 (13.3%) of the well-nourished group (P<0.05 OR=66.62). Malaria parasitemia was highest in those with kwashiorkor and marasmic kwashiorkor compared with underweight. These differences were statistically significant (P<0.05). The study demonstrates that malnourished children have higher degree of malaria parasitemia and are at risk of malaria. It also shows that severe forms of malnutrition are associated with heavier malaria parasitemia. It is therefore recommended that all malnourished children should have access to use of Insecticide Treated Nets (ITN), malaria chemoprophylaxis as well as empiric treatment of malaria in endemic areas where access to malaria parasite diagnosis is difficult.

Increased Food Intake after the Addition of Amylase-Rich Flour to Supplementary Food for Malnourished Children in Rural Communities of Bangladesh

2005 ◽  
Vol 26 (4) ◽  
pp. 323-329 ◽  
Author(s):  
M. Iqbal Hossain ◽  
M. A. Wahed ◽  
Shaheen Ahmed
Keyword(s):  
Rural Communities ◽  
Food Intake ◽  
Protein Energy Malnutrition ◽  
Effective Means ◽  
The Other ◽  
Community Nutrition ◽  
Supplementary Food ◽  
Malnourished Children ◽  
Protein Energy ◽  
Added Water

Background In Bangladesh, as in other developing countries, protein–energy malnutrition is most prevalent among children during weaning. After weaning, children are often fed cereal-based diluted low-calorie porridge, resulting in growth-faltering. Objective To assess the effect on food intake of adding amylase-rich flour (ARF) from germinated wheat to supplementary food among children in nine rural Community Nutrition Centers under the Bangladesh Integrated Nutrition Project (BINP). Methods A total of 166 malnourished children of either sex, aged 6 to 24 months, received one of three diets randomly allocated to the Community Nutrition Centers. The composition of the diets was the same; however, the consistency and calorie density were altered by adding either ARF or water. Thirty-five children received the standard supplementary food of the BINP (S-SF), 65 received supplementary food with added ARF (ARF-SF), and 66 received supplementary food with added water (W-SF). The children were studied for six weeks. Results The mean ± SD intake of supplementary food from a single meal by children completing six weeks on the diets was higher for children receiving ARF-SF (33.91 ± 8.25 g) than for those receiving S-SF (25.66 ± 6.73 g) or W-SF (30.26 ± 8.39 g) (p < .05 for both comparisons). The weight of vomited food was significantly higher for children receiving W-SF than for children in the other two groups. Weight gain and increments in length and weight-for-height were higher for children who received ARF-SF than for children in the other two groups, but the differences were not statistically significant. The acceptability of ARF-SF was higher than that of the two other diets. The additional cost of adding 2 g of ARF to the diet was about Taka 0.25 (US$1 = Taka 48). Conclusions Addition of ARF to existing standard supplementary food, as used under the BINP program, is a simple and effective means to increase the intake of food by changing its consistency, thus making it easier for malnourished children to ingest.

scholarly journals Flow Cytometry Study of Lymphocyte Subsets in Malnourished and Well-Nourished Children with Bacterial Infections

2004 ◽  
Vol 11 (3) ◽  
pp. 577-580 ◽  
Author(s):  
Oralia Nájera ◽  
Cristina González ◽  
Guadalupe Toledo ◽  
Laura López ◽  
Rocío Ortiz
Keyword(s):  
Flow Cytometry ◽  
B Lymphocytes ◽  
T Lymphocyte ◽  
Bacterial Infections ◽  
B Lymphocyte ◽  
Lymphocyte Subsets ◽  
Protein Energy Malnutrition ◽  
T Lymphocyte Subsets ◽  
Malnourished Children ◽  
Protein Energy

