title: Albumin concentration determined by the modified bromocresol purple method is superior to that by the bromocresol green method for assessing nutritional status in malnourished patients with inflammation.
abstract: BACKGROUND
  The controlling nutritional status (CONUT) score (CS), a simple score for assessing nutritional status, is calculated using laboratory data, including serum albumin concentration. Although dye-binding assays such as the bromocresol green (BCG) and modified bromocresol purple (mBCP) methods are widely used for albumin measurement, acute-phase proteins interfere with the BCG method.
  
  
  OBJECTIVE
  We aimed to determine whether the choice of albumin assay affects assessment of nutritional status using CONUT scores (CSs).
  
  
  METHODS
  We measured serum albumin concentrations by the BCG (ALBBCG) and mBCP (ALBmBCP) methods in 44 malnourished inpatients, 27 of whom underwent nutritional intervention, and compared them to 30 age-matched healthy volunteers. In treated patients, CSs were calculated by ALBBCG (CS-BCG) and ALBmBCP (CS-mBCP).
  
  
  RESULTS
  C-reactive protein (CRP) concentrations were positively correlated with the difference between ALBBCG and ALBmBCP in malnourished inpatients (r = 0.59, p < 0.001). CS-BCG was always lower than CS-mBCP (lower CS indicates superior nutritional status) in treated patients with persistently high CRP levels. However, in patients whose CRP decreased gradually, this difference diminished over the clinical course. CS-BCG and CS-mBCP were similar throughout their courses in patients with normal CRP concentrations. Adding haptoglobin to the human albumin solutions increased ALBBCG in a dose-dependent manner.
  
  
  CONCLUSIONS
  The choice of albumin assay affected the assessment of nutritional status using CSs in patients with inflammation. We recommend that the modified BCP assay be used to assess nutritional status, particularly in patients with inflammation.
authors.affiliation: Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Ueno
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hirayama
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ito
authors.forename: Emiko
authors.initials: E
authors.lastname: Nishioka
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Fukushima
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Satoh
authors.forename: Mayumi
authors.initials: M
authors.lastname: Idei
authors.forename: Yuki
authors.initials: Y
authors.lastname: Horiuchi
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Shoji
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Ohmura
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Shimizu
authors.forename: Takashi
authors.initials: T
authors.lastname: Miida
mesh_terms: D000368:Aged; D016477:Artifacts; D001774:Blood Chemical Analysis / Q000379:methods*; D001961:Bromcresol Green / Q000032:analysis / Q000737:chemistry; D001962:Bromcresol Purple / Q000032:analysis / Q000737:chemistry; D005260:Female; D006242:Haptoglobins / Q000494:pharmacology; D006801:Humans; D007249:Inflammation / Q000150:complications; D008297:Male; D044342:Malnutrition / Q000097:blood* / Q000150:complications / Q000503:physiopathology*; D008875:Middle Aged; D009752:Nutritional Status; D012709:Serum Albumin / Q000032:analysis*
chemical_list: D006242:Haptoglobins; D012709:Serum Albumin; D001962:Bromcresol Purple; D001961:Bromcresol Green
keywords: Albumin measurement; bromocresol green (BCG) method; controlling nutritional status (CONUT) score; inflammation; modified bromocresol purple (mBCP) method; nutrition support team (NST)