Changes in prealbumin, nutrient intake, and systemic inflammation in elderly recuperative care patients.
OBJECTIVE
To determine the relationship between prealbumin, nutrient intake, and indicators of inflammation for recuperative and rehabilitative care patients.


METHODS
Prospective cohort.


METHODS
Recuperative Care Unit within a Veterans Administration Nursing Home Care Unit.


METHODS
One hundred eleven men (100 white; mean age 80, range 64-93).


METHODS
Prealbumin and seven markers of inflammation (C-reactive protein (CRP), tumor necrosis factor, and interleukin-6 (IL-6) and their soluble receptors) were measured at admission and discharge (median length of stay 23 days, interquartile range 15-40 days). Detailed calorie counts were performed daily, and intake was expressed as a percentage of estimated requirements for protein (1.5 g/kg body weight per day) and energy (Harris-Benedict equation). The study objective was examined using least-squares regression analysis.


RESULTS
Discharge prealbumin and the change in prealbumin were positively correlated with protein and energy intake and inversely correlated with markers of inflammation, particularly CRP and IL-6. When all covariates were included in a multivariable regression analysis, the markers of inflammation predominantly accounted for the variance in prealbumin change (56%), whereas discharge protein intake accounted for 6%.


CONCLUSIONS
For older recuperative care patients, prealbumin and its change during hospitalization are positively associated with protein intake, but inflammation or changes in inflammation appear to exert a much more-powerful influence on prealbumin concentration. Given the potential confounding effects of inflammation, monitoring the change in prealbumin is not an adequate substitute for a more-detailed nutritional assessment in this population.
Dennis
Richard A
RA
Geriatric Research Education and Clinical Center, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas 72205, USA.
Johnson
Larry E
LE
Roberson
Paula K
PK
Heif
Muhannad
M
Bopp
Melinda M
MM
Cook
Judy
J
Sullivan
Dennis H
DH
D000368:Aged; D000369:Aged, 80 and over; D001131:Arkansas; D002097:C-Reactive Protein / Q000378:metabolism*; D002149:Energy Intake; D006787:Hospitals, Veterans; D006801:Humans; D007249:Inflammation / Q000378:metabolism* / Q000628:therapy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D011228:Prealbumin / Q000378:metabolism*; D011446:Prospective Studies
D011228:Prealbumin; D002097:C-Reactive Protein