Mid-arm Circumference Values Research Articles

Defining anthropometric thresholds (mid-arm circumference and calf circumference) in older adults residing in the community: a cross-sectional analysis using data from the population representative Longitudinal Aging Study in India (LASI DAD)

ObjectivesTo identify factors associated with malnutrition (undernutrition and overnutrition) and determine appropriate cut-off values for mid-arm circumference (MAC) and calf circumference (CC) among community-dwelling Indian older adults.DesignData from the first...

#5742 MID-ARM CIRCUMFERENCE AS A CORRELATE TO DIFFERENT: ASPECT NEUROCOGNITIVE IMPAIRMENT IN HEMODIALYSIS PATIENTS

Abstract Background and Aims Malnutrition is associated with poor cognitive function (CI) in Hemodialysis (HD) patients. Both have multiple ways of assessment scaled from simple bedside screening tests to more sophisticated time- and cost-consuming measures. This work aims to define the best nutritive assessment measure that correlates to the degree of CI. Method A cross-sectional study was carried out on 116 patients in 4 different HD units from Delta Nile, Egypt. The nutritional status was examined after the dialysis session in euvolemic patients using (1) anthropometric measurements, including body mass index (BMI), mid-arm circumference (MAC), skin fold thickness (SFT), and mid-arm muscle circumference (MAMC); (2) bioelectrical impedance analysis for assessment of skeletal muscle mass (SMM), skeletal muscle index (SMI), free fat mass (FFM), body fat mass (BFM), and total body water (TBW); (3) Hand grip strength was used to assess muscle power. The assessment of cognition was made using (1) a mini-mental state examination (MMSE) for orientation, registration, attention, recall, language, and copying; (2) Saint Louis University Mental Status Exam (SLUMS) for early CI and executive functioning; (3) Arabic version of Penn Web-Based Computerized Neurocognitive Battery (WebCNP) for those who scored no CI in the previous two tests. Results The results of MMSE and SLUMS tests showed that 34.5% of our cohort (n = 40) had no CI, 34.5% (n = 40) had mild to moderate degrees of CI, and 31% (n = 36) had a severe form of CI. Comparing the nutritional assessment parameters between the categories of cognitive scores revealed that there were no significant differences except in significantly lower median values of MAC (P 0.01), SMI in bioelectrical impedance analysis (P0.01), and hand grip strength (P 0.002) in severe CI group than the normal to patients without CI. In correlation statistics, MAC and hand grip strength were negatively correlated to the degree of CI (r = -0.3, P 0.006 and r = -0.26, P 0.009, respectively). MAC was the only parameter correlated with attention, emotional recognition, and differentiation functioning in the forty patients with no CI who underwent computerized neurocognitive assessment. The highest reported positive correlations reported were between the MAC and response time of both emotion recognition (r = 0.57, P <0.001) and differentiation (r = 0.55, P <0.001). Conclusion Of the different parameters of nutritional state assessment, MAC, the simple bedside measurement, was the best correlate with the degree of cognitive impairment in HD patients, even in its mild primitive forms.

The association between reduced calf and mid-arm circumferences and ICU mortality in critically ill COVID-19 patients

Patients with COVID-19 are at a high risk of malnutrition caused by inflammatory syndrome and persistent hypermetabolism, which may affect clinical outcomes. This study aimed to evaluate the changes in nutritional status indicators between two time points of nutritional assessments of COVID-19 patients during their stay in the intensive care unit (ICU). Moreover, the study also assessed the association of nutritional status with ICU mortality. This cohort study included retrospective data of adult patients admitted to a public hospital ICU in southern Brazil, between March and September 2020. These participants with confirmed COVID-19 diagnosis received nutritional assessment within the first 72h after ICU admission. The anthropometric measurements collected included mid-arm circumference (MAC) and calf circumference (CC). The percentage (%) of MAC adequacy was calculated, and values<50th percentile for sex and age were considered low. CC values of ≤33cm for women and ≤34cm for men were indicative of reduced muscle mass. Data on the date of discharge from the ICU and mortality outcome were collected. A total of 249 patients were included (53.4% men, 62.2±13.9 years of age, SOFA severity score 9.6±3.5). Of these, 22.7 and 39.1% had reduced MAC and CC at ICU admission, respectively. In these participants, weight, MAC, CC, and % MAC decreased significantly from the first to second nutritional assessment (p<0.05), but there was no significant difference between survivors and non-survivors. Patients with reduced CC (HR=2.63; 95% CI 1.65-4.18) or reduced MAC (HR=2.11; 95% CI 1.37-3.23) at the first nutritional assessment had approximately twice the risk of death in the ICU than those with normal CC and normal MAC, regardless of the severity assessed by the SOFA score and age. Reduced MAC and CC values were identified in approximately 20 and 40% of COVID-19 patients admitted to the ICU, respectively. Additionally, these indicators of nutritional depletion were associated with an approximately 2-fold increase in the risk of ICU mortality. A significant reduction in anthropometric indicators during the first weeks of ICU stay confirmed the deterioration of nutritional status in these patients, although this was not associated with mortality.

