Assessment of a Correlation between Malnutrition, Serum Hypotransferrin and Chronic Skin Ulcers

Crisci A,Pollastro L,Crisci M

doi:10.18314/jnb.v2i1.111

Abstract

The aims of this study were to evaluate the correlation between malnutrition, serum hypotransferrin and chronic skin ulcers and the effect of supplementation with a dietary integrator on wound healing. The study population was 20 patients with chronic skin ulcers (12 men and 8 women; mean age 75.58 Â± 8.51 years). Monthly assessments were carried out for 6 months (V1-V6) and comprised measurement of changes in wound surface area and blood chemistry parameters (hemoglobin [Hb], total proteins, albumin, transferrin, iron, total iron-binding capacity [TIBC], latent iron-binding capacity [LIBC], transferrin saturation index). Nutritional supplementation with an oral dietary integrator was initiated at day 45. At day 45, the mean blood chemistry values were: serum albumin 2.73 Â± 1.07 g/dL (45.05 Â± 15.84%); total proteins 6.35 Â± 0.65 g/dL; total lymphocyte count 24.17 Â± 0.09%; serum Hb 10.86 Â± 1.47 g/dL; serum trasferrin 165.92 Â± 75.95 g/dL; serum iron 40.5 Â± 19.65 mg%; TIBC 207.4 Â± 94.94 mgr%; LIBC 166.9 Â± 92.45 mg%; transferrin saturation index 20.63 Â± 9.73%. These values indicated moderate protein malnutrition. The mean wound surface area was 56.92 Â± 47.95 cm2. At 90 days (V4) the mean values were: serum albumin 3.43 Â± 0.68 g/dL (48.05 Â± 8.15%); serum proteins 6.91 Â± 0.51 g/dL; total lymphocyte count 40.44 Â± 0.44%; serum Hb 12.47 Â± 1.91 g/dL; serum trasferrin 223.73 Â± 104.07 g/dL; serum iron 51.09 Â± 22.66 mgr%; TIBC 279.66 Â± 130.09 mgr%; LIBC 228.57 Â± 133.37 mgr%; transferrin saturation index 21.54 Â± 12.15%. The mean wound surface area was 20.41 Â± 25.91 cm2. In conclusion, a correlation emerged between hypotransferrinemia and chronic skin ulcers, as demonstrated by the improvement in both parameters with treatment. Supplementation with the oral dietary integrator led to an increase in serum transferrin, and particularly in serum Hb and proteins and total lymphocyte counts, stimulating the healing of the chronic skin ulcers.

Highlights

Various risk factors interact to produce the tissue damage seen in patients with chronic skin ulcers
The aim of this study was to determine whether there is an association between hypotransferrinemia and chronic skin ulcers or both have been an independent factors
Our data show a correlation between hypotransferrinemia and wound surface area, demonstrating a parallel improvement in both parameters during treatment with the study product

Summary

Introduction

Various risk factors interact to produce the tissue damage seen in patients with chronic skin ulcers. Among the extrinsic and intrinsic causes are uninterrupted pressures on a particular body area, immobility, incontinence, and advanced age. The physiological consequences of immobility are regarded as the main predisposing factor, just as important is the direct causal relationship between nutritional status and the development of pressure ulcers. Biochemical indicators of malnutrition include levels of serum albumin and transferrin and total lymphocyte count. Numerous studies have shown an association between hypoalbuminemia and pressure ulcers (Table 1) [1,2]. The aim of this study was to determine whether there is an association between hypotransferrinemia and chronic skin ulcers or both have been an independent factors

Objectives

Methods

Results

Discussion

Conclusion