Pre-albumin as a marker for predicting weight loss in hospitalised children

Abstract

Objectives: This study sought to determine the diagnostic utility of serum pre-albumin in predicting weight loss in hospitalised children. Design: A hospital-based longitudinal survey was carried out between December 2013 and February 2014. Setting: Aga Khan University Hospital, Nairobi, Kenya, a tertiary care hospital. Subjects: A total of 170 children aged 29 days to 15 years who met the inclusion criteria were included in the study. Outcome measures: Serum pre-albumin levels and weight were measured at admission and repeated after 48-96 h. Sensitivity, specificity, and positive and negative predictive values were calculated to determine the diagnostic utility of serum pre-albumin in predicting weight loss in hospitalised children. Results: Of the 170 children studied, 57% and 60% had a drop in serum pre-albumin level and weight within the first four days of hospitalisation respectively. A drop in pre-albumin occurred in 68% of the 103 patients who had weight loss (p < 0.001). Using a serum pre-albumin cut off point of < 0.15 g/l at admission, sensitivity and specificity of serum pre-albumin in predicting weight loss were 76.7% and 29.0% (negative predictive value = 42.9%; positive predictive value = 64.2%). Positive and negative likelihood ratios were low at 1.08 and 0.8. The majority of the patients (72.3%) were already at risk of malnutrition as determined by the pre-albumin risk stratification on admission. Conclusion: Serum pre-albumin is not an accurate surrogate for weight loss during hospitalisation. It is, however, useful in identifying patients at risk of malnutrition on admission and during hospitalisation.

Umbilical Cord and Neonatal Transthyretin and Their Relationship to Growth and Nutrition in Preterm Infants

“…These findings address the debate in the medical literature as to whether or not serum protein markers such as TTR are really good indicative markers of nutritional status. 2,[15][16][17] Albumin, TTR, transferrin, and RBP are all synthesized in the liver and integrate protein synthesis and degradation over longer periods of time. Traditionally they have been used as part of the nutritional assessment.…”

“…The levels of serum protein levels such as TTR are often maintained in a chronic malnourished state (such as anorexia nervosa), and are decreased in wellnourished individuals who have experienced a recent stress or trauma. 2,[15][16][17] The question has been raised whether, instead of reflecting overall nutritional status, low serum TTR should be regarded as a bio-marker of increased risk of malnutrition, requiring further nutritional assessment. It was suggested that it could be thus used more as a prognostic marker for monitoring patients receiving nutritional support.…”

Physical Features and Vital Signs Predict Serum Albumin and Globulin Concentrations Using Machine Learning

“…Furthermore, there is a relation between albumin levels and weight. For instance, albumin concentration is associated with weight loss in cancer patients (McMillan et al, 2001) and serum albumin levels collected at admission to a hospital can predict weight loss in children during their stay (Quadros et al, 2019). Albumin is also a useful indicator of nutritional status.…”