Predicational ability of phase angle on protein energy wasting in kidney disease patients with renal replacement therapy: A cross-sectional study.

ObjectiveTo investigate the ability of phase angle (PA) and body composition for predicting protein energy wasting (PEW) in renal replacement therapy (RRT) patients.MethodsRenal replacement therapy (RRT) patients were enrolled in this study. Body composition was measured by direct segmental multi‐frequency biolectrical impedance analysis method (DSM‐BIA); phase angle (PA), fat‐free mass (FFM), fat mass (FM), mid‐arm circumference (MAC), WC (waist circumference), and ECW/TBW (extracellular water/total body water) were obtained. Biochemicals (serum albumin, triglyceride, and cholesterol) were tested. PEW patients were classified according to ISRNM (The International Society of Renal Nutrition and Metabolism) criteria. Cutoff value of PA and related variables was calculated by ROC analysis. The ability of body composition variables as indicators to predict PEW was evaluated.ResultsSixty‐four patients were enrolled in this study. Thirty‐three patients (52.6%) were males, and forty (62.5%) patients were diagnosed with PEW. The ROC curve showed that the optimal cutoff values of PA, FFMI (fat‐free mass index), MAC, WC, and BMI for PEW risk were 4.45°, 16.71, 29.7 cm, 86.4 cm, and 21.1 kg/m2, respectively. These indicators showed significant association with PEW; meanwhile, the PA and MAC can be used as the predictors for PEW with OR 6.333 (95% CI, 1.956–20.505) and 3.267 (95% CI, 1.136–9.394), respectively. Both groups have a lower BUN/Cr ratio (<20).ConclusionIn the RRT patients, over than 60% patients were diagnosed with PEW. PA, MAC, and other body composition can be used as the independent indicators for predicting PEW in renal replacement therapy kidney disease patients.

Mid-Arm Circumference is an Independent Predictor of 30-Days Mortality in Patients with Decompensated Cirrhosis

Abstract Objectives Malnutrition is common in cirrhosis and is associated with a worse prognosis. This study aimed to evaluate the nutritional status by mid-arm circumference (MAC) and the association between MAC and mortality in patients with decompensated cirrhosis. Methods This is a prospective cohort study performed with hospitalized decompensated cirrhotic patients. Nutritional status was assessed within 72 hours of admission, from April 2017 to April 2018. Patients with values of MAC ≤5th percentile were considered malnourished. Survival over time was estimated using Kaplan-Meier curves and significant predictors of 30-days and long-term mortality were identified using Cox proportional hazards models. Results One-hundred patients with an average age of 60.1 ± 10.3 years were evaluated. Of these, 63% were male. The presence of ascites was the most observed complication with a prevalence of 69%, followed by variceal bleeding in 24% and hepatic encephalopathy in 22%. The median of follow-up time of patients was 11.2 months (range, 2.4–21). Overall mortality was 60% and mortality in 30-days was 16%. Malnourished patients through MAC (30%) were significantly more likely to die in either follow-up of 30-days (Log-rank value: 0.008) and long-term mortality (Log-rank value: 0.001). The 30-days probabilities of survival were 70% in patients malnourished by MAC compared to 90% in patients with MAC values &amp;gt; 5th percentile. In multivariate analysis, after adjustment for age and Child-Pugh score, patients with malnutrition had a higher risk of 30-days mortality (HR: 3.64; 95% CI 1.33–9.95; P = 0.012) and after total period of follow-up (HR: 2.21; 95% CI 1.30–3.73; P &amp;lt; 0.001). Higher values of MAC were associated with a reduced overall mortality risk in 30-days and long-term of 15% and 8%, respectively. Conclusions Malnutrition, assessed by a simple bedside anthropometric parameter, can predict short-term and long-term follow-up mortality risk in patients with decompensated cirrhosis. Therefore, MAC may be an efficacious tool to assess nutritional status and identify patients with a high risk of mortality. Funding Sources This study was supported by a CAPES and FIPE/HCPA scholarship. The sources of funding were not involved in study design; in collection, analysis and interpretation of the data.

