title: Albumin and pre-albumin levels do not reflect the nutritional status of female adolescents with restrictive eating disorders.
abstract: OBJECTIVE
  Albumin and pre-albumin are frequently used as nutritional markers in clinical practice. We examined whether serum albumin and pre-albumin were predicted by body mass index (BMI), hydration and/or inflammation in female adolescents with a recently diagnosed restrictive eating disorder (RED).
  
  
  METHODS
  This was a retrospective study of female adolescents with RED from 2002 to 2011. Low albumin and pre-albumin levels were defined as <3.5 g/dL and <20 mg/dL, respectively. We assessed inflammation using the erythrocyte sedimentation rate (ESR) and dehydration using the haematocrit levels.
  
  
  RESULTS
  We included 75 females with a mean age of 15.2 years and 64% had a BMI Z score of <-2. The mean albumin and pre-albumin levels were 4.8 g/dL and 22.2 mg/dL, respectively, with 24% of the children having low pre-albumin and none having low albumin levels. The stepwise multiple regression for albumin identified ESR and haematocrit as significant predictors, which explained 14.8% of the variance. Age was the only significant predictor for pre-albumin, which explained 15.3% of the variance.
  
  
  CONCLUSIONS
  Albumin, but not pre-albumin, levels were primarily predicted by low-grade inflammation and hydration, but not by BMI. These markers should not be used to assess nutritional status in adolescents with RED.
authors.affiliation: Department of Paediatrics, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Huysentruyt
authors.affiliation: Department of Paediatrics, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
authors.forename: Jean
authors.initials: J
authors.lastname: De Schepper
authors.affiliation: Department of Paediatrics, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
authors.forename: Jesse
authors.initials: J
authors.lastname: Vanbesien
authors.affiliation: Department of Paediatrics, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium.
authors.forename: Yvan
authors.initials: Y
authors.lastname: Vandenplas
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000097:blood*; D005260:Female; D006801:Humans; D009752:Nutritional Status; D011228:Prealbumin / Q000378:metabolism*; D012189:Retrospective Studies
chemical_list: D011228:Prealbumin
keywords: Albumin; Anorexia nervosa; Nutritional status; Pre-albumin; Restrictive eating disorder