ABSTRACT Protein-energy malnutrition is the primary cause of immune deficiency in children across the world. It has been related to changes in peripheral T-lymphocyte subsets. The aim of the present study was to evaluate the effects of infection and malnutrition on the proportion of peripheral-lymphocyte subsets in well-nourished non-bacterium-infected (WN), well-nourished bacterium-infected (WNI), and malnourished bacterium-infected (MNI) children by flow cytometry. A prospectively monitored cohort of 15 MNI, 12 WNI, and 17 WN children was studied. All the children were 3 years old or younger and had only bacterial infections. Results showed a significant decrease in the proportion of T CD3+ (P < 0.05 for relative and P < 0.03 for absolute values), CD4+ (P < 0.01 for relative and absolute values), and CD8+ (P < 0.05 for relative values) lymphocyte subsets in WNI children compared to the results seen with WN children. Additionally, B lymphocytes in MNI children showed significant lower values (CD20+ P < 0.02 for relative and P < 0.05 for absolute values) in relation to the results seen with WNI children. These results suggest that the decreased proportions of T-lymphocyte subsets observed in WNI children were associated with infection diseases and that the incapacity to increase the proportion of B lymphocyte was associated with malnutrition. This low proportion of B lymphocytes may be associated with the mechanisms involved in the immunodeficiency of malnourished children.

scholarly journals Prealbumin Serum Concentrations as a Useful Tool in the Assessment of Malnutrition in Hospitalized Patients

2006 ◽  
Vol 52 (12) ◽  
pp. 2281-2285 ◽  
Author(s):  
Gianluigi Devoto ◽  
Fabrizio Gallo ◽  
Concetta Marchello ◽  
Omar Racchi ◽  
Roberta Garbarini ◽  
...  
Keyword(s):  
Nutritional Assessment ◽  
Protein Energy Malnutrition ◽  
Reference Method ◽  
Hospitalized Patients ◽  
Severe Malnutrition ◽  
Serum Concentrations ◽  
Nutritional Index ◽  
Protein Energy ◽  
Sensitivity Specificity ◽  
Worse Prognosis

Abstract Background: Protein-energy malnutrition (PEM) is a common condition among patients admitted to hospitals, and it is associated with a worse prognosis and increased mortality. Although several screening systems have been developed, PEM is still poorly recognized, and there is no consensus on which test is more reliable and feasible in clinical practice. Prealbumin (PAB) is a potential useful PEM marker because its serum concentrations are closely related to early changes in nutritional status. Methods: We studied PEM prevalence and PAB serum concentrations in 108 hospitalized patients. The Detailed Nutritional Assessment (DNA) was used as the reference method to determine PEM. PAB performance was compared with that of 2 other methods, the Subjective Global Assessment (SGA) and the Prognostic Inflammatory and Nutritional Index score (PINI). Results: According to the DNA reference method, 41% of patients were classified with mild malnutrition and 19% with severe malnutrition. PAB showed the best concordance with the standard DNA method (concordance index, 76.8%) and a good sensitivity/specificity profile (83.1%/76.7%) compared with SGA and PINI. Conclusions: We conclude that PAB could represent a feasible and reliable tool in the evaluation of malnutrition, especially in settings where it is difficult to obtain a more detailed and comprehensive nutritional assessment such as the DNA.

scholarly journals Severe malnutrition is associated with decreased levels of plasma transferrin receptor

1997 ◽  
Vol 77 (3) ◽  
pp. 391-397 ◽  
Author(s):  
Francis O. T. Akenami ◽  
Antti Vaheri ◽  
Marjaleena Koskiniemi ◽  
Sanna-Maria Kivivuori ◽  
Emmanuel E. Ekanem ◽  
...  
Keyword(s):  
Transferrin Receptor ◽  
Plasma Concentrations ◽  
Fe Deficiency ◽  
Severe Malnutrition ◽  
Reference Ranges ◽  
Healthy Children ◽  
Plasma Albumin ◽  
Malnourished Children ◽  
The Mean ◽  
Apparently Healthy

Sixty children aged 1-3 years with protein malnutrition were involved in the present study. Measurements were made of plasma transferrin receptor (TfR), haemoglobin (Hb), ferritin, transferrin and Fe in comparison with twenty apparently healthy age- and sex-matched reference children in Nigeria. Plasma TfR was measured by an immunofluorometric assay. The mean plasma concentrations of both albumin (37 g/l) and transferrin (1·88 g/l) were within reference ranges in the ‘healthy’ children. The malnourished children had severe protein deficiency as indicated by their significantly lower mean plasma albumin (24·4-28·2 g/l; P < 0·0001) and transferrin (1·24-1·53 g/l; P < 0·0001) concentrations in comparison with the reference children. In the reference children, the traditional indicators of Fe nutrition (plasma Fe, transferrin Fe saturation and Hb) were within the reference ranges, but ferritin values were raised, indicating acute or chronic infection and/or inflammation. The mean concentrations of plasma TW (4·2-5-2 mg/l) in the malnourished group were significantly lower than the mean (6·1 mgn) of the reference children (P=0·0009). In the children with severe malnutrition, none of the indicators of Fe status except Hb (81·5-86·7 g/l; P<0·0001) showed Fe deficiency, including the serum concentration of TfR and the TfR : ferritin ratio, although the Fe status was lower than in the reference children (for Fe P = 0·009; and ferritin P=0·0004). In the absence of haemodilution, the low Hb values are a clear indication that the malnourished children were Fe deficient; none of the other indices was indicative of Fe deficiency. This is the first report of TfR levels in malnourished and healthy African children.

