The role of serum albumin in the prediction of malnutrition in patients at least five yr after heart transplantation.
OBJECTIVE
Malnutrition after heart transplantation (HTX) is related to graft sclerosis. The risk for malnutrition is often underestimated by conventional measurements. We aimed to compare these with objective assessors for malnutrition.


METHODS
Recipients at least five yr after HTX were included. Body mass index (BMI), bioimpedance analysis (BIA), serum albumin (SA) and subjective global assessment (SGA) malnutrition, and concomitant diseases were assessed. The BIA was used as gold standard, and a phase difference (PD) <4 was defined as cutoff.


RESULTS
Sixty recipients (47 male, 13 female) were analyzed. The prevalence of malnutrition was according to SGA 6.6% (4/60), BMI 8.3% (5/60), SA 31.6% (19/60), and BIA 48.3% (19/60). PD values did not correlate with BMI (r = 0.118; p = 0.079) or SGA (r = 0.289; p = 0.65), but with SA (r = 0.458; p = 0.001). Multivariate analysis yield SA and sCr as independent predictors for an existing malnutrition. ROC analysis showed an area under the receiver operating characteristic curve of 0.606 for SA as compared to 0.515 for the BMI and 0.698 for sCr in the prediction of existing malnutrition as defined by the PD.


CONCLUSIONS
The BMI or the SGA did not show as much power in predicting an existing alimentary deficiency for heart recipients as did SA.
Division for Transplantation, Department of Surgery, Medical University of Graz, Graz, Austria.
Günther
G
Prenner
Andrä
A
Wasler
Astrid
A
Fahrleinter-Pammer
Georg
G
Werkgartner
Hans Jörg
HJ
Mischinger
Stephan
S
Koter
Regina
R
Roller
Doris
D
Wagner
D000368:Aged; D015415:Biomarkers / Q000032:analysis*; D015992:Body Mass Index; D017097:Electric Impedance; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000601:surgery; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000175:diagnosis*; D008875:Middle Aged; D009752:Nutritional Status; D011379:Prognosis; D012372:ROC Curve; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis*
D015415:Biomarkers; D012709:Serum Albumin
body mass index; heart transplantation; malnutrition; serum albumin