Abstract
Essential amino acids (EAAs) are nutritional substrates that promote body protein synthesis; thus we hypothesised that their supplementation may improve circulating albumin (Alb) and haemoglobin (Hb) in rehabilitative elderly patients following hip fractures (HF). Out of the 145 HF patients originally enrolled in our study, 112 completed the protocol. These subjects were divided into two randomised groups, each containing 56 patients. For a period of two months, one group (age 81.4 ± 8.1 years; male/female 27/29) received a placebo, and the other (age 83.1 ± 7.5 years; male/female 25/31) received 4 + 4 g/day oral EAAs. At admission, the prevalence of both hypoAlb (<3.5 g/dL) and hypoHb (<13 g/dL male, <12 g/dL female) was similar in the placebo group (64.3% hypoAlb, 66% hypoHb) and the treated group of patients (73.2% hypoAlb, 67.8% hypoHb). At discharge, however, the prevalence of hypoAlb had reduced more in EAAs than in placebo subjects (31.7% in EAAs vs. 77.8% in placebo; p < 0.001). There was a 34.2% reduction of anaemia in hypoHb in EAA subjects and 18.9% in placebo subjects, but the difference was not statistically significant. Oral supplementation of EAAs improves hypoAlb and, to a lesser extent, Hb in elderly rehabilitative subjects with hip fractures. Anaemia was reduced in more than one third of patients, which, despite not being statistically significant, may be clinically relevant.
Highlights
Circulating albumin (Alb) and haemoglobin (Hb) proteins are considered to be indicators of the status of general health [1] both in community and clinical settings
We aimed to investigate whether supplementation with essential amino acids (EAAs) could improve hypoAlb and anaemia in rehabilitative elderly subjects with hip fractures (HF) surgery and mild hypoAlb and anaemia
Poor nutritional intake during an acute hospital stay is another factor that contributes to impaired circulating Alb levels because low calorie-protein intake reduces synthesis and accelerates the catabolism of Alb [5]
Summary
Circulating albumin (Alb) and haemoglobin (Hb) proteins are considered to be indicators of the status of general health [1] both in community and clinical settings (acute-, long-term care-, rehabilitation-environments). Low Alb in community-dwelling healthy elderly individuals is independently associated with poorer performance [2] and predicts a greater decline in functional. In a clinical setting, low Alb correlates with disease severity and mortality [1,4,5], predicts a prolonged hospital stay, and increases the complication rate and all-cause mortality [5,6,7]. Low Hb has been documented to be an independent factor of increased mortality [16,17] in hospitalized medical and surgical patients, and the degree of anaemia is associated with short-term mortality in many studies [18]
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