PREVALENCE OF HEPATIC STEATOSIS AMONG CHILDREN AND ADOLESCENTS WITH CYSTIC FIBROSIS AND ITS ASSOCIATION WITH NUTRITIONAL STATUS.

ABSTRACTObjective: To determine the prevalence of hepatic steatosis (HS) in children and adolescents with cystic fibrosis (CF) and associate it with nutritional status.Methods: Cross-sectional study with children and adolescents with CF diagnosis. Weight and height were used to calculate the body mass index (BMI) and subsequent classification of the nutritional status. The midarm circumference (MAC), triceps skinfold thickness (TSF) and midarm muscle circumference (MAMC) were used to evaluate body composition. Abdominal ultrasonography was performed for diagnosis of HS. The statistical tests used were Student’s t test, Mann-Whitney test and chi-square test with significance level of 5%.Results: 50 patients with CF were evaluated, 18 (36%) were diagnosed with HS (Group A) and 32 (64%) without HS (Group B). The mean age of Group A was 13,2±4,9 years old and Group B 11,7±4,9; for BMI, the value for Group A was 18,0±4,1 and Group B was 15,7±3,8; the TSF of Group A was 8,4±3,5 mm and Group B was 7,0±2,5 mm. For these variables, there was no significant difference between the groups. The mean of MAC and MAMC differed significantly between the groups, being higher in the HS group, with p values of 0,047 and 0,043.Conclusions: The frequency of HS in patients with CF is high and it is not related to malnutrition, according to the parameters of BMI, TSF and MAMC. The values of MAC and MAMC indicated a greater reserve of muscle mass in patients with HS.

Study of Male Sex Hormone Levels in Male Egyptian Children and Adolescents with End Stage Renal Disease under Regular Haemodialysis

Background: Delayed puberty is a common pathological finding in male children with chronic renal failure (CRF) secondary the pathological changes in testosterone hormone. Aim: The aim of this study was to assess the plasmalevels of total testosterone hormone in male pediatric patients with CRF under regular haemodialystic therapy. Subjects and methods: This work was conducted on forty male children with End Stage Renal Disease (ESRD) under regular hemodialysis who were selected from the Pediatric Department of Tanta University Hospital and Zagazig University Hospital at Egypt. 40 healthy age and sex matched children were chosen as control group. All patients and controls were subjected to full history taking, thorough clinical examination including weight, height, Body Mass Index (BMI), Mid Arm Circumference (MAC), arterial blood pressure, pubertal assessment according to Tanner's stages, Routine laboratory investigation: including complete blood count (CBC), blood urea, blood urea nitrogen (BUN), serum creatinine, serum albumin, serum electrolytes (Ionized calcium, Potassium and Phosphorus), serum total testosterone levels and testicular volume by orchidometry and by testicular ultasound. Results: The mean values of weight, height, BMI and MAC of patients group were significantly lower than that of control group. The total male serum testosterone levels and testicular volumes were significantly lower in the patients group than in control group. (Mean testosterone level was 1.01 ± 1.61 ng/ml in Group I vs. 2.73 ± 2.66 ng/ml in Group II and mean testicular volume was 4.45 ± 4.92 ml in Group I vs. 8.66 ± 7.08/ml in Group II). A significant negative correlations was observed between the dialysis duration and the serum total Testosterone level and testicular size in patients group (P value=0.011 and 0.001 respectively).

Evaluation of Neurodevelopment Using Bayley-III in Children with Cyanotic or Hemodynamically Impaired Congenital Heart Disease.

The purpose of this study was to compare neurological development of children with cyanotic or hemodynamically impaired congenital heart disease (CHD) and healthy controls by using "Bayley Scales of Infant and Toddler Development Screening Test, Third Edition" (Bayley-III). Children with CHD (n = 37) and healthy controls (n = 24) aged between 1 and 41 months who were admitted to the Department of Pediatric Cardiology at our university hospital were included. The participants were assessed using Bayley-III test. All patients had cyanotic or hemodynamically impaired CHD. Weight, height, body mass index (BMI), mid-arm circumference (MAC), triceps skinfold thickness (TSF), and head circumference (HC) were measured and standard deviation scores (SDSs) were determined. SDS values of weight, height, BMI, MAC, and TSF of the patients as well as HC values were significantly lower than the control group (P < .001). Compared with controls, the patients had significantly lower mean scores in all Bayley-III subscales (P < .001). We observed similar results in Bayley-III scores including the mean values of cognitive, language, and global motor scores for the CHD patients with and without cardiac surgery (P > .05). This study demonstrated that children with cyanotic or hemodynamically impaired CHD have delayed neurodevelopmental outcomes compared with healthy children as assessed using Bayley-III.

