LEPTIN IS BETTER THAN ANY OTHER BIOLOGICAL PARAMETER FOR MONITORING THE EFFICACY OF RENUTRITION IN HOSPITALIZED MALNOURISHