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Meta-Analysis
. 2017 Aug 3;9(8):829.
doi: 10.3390/nu9080829.

Evaluation of Blood Biomarkers Associated with Risk of Malnutrition in Older Adults: A Systematic Review and Meta-Analysis

Zhiying Zhang  1   2 , Suzette L Pereira  3 , Menghua Luo  4 , Eric M Matheson  5
Affiliations
Meta-Analysis

Evaluation of Blood Biomarkers Associated with Risk of Malnutrition in Older Adults: A Systematic Review and Meta-Analysis

Zhiying Zhang et al. Nutrients. .

Abstract

Malnutrition is a common yet under-recognized problem in hospitalized patients. The aim of this paper was to systematically review and evaluate malnutrition biomarkers among order adults. Eligible studies were identified through Cochrane, PubMed and the ProQuest Dialog. A meta-regression was performed on concentrations of biomarkers according to malnutrition risks classified by validated nutrition assessment tools. A total of 111 studies were included, representing 52,911 participants (55% female, 72 ± 17 years old) from various clinical settings (hospital, community, care homes). The estimated BMI (p < 0.001) and concentrations of albumin (p < 0.001), hemoglobin (p < 0.001), total cholesterol (p < 0.001), prealbumin (p < 0.001) and total protein (p < 0.05) among subjects at high malnutrition risk by MNA were significantly lower than those without a risk. Similar results were observed for malnutrition identified by SGA and NRS-2002. A sensitivity analysis by including patients with acute illness showed that albumin and prealbumin concentrations were dramatically reduced, indicating that they must be carefully interpreted in acute care settings. This review showed that BMI, hemoglobin, and total cholesterol are useful biomarkers of malnutrition in older adults. The reference ranges and cut-offs may need to be updated to avoid underdiagnosis of malnutrition.

Keywords: BMI; albumin; biomarker; hospitalized patients; malnutrition; nutrition screening tools; prealbumin.

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Conflict of interest statement

Abbott Nutrition was responsible for the study design, data analysis and manuscript preparation and submission. Z.Z., S.L.P., M.L. and K.D. are employees of Abbott Nutrition. E.M. did not receive funding from Abbott Nutrition.

Figures

Figure 1
Figure 1
Flow diagram of the search and review process.
See this image and copyright information in PMC

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