scholarly journals Serum albumin as predictor of post-operative morbidity and mortality

2017 ◽  
Vol 4 (3) ◽  
pp. 1078
Author(s):  
Latika Sharma ◽  
Poojan M. Purohit ◽  
Dharmendra Pipal ◽  
Saurabh Kothari ◽  
Harshit Srivastava ◽  
...  
Keyword(s):  
Serum Albumin ◽  
Protein Energy Malnutrition ◽  
Organ System ◽  
Morbidity And Mortality ◽  
Surgical Patients ◽  
P Value ◽  
Age Group ◽  
Operative Morbidity ◽  
Medical College ◽  
Protein Energy

Background: Protein energy malnutrition affects every organ system. So correct assessment of nutritional status is important as malnourishment is a risk factor for morbidity and morality in surgical patients. In our study, serum albumin has been taken as parameter for nutritional assessment.Methods: Study is conducted on 50 patients admitted in Department of General Surgery, Dr. Sampurnanand Medical College and associated Hospital, Jodhpur, Rajasthan, India for surgeries during January 2014-December 2015. Data was analyzed using Z-test and Fischer exact t-test and p value was calculated. P value <0.05 is considered statistically significant.Results: Patients with serum albumin <3gm/dl had more complications with maximum number of complications in age group of 41-60 year group. This finding was statistically significant.Conclusions: Low serum albumin patients has more post-operative complication than those with normal level and so is a good indicator of post-operative morbidity and mortality.

scholarly journals Nutritional status changes in children with malignant solid tumor before and after chemotherapy

2016 ◽  
Vol 45 (4) ◽  
pp. 166
Author(s):  
Boris Januar ◽  
Sri S Nasar ◽  
Rulina Suradi ◽  
Maria Abdulsalam
Keyword(s):  
Nutritional Status ◽  
Serum Albumin ◽  
Solid Tumors ◽  
Protein Energy Malnutrition ◽  
Survival Rates ◽  
Albumin Level ◽  
Level Measurement ◽  
Protein Energy ◽  
Before And After ◽  
Malignant Solid Tumor

Background Although aggressive multimodal treatment programsin childhood cancer have significantly increased survival rates, themorbidity caused by protein energy malnutrition related to therapyis still high.Objective To describe nutritional status changes in children withmalignant solid tumors after 21 days of chemotherapy.Methods A descriptive prospective study with pre- and post-testdesign in children with malignant solid tumors was conducted inthe Department of Child Health, Medical School University of In-donesia/Cipto Mangunkusumo Hospital, Jakarta between Janu-ary and July 2004. Anthropometrics (body weight, BW and mid-upper-arm circumference, MUAC) and serum albumin measure-ments were performed before and after 21 days of chemotherapy.Results Twenty-two children were enrolled in this study. After 21days of chemotherapy, 8 children had decreased BW and 6 chil-dren had decreased MUAC, but 3 children gained weight and hadincreased MUAC. Based on MUAC-for-age, 7 children had de-creased nutritional status. Fifteen children had reduced serum al-bumin levels based on a 10% cut-off point. The number of childrenwho had reduced serum albumin was larger than those who hadreduced BW and MUAC. In the evaluation of average oral foodconsumption during 21 days, 7 out of 16 children could acceptmore than 2/3 portion of served food. All of the children who re-ceived enteral feeding could accept more than 2/3 portion of servedfood.Conclusion There was a decrease of nutritional status, BW,MUAC, and serum albumin in most of the subjects after chemo-therapy. Serum albumin level measurement was the more sensi-tive parameter in determining nutritional status changes. Enteralfeeding seems more appropriate to fulfill nutritional needs than oralfeeding

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