Kergoat M J, Leclerc B S, PetitClerc C, Imbach A
Department of General Medicine, Centre hospitalier Côte-des-Neiges, Montreal, Québec, Canada.
Am J Clin Nutr. 1987 Nov;46(5):849-61. doi: 10.1093/ajcn/46.5.849.
To determine the most discriminant serum markers of protein-energy status in elderly patients, we performed a discriminant analysis of 85 subjects grouped according to triceps skinfold and midarm circumference values as compared with reference percentiles. Results indicated that neither the classic serum indices of nutritional assessment nor retinol-binding protein can predict undernutrition. However, creatinine, urea, carotene, complement C3, and prealbumin included in a function enabled high discrimination between groups: 68% of subjects in 0-5th percentile for triceps skinfold and 75% of subjects in 0-5th percentile for midarm circumference are correctly predicted. Lower serum concentration was found in the lower anthropometric percentiles except for serum carotene, which showed an inverse relation not explained by diet. We found that nutritional alterations exist in hospitalized elderly patients. We emphasize the importance of considering several biochemical markers for detection of mal-nutrition and the pertinency of further exploration of serum carotene profiles in undernourished elderly patients.
为了确定老年患者蛋白质能量状态最具鉴别力的血清标志物，我们对85名受试者进行了判别分析，这些受试者根据三头肌皮褶厚度和上臂围值分组，并与参考百分位数进行比较。结果表明，经典的营养评估血清指标和视黄醇结合蛋白均不能预测营养不良。然而，纳入一个函数中的肌酐、尿素、胡萝卜素、补体C3和前白蛋白能够在各组之间实现高度鉴别：三头肌皮褶厚度处于第0至第5百分位数的受试者中有68%被正确预测，上臂围处于第0至第5百分位数的受试者中有75%被正确预测。除血清胡萝卜素外，在较低的人体测量百分位数中发现血清浓度较低，血清胡萝卜素呈反比关系，无法用饮食来解释。我们发现住院老年患者存在营养改变。我们强调考虑多种生化标志物以检测营养不良的重要性，以及进一步探索营养不良老年患者血清胡萝卜素谱的相关性。