Anthropometric Indices, Plasma Albumin, Uric Acid and Packed Cell Volume in Students of Tertiary Institutions

Background: Anthropometric indices, plasma albumin, uric acid and packed Cell Volume(PCV) are good markers of malnutrition and the associated disorders. Aim and Objective: This work aimed to evaluate the anthropometric indices, plasma albumin, uric acid and packed cell volume in tertiary institution students. Materials and Methods : Anthropometric indices, plasma albumin, uric acid and packed cell volume (PCV) were evaluated in 200 students of two tertiary institutions in Owo-Nigeria which include Achievers University and Rufus Giwa polytechnic, Owo, Ondo state-Nigeria (comprising of 95 males and 105 females). Anthropometric measurements including weight, height, and waist and hips circumference were measured. Body mass index and waist-hip ratio were also calculated. Plasma uric acid, and albumin were estimated biochemically by spectrophotometry while PCV was determined by capillary tube method. Results: The results showed a statistically higher significant difference in the values of mid arm circumference obtained from Achievers University (10.48±0.72) than the values obtained in the students of Rufus Giwa Polytechnic Owo (9.72±1.14) with P < 0.05. The values of plasma albumin were also statistically significantly higher (P< 0.05) in students of Achievers University, Owo (47.84±4.5) than the values obtained in the students of Rufus Giwa Polytechnic Owo (42.36±4.89) with P < 0.05. There was also a significant gender difference in the values of mid arm circumference and plasma albumin obtained from the students of the two institutions with p<0.05. Conclusion: We therefore recommend routine measurements of anthropometric indices, Packed Cell Volume and biochemical parameters (Serum Uric acid and Albumin) are hereby suggested for early detection of malnutrition and its associated disorders among students of tertiary institutions due to significant alterations in the level of the parameter.

Anthropometric Indices and Lipid Profiles in Tertiary Institution Students

Anthropometric indices and lipid profiles are useful markers of malnutrition and could reveal risk of cardiovascular disease. This work aimed at evaluating the anthropometric indices and lipid profiles in students of tertiary institutions.Anthropometric indices and lipid profiles were evaluated in 200 students of students of tertiary institutions including Achievers University and Rufus Giwa Polytechnic, Owo, Nigeria, aged 18 -46 years, comprising 95 males and 105 females recruited for this study. Anthropometric measurements including weight, height, and waist and hips circumference were measured. Body mass index and waist-hip ratio were also calculated. Fasting lipid profile including total cholesterol (TC), low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL), and triglycerides (TG) were estimated biochemically by auto chemistry analyzer. The results showed statistically significant higher mean values of mid arm circumference (MAC) and triglycerides (TG) in the University students than the Polytechnic students studied (p<0.05). A significantly higher mean value of low density lipoprotein (LDL) was obtained in the Polytechnic students than in the University students with p<0.05. The result also showed a significantly higher mean value of MAC, TC, and LDL in females than their male counterparts (p<0.05). A significantly higher mean value of total triglyceride was, however, obtained in males than in the female students (p<0.05). This work revealed statistical differences in the MAC, plasma TG, LDL, and TC based on the category of school and gender. We therefore recommend routine measurement of anthropometric indices and blood lipid levels for early detection of malnutrition to avoid complications such as cardiovascular disease.

