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The correlation between nutritional status with subjective global assessment and serum albumin concentration in elderly patients
PHYSIOLOGY
AND
NUTRITIONAL
s13
ASSESSMENT
pothesized that CD could alter muscle mass and function. This study was designed to assessmuscle performance in CD patients. Method: 67 CD outpatients in remission (CDAIs150) (28 men and 39 women; 35.5 f 1.4 years) and 24 age-matched healthy controls (CON: 9 men and 15 women; 37.1 f 2.7 years) were evaluated. Body composition was assessedusing bio-impedance analysis. Strength testing included a 12rep sit-up test (SUT), a 3-s maximal isometric test for legs (MIL) and non dominant arm (MIA), and a 15-s maximal isometric fatigue test for legs (FIL) and un (FIA). An unpaired t-test was used for statistical analysis. Results: No significant difference were found between CD and CON groups regarding BMI (22.0 f 0.4 vs 22.3 f 0.5 kg.m-2), fat mass (14.1 f 0.7 vs 16.2 f 0.9 kg), and fat-free mass (48.6 f 1.1 vs 47.0 f 2.1 kg). Strength performances were lower in CD comparatively to CON, for SUT (29.2 f 0.8 vs 21.8 f 0.6 s, piO.OOl), MIL (27.55 f 0.70 vs 35.85 f 1.39 N.kgFFM-1, piO.OOl), FIL (20.16 f 0.57 vs 26.58 f 1.23 N.kgFFM-1, piO.001) and FIA (4.34 f 0.13 vs 4.91 f 0.20 N.kgFFM-1, piO.05). No significant difference was observed for MIA (6.18 f 0.16 vs 6.61 f 0.26 N.kgFFM-1). Conclusions: CD patients exhibit a decreased muscle function of the lower limbs. This pattern is confilmed by reduced strength and increased fatigability of the lower-body, independently of fat free mass. Whether these changes xe secondary to the CD per se, associated treatments, or to behavioml adaptations to the disease remains to be explored.
046-P. PROGNOSTIC INFLAMMATORY AND NUTRITIONAL INDEX (PINI) IN NON-CRITICALLY ILL PATIENTS W ITH TOTAL PARENTERAL NUTRITION (TPN) R. Burgos’, G. Francisco’, P. Chat n3, C. Puiggr st , M. Planas’ ‘Nutritional Support Unit, 2Endocrinology Depf 3Biochemistry Depf University Hospital Vail d’Hebron, Barcelona, Spain Rationale: PIN1 [alphal-acid glycoprotein (mg/I) x C-reactive protein (mg/I) I albumin (g/I) x thyroxine-binding piealbumin (mg/I) ] was firstly described in 1985 to provide a discriminatory method to assess the risk of complications in critically ill patients. Until data, few studies have been performed using this prognostic index.Aims: To evaluate the usefulness of PIN1 to assessclinical outcome in non-critically ill patients with TPN, and to correlate with the Nutritional Risk Index (NRI, Ma&rich Index). Method: PIN1 was evaluated at the beginning of TPN (PINIl) and weekly (PIN12, PINIS). Variables analyzed: age, length of stay in hospital (LOS), duration of TPN (TPNd), NRI, diagnosis, nitrogen balance (NB) and lymphocytes. Statistics: X2, Pearson col7-elation. Results: 71 non-critically ill patients treated with TPN were included (age 56.6 f 18 y). Diagnosis: digestive diseases (n=9), pancreatitis (n=17), hematology malignancies (n=9), cancer (n=lS), post-surgery ileum (n=lS). A high values and a skewed distribution of PIN11 was found in the majority of patients (213.3 f 317), followed by a decreased in the first and second week (PIN12: 152.4 f 229; PINS: 121.5 f 176). NRI: 78.8 f 11.0. No coilelation was found between PINI and NRI, NB, diagnosis, severity of pancleatitis, LOS, TPNd and lymphocytes. Conclusions: In the group of patients studied, PINI has not been an useful tool to predict clinical outcome
Results: A simple regression of REE on TBK, was highly collelative, indicated anon-constant relationship (3357+33&I/d/g boys and 3261+415 girls p~O~OOO1). In order to explain the non-constant relationship, we studied possible additional predictors which included age, body size pxameters, body composition pxameters (fat% and mid-am muscle circumference) and relative values of TBK (TBWht and TBWwt).Log (TBWht) was the single best predictor in both groups (R2=0.81 girls, R2=0.86). Adding more predictors increased the predicting power to some extent (R2=0.85 girls, R2=0.92 for boys). Conclusions: The different derived equations use the same explanatory vxiables, enabling us to compxe different genders in spite of their different body composition. Our results indicate that standardized REE (REE/TBK) tends to decrease in both genders as log (TBKW) increases and its variability tends to diminish with age. This trend is most probably explained by the relatively greater contribution of muscle mass to body composition towxds the end of puberty. Standxdized REE is lower for boys than for girls, probably due to greater nuscle mass which is expressed by gleater TBWht. Knowledge of body composition (log TBWht) is needed in order to predict standardized resting energy expenditue for peripubertal subjects.
