Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA.
Abbott Nutrition Research and Development Asia-Pacific Center, 138668 Singapore, Singapore.
Nutrients. 2017 Aug 3;9(8):829. doi: 10.3390/nu9080829.
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 ( < 0.001) and concentrations of albumin ( < 0.001), hemoglobin ( < 0.001), total cholesterol ( < 0.001), prealbumin ( < 0.001) and total protein ( < 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.
营养不良是住院患者中常见但未被充分认识的问题。本文旨在系统回顾和评估成年住院患者的营养不良生物标志物。通过 Cochrane、PubMed 和 ProQuest Dialog 检索合格研究。根据经验证的营养评估工具对营养不良风险进行分类，对生物标志物浓度进行荟萃回归分析。共纳入 111 项研究，涉及来自各种临床环境（医院、社区、护理院）的 52911 名参与者（55%为女性，72±17 岁）。MNA 评估的高营养不良风险人群中，估计 BMI（<0.001）和白蛋白（<0.001）、血红蛋白（<0.001）、总胆固醇（<0.001）、前白蛋白（<0.001）和总蛋白（<0.05）浓度显著低于无风险人群。SGA 和 NRS-2002 评估的营养不良也观察到类似结果。对包括急性病患者的敏感性分析表明，白蛋白和前白蛋白浓度显著降低，表明在急性护理环境中必须仔细解释这些指标。本综述表明，BMI、血红蛋白和总胆固醇是老年人群营养不良的有用生物标志物。为避免营养不良漏诊，参考范围和切点可能需要更新。
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