Evaluation of growth and neurodevelopment in children with congenital heart disease

Children with congenital heart disease are under risk of delayed growth and development. We evaluated physical growth parameters and neurodevelopment in these patients in comparison with normal children and examined the effect of hemodynamic status. Patients with congenital heart disease (n= 76) and healthy children (n= 51) aged 1-72 months applied to Mersin University Hospital, Mersin, Turkey were included. Patients with heart failure and those requiring intervention or surgery were classified as hemodynamically impaired (HI group, n= 30), and the others, hemodynamically normal (HN group, n= 46). Growth parameters including weight, height, body mass index (BMI), mid-arm circumference (MAC), and triceps skin fold thickness (TSF) were measured and standard deviations (SD) were determined. Functional development was assessed by Denver Developmental Screening Test-II (DDST II). MAC and BMI values of the group with impaired hemodynamic status were significantly lower than the hemodynamically normal and control groups (MAC P < 0.05 and BMI P < 0.01). In the DDST II, the group with hemodynamic abnormality had more failures in gross motor and fine motor skills than HN group and controls (gross motor P= 0.011, P < 0.001 and fine motor P= 0.028, P= 0.001, respectively) and more failures in language development than the control group (P= 0.001). The results showed the importance of hemodynamic status in growth and neurodevelopment of children with congenital heart disease. Besides routine growth parameters, more detailed examinations such as BMI, MAC, TSF, and developmental screening tests appear useful in identifying children with cardiac disease who are under risk for delayed growth and development.

Leptin Levels in Boys with Pubertal Gynecomastia

It has been reported that there is a relationship between circulating leptin and sex steroid hormones and leptin is able to stimulate estrogen secretion by increasing aromatase activity in adipose stromal cells and breast tissue. Leptin receptors have been also shown in mammary epithelial cells and it has been suggested that leptin is involved in the control of the proliferation of both normal and malignant breast cells. To investigate circulating leptin levels in boys with pubertal gynecomastia. Twenty boys with pubertal gynecomastia who were in early puberty and had no obesity, and 20 healthy individuals matched for age, pubertal stage and body mass index (BMI) with the study group, were enrolled in the study. Body weight, height and left midarm circumference (MAC) and left arm triceps skinfold thickness (TSF) were measured and BMI was calculated. A fasting blood sample was collected and routine hormonal parameters including prolactin, beta-human chorionic gonadotropin (betaHCG), total and free testosterone, estradiol, luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin, androstenedione (AS) and dehydroepiandrosterone sulfate (DHEAS) levels were studied. Serum leptin levels were analyzed using radioimmunoassay. The mean ages of the study and control group were not different (13.9 +/- 0.89 and 14.2 +/- 0.66, respectively). No significant difference was found for BMI, MAC and TSF values between the two groups. There was no significant difference for hormonal parameters including FSH, LH, total and free testosterone, estradiol, AS, DHEAS and estradiol/total testosterone ratio between boys with pubertal gynecomastia and the controls. Serum leptin levels were found significantly higher in the study group compared with the healthy controls (5.58 +/- 0.81 and 2.39 +/- 0.29 ng/ml, respectively; p <0.001). No correlation could be determined between serum leptin levels and hormonal parameters. The presence of higher leptin levels in boys with pubertal gynecomastia indicates that leptin may be involved in the pathogenesis of pubertal gynecomastia. The role of circulating leptin in pubertal gynecomastia is probably related to increase in estrogen and/or estrogen/ androgen ratio by the stimulating effect of leptin on aromatase enzyme activity in both adipose and breast tissues, or a direct growth stimulating effect of leptin on mammary epithelial cells, or increase in sensitivity of breast epithelial cells to estrogen with inducing functional activation of estrogen receptors by leptin in breast tissue.

Mid-arm circumference and mid-arm/head circumference ratio in term newborns.

Mid-arm circumference of the newborn is strongly associated with birth weight and is a very good indicator of low and insufficient birth weight. However, there are few Brazilian studies on the relationship between mid-arm and head circumferences and, thus, this does not form part of the routine evaluation for newborns. To establish the mid-arm circumference and mid-arm/head circumference ratio in a population of term newborns. Cross-sectional study carried out between June 1997 and August 1999. Hospital Maternidade Leonor Mendes de Barros, São Paulo. Term newborns (66 males and 65 females) of appropriate growth for gestational age, whose mothers were healthy, were included in the study. Arm circumference, arm circumference/head circumference ratio, birth weight and gestational age were measured within 48 hours of birth. Data were considered significant when p < 0.01. The mean values for the mid-arm circumference were 10.76 cm (standard deviation, SD = 0.68) for females and 10.76 (SD = 0.81) for males. The mean value for the mid-arm/head circumference ratio was 0.31 (SD = 0.02) for both sexes. Mid-arm circumference values were significantly related to birth weight and gestational age, whereas mid-arm/head circumference ratio was related only to birth weight. Mid-arm circumference and mid-arm/head circumference ratio values were established for the studied population. It was possible to obtain curves for both mid-arm circumference and mid-arm/head circumference ratio in relation to birth weight. However, for mid-arm circumference, it was only possible to obtain curves in relation to gestational age. The use of the regression curves did not seem powerful enough to predict the mid-arm circumference and mid-arm/head circumference ratio in this population of term newborns. There were no gender differences for either of the measurements studied.