048-P. THE CORRELATION BETWEEN NUTRITIONAL STATUS W ITH SUBJECTIVE GLOBAL ASSESSMENT AND SERUM ALBUMIN CONCENTRATION IN ELDERLY PATIENTS A. Altan ‘, A. Turkmen ‘, N. Turgut ‘, S. Kamali’, A. Ersoy ’ ‘Department of Anaestesiology and Reanimation, ‘Department of Surgery, SSK Okmeydani Traninig Hospital, Istanbul, Turkey Rationale: Malnutrition is mostly assessedin elderly patients who are hospitalised. If affects the prognosis and the mortality rate. Subjective Global Assessment (SGA) is a method which is lately used to assessthe nutritional status of hospitalized patients. In this study, we wanted to find out if any relation exists with malnutrition based on SGA and serum albumin concentration. Method: In this prospective study, nutritional status of 114 patients (66 male, 48 female) aged between 60 and 85 (mean 67, 9 SE 0, 57) were assessedwith SGA and their serum albumin concentrations were measured. Degree of malnutrition was evaluated as: severe malnutrition (more than 10% of weight loss in the last 6 months), medium malnutrition (5-10% weight loss) and well nourished (no malnutrition). Spearnan test was used for correlation analysis Results: 51% of 114 patients were well nourished. In 4% of the patients, severe malnutrition and in 45%, medium malnutrition was present. Serum albumin levels were as follows: 3,88+ 0,49 g dl-1 in the well nourished, 3,22 4 0,59g dl-1 in medium malnutrition and 3,1+0,42 g dl-1 in severe malnutrition group. A significant correlation was found between nutritional status assessedwith SGA and serum albumin levels. ( r: -0,545 p’ 0,OOOl) Conclusions: Correlation was found between malnutrition and serum albumin levels. The present data justify the use of SGA and serum albumin measurement for the assessment of nutritional status in elderly patients.
049-P. THE GLYCEMIC INDEX (GI) O F STANDARD AND DIABETES-SPECIFIC CLINICAL NUTRITION PRODUCTS 047-P. STANDARTIZATION O F RESTING ENERGY EXPENDITURE IN PERIPUBERTAL BOYS AND GIRLS BY LBM ONLY IS UNSATISFACTORY N. W & m a n ’, H. Vcet’, A. Akivis ‘, R. Dukhan3 ‘Unit of Clinical Nutrition, Tel Aviv sourasky Medical center, Tel Aviv, 2Faculty of agricolture, Hebrew University, Rehovot, 3 Unit of Clinical Nutrition, The Soreq nuclear research center; Yavne, Israel Rationale: To create new prediction equations for standardized resting energy expenditure (REE) for normal p&pubertal (S-18 y) boys (n=34) and girls (n= 40). Method: 40 girls and 33 boys aged 8-17.8~. Body composition measured by anthropometric measurements including LBM by whole body potassium count (TBK). REE by indirect calorimetry
J.D.E. Van Drunen ‘, Z. Hofman’, H. Kuipers’ ‘Clinical Nutrition and Diets, Numico Research, Wageningen, ‘Movement Sciences, Maastricht University, Maastricht, Netherlands Rationale: For diabetic patients who can or will not eat or drink sufficiently special diabetic feeds for nutritional support xe available. In this study the GI of 6 of these products was assessed and compxed with the GI of 6 standxd clinical nutrition products. Method: This was a randomised, double blind, cross-over trial. Healthy volunteers received a portion of product containing 25 grams of cxbohydrate or 25 grams of glucose in 200 ml water (reference food), on different occasions after an overnight fast. Venous blood samples were taken at set time points for up to two horns. Plasma glucose concentrations were measured in whole blood (EML-105, Radiometer, Copenhagen, Denmxk). The
AND
NUTRITIONAL
s13
ASSESSMENT
pothesized that CD could alter muscle mass and function. This study was designed to assessmuscle performance in CD patients. Method: 67 CD outpatients in remission (CDAIs150) (28 men and 39 women; 35.5 f 1.4 years) and 24 age-matched healthy controls (CON: 9 men and 15 women; 37.1 f 2.7 years) were evaluated. Body composition was assessedusing bio-impedance analysis. Strength testing included a 12rep sit-up test (SUT), a 3-s maximal isometric test for legs (MIL) and non dominant arm (MIA), and a 15-s maximal isometric fatigue test for legs (FIL) and un (FIA). An unpaired t-test was used for statistical analysis. Results: No significant difference were found between CD and CON groups regarding BMI (22.0 f 0.4 vs 22.3 f 0.5 kg.m-2), fat mass (14.1 f 0.7 vs 16.2 f 0.9 kg), and fat-free mass (48.6 f 1.1 vs 47.0 f 2.1 kg). Strength performances were lower in CD comparatively to CON, for SUT (29.2 f 0.8 vs 21.8 f 0.6 s, piO.OOl), MIL (27.55 f 0.70 vs 35.85 f 1.39 N.kgFFM-1, piO.OOl), FIL (20.16 f 0.57 vs 26.58 f 1.23 N.kgFFM-1, piO.001) and FIA (4.34 f 0.13 vs 4.91 f 0.20 N.kgFFM-1, piO.05). No significant difference was observed for MIA (6.18 f 0.16 vs 6.61 f 0.26 N.kgFFM-1). Conclusions: CD patients exhibit a decreased muscle function of the lower limbs. This pattern is confilmed by reduced strength and increased fatigability of the lower-body, independently of fat free mass. Whether these changes xe secondary to the CD per se, associated treatments, or to behavioml adaptations to the disease remains to be explored.
046-P. PROGNOSTIC INFLAMMATORY AND NUTRITIONAL INDEX (PINI) IN NON-CRITICALLY ILL PATIENTS W ITH TOTAL PARENTERAL NUTRITION (TPN) R. Burgos’, G. Francisco’, P. Chat n3, C. Puiggr st , M. Planas’ ‘Nutritional Support Unit, 2Endocrinology Depf 3Biochemistry Depf University Hospital Vail d’Hebron, Barcelona, Spain Rationale: PIN1 [alphal-acid glycoprotein (mg/I) x C-reactive protein (mg/I) I albumin (g/I) x thyroxine-binding piealbumin (mg/I) ] was firstly described in 1985 to provide a discriminatory method to assess the risk of complications in critically ill patients. Until data, few studies have been performed using this prognostic index.Aims: To evaluate the usefulness of PIN1 to assessclinical outcome in non-critically ill patients with TPN, and to correlate with the Nutritional Risk Index (NRI, Ma&rich Index). Method: PIN1 was evaluated at the beginning of TPN (PINIl) and weekly (PIN12, PINIS). Variables analyzed: age, length of stay in hospital (LOS), duration of TPN (TPNd), NRI, diagnosis, nitrogen balance (NB) and lymphocytes. Statistics: X2, Pearson col7-elation. Results: 71 non-critically ill patients treated with TPN were included (age 56.6 f 18 y). Diagnosis: digestive diseases (n=9), pancreatitis (n=17), hematology malignancies (n=9), cancer (n=lS), post-surgery ileum (n=lS). A high values and a skewed distribution of PIN11 was found in the majority of patients (213.3 f 317), followed by a decreased in the first and second week (PIN12: 152.4 f 229; PINS: 121.5 f 176). NRI: 78.8 f 11.0. No coilelation was found between PINI and NRI, NB, diagnosis, severity of pancleatitis, LOS, TPNd and lymphocytes. Conclusions: In the group of patients studied, PINI has not been an useful tool to predict clinical outcome
Results: A simple regression of REE on TBK, was highly collelative, indicated anon-constant relationship (3357+33&I/d/g boys and 3261+415 girls p~O~OOO1). In order to explain the non-constant relationship, we studied possible additional predictors which included age, body size pxameters, body composition pxameters (fat% and mid-am muscle circumference) and relative values of TBK (TBWht and TBWwt).Log (TBWht) was the single best predictor in both groups (R2=0.81 girls, R2=0.86). Adding more predictors increased the predicting power to some extent (R2=0.85 girls, R2=0.92 for boys). Conclusions: The different derived equations use the same explanatory vxiables, enabling us to compxe different genders in spite of their different body composition. Our results indicate that standardized REE (REE/TBK) tends to decrease in both genders as log (TBKW) increases and its variability tends to diminish with age. This trend is most probably explained by the relatively greater contribution of muscle mass to body composition towxds the end of puberty. Standxdized REE is lower for boys than for girls, probably due to greater nuscle mass which is expressed by gleater TBWht. Knowledge of body composition (log TBWht) is needed in order to predict standardized resting energy expenditue for peripubertal subjects.
048-P. THE CORRELATION BETWEEN NUTRITIONAL STATUS W ITH SUBJECTIVE GLOBAL ASSESSMENT AND SERUM ALBUMIN CONCENTRATION IN ELDERLY PATIENTS A. Altan ‘, A. Turkmen ‘, N. Turgut ‘, S. Kamali’, A. Ersoy ’ ‘Department of Anaestesiology and Reanimation, ‘Department of Surgery, SSK Okmeydani Traninig Hospital, Istanbul, Turkey Rationale: Malnutrition is mostly assessedin elderly patients who are hospitalised. If affects the prognosis and the mortality rate. Subjective Global Assessment (SGA) is a method which is lately used to assessthe nutritional status of hospitalized patients. In this study, we wanted to find out if any relation exists with malnutrition based on SGA and serum albumin concentration. Method: In this prospective study, nutritional status of 114 patients (66 male, 48 female) aged between 60 and 85 (mean 67, 9 SE 0, 57) were assessedwith SGA and their serum albumin concentrations were measured. Degree of malnutrition was evaluated as: severe malnutrition (more than 10% of weight loss in the last 6 months), medium malnutrition (5-10% weight loss) and well nourished (no malnutrition). Spearnan test was used for correlation analysis Results: 51% of 114 patients were well nourished. In 4% of the patients, severe malnutrition and in 45%, medium malnutrition was present. Serum albumin levels were as follows: 3,88+ 0,49 g dl-1 in the well nourished, 3,22 4 0,59g dl-1 in medium malnutrition and 3,1+0,42 g dl-1 in severe malnutrition group. A significant correlation was found between nutritional status assessedwith SGA and serum albumin levels. ( r: -0,545 p’ 0,OOOl) Conclusions: Correlation was found between malnutrition and serum albumin levels. The present data justify the use of SGA and serum albumin measurement for the assessment of nutritional status in elderly patients.
049-P. THE GLYCEMIC INDEX (GI) O F STANDARD AND DIABETES-SPECIFIC CLINICAL NUTRITION PRODUCTS 047-P. STANDARTIZATION O F RESTING ENERGY EXPENDITURE IN PERIPUBERTAL BOYS AND GIRLS BY LBM ONLY IS UNSATISFACTORY N. W & m a n ’, H. Vcet’, A. Akivis ‘, R. Dukhan3 ‘Unit of Clinical Nutrition, Tel Aviv sourasky Medical center, Tel Aviv, 2Faculty of agricolture, Hebrew University, Rehovot, 3 Unit of Clinical Nutrition, The Soreq nuclear research center; Yavne, Israel Rationale: To create new prediction equations for standardized resting energy expenditure (REE) for normal p&pubertal (S-18 y) boys (n=34) and girls (n= 40). Method: 40 girls and 33 boys aged 8-17.8~. Body composition measured by anthropometric measurements including LBM by whole body potassium count (TBK). REE by indirect calorimetry
J.D.E. Van Drunen ‘, Z. Hofman’, H. Kuipers’ ‘Clinical Nutrition and Diets, Numico Research, Wageningen, ‘Movement Sciences, Maastricht University, Maastricht, Netherlands Rationale: For diabetic patients who can or will not eat or drink sufficiently special diabetic feeds for nutritional support xe available. In this study the GI of 6 of these products was assessed and compxed with the GI of 6 standxd clinical nutrition products. Method: This was a randomised, double blind, cross-over trial. Healthy volunteers received a portion of product containing 25 grams of cxbohydrate or 25 grams of glucose in 200 ml water (reference food), on different occasions after an overnight fast. Venous blood samples were taken at set time points for up to two horns. Plasma glucose concentrations were measured in whole blood (EML-105, Radiometer, Copenhagen, Denmxk). The