An audit of nutritional status in renal replacement therapy patients — Is there a place for hand dynamometry?

• ■ Objective: To audit the nutritional status (including hand dynamometry) of patients receiving renal replacement therapy. • ■ Design: To audit the physical nutritional measurements performed regularly on dialysis patients. Body mass index (BMI), midarm circumference (MAC), triceps skinfold thickness (TSF), midarm muscle circumference (MAMC), and grip strength (GS) were examined. • ■ Setting: Hospital. • ■ Patients: 140 patients (69 on hemodialysis [HD] and 71 on continuous ambulatory peritoneal dialysis [CAPD]). Hand dynamometry quantifying GS was measured in 90 patients. • ■ Results: TSF in male patients on CAPD was significantly higher than in those on HD. For patients younger than 65 years, BMI and MAC values were compared with British norms. In female patients, a distribution similar to that of the normal population was found. In men, a higher proportion (mainly on HD) than expected had low BMI values. For patients older than 65 years, TSF values were distributed in a pattern similar to that of published norms. MAMC values were highly skewed toward the upper range; more than 30% had values above the 90th percentile. Only 12% were classified as mildly/moderately undernourished. None were severely undernourished. Mean GS values achieved were poor (53.8% of expected normative standards) despite favorable nutritional profiles. Multiple regression modeling suggests that the bulk of variability in GS is due to age and gender (51%). Of nutritional parameters examined, only MAMC and albumin contribute together to account for only 6% of the variability. A total of 40% of the variability could not be explained on the basis of the examined variables. • ■ Conclusion: Undernutrition is not as prevalent as cited in other studies. Poor Gs justifies further research, but it does not appear to enhance nutritional assessment.

Nutritional status of anaemic and non-anaemic young Punjabi women

Ninety young women in the age group of 16 to 20 years from the women hostel of Punjab Agricultural university, Ludhiana were selected to assess their nutritional status, The subjects were classified into three groups of 30 each on the basis of their haemoglobin and food habits i.e. anaemic vegetarian (AV), anaemic non-vegetarian (ANV) and non-anaemic group. The average haemoglobin (Hb) levels of the subjects of AV, ANV and NA group were 10.4 ± 0.11, 10.7 ± 0.13 and 12.5 ± 0.10 g/dl respectively. The average packed cell volume (PCV) of the subjects in all the groups was within the normal range while the mean corpuscular haemoglobin concentration (MCHC) value was significantly high among the subjects of NA group as compared to other two groups. The mean daily energy and iron intake was inadequate while the intake of protein, calcium, phosphorus and ascorbic acid was sufficient in all the groups as compared to RDI(1). The seasonal differences in the average daily intake of protein, iron and ascorbic acid were significant (P < 0.05) only in the NA group. The ionizable iron accounted for 5.97 to 7.06 per cent of the total iron in the diets consumed by all the subjects in both the seasons. The average weights and heights of the subjects were normal. The mean mid arm circumference values of the subjects were between 80 to 90 Per cent, while the mean triceps skin fold thickness values were more than that of the standards. The clinical symptoms of anaemia and B complex deficiency were observed in the subjects of all the groups but the incidence was higher in AV and ANV groups as compared to NA group.

Discriminant biochemical markers for evaluating the nutritional status of elderly patients in long-term care

To determine the most discriminant serum markers of protein-energy status in elderly patients, we performed a discriminant analysis of 85 subjects grouped according to triceps skinfold and midarm circumference values as compared with reference percentiles. Results indicated that neither the classic serum indices of nutritional assessment nor retinol-binding protein can predict undernutrition. However, creatinine, urea, carotene, complement C3, and prealbumin included in a function enabled high discrimination between groups: 68% of subjects in 0–5th percentile for triceps skinfold and 75% of subjects in 0–5th percentile for midarm circumference are correctly predicted. Lower serum concentration was found in the lower anthropometric percentiles except for serum carotene, which showed an inverse relation not explained by diet. We found that nutritional alterations exist in hospitalized elderly patients. We emphasize the importance of considering several biochemical markers for detection of mal-nutrition and the pertinency of further exploration of serum carotene profiles in undernourished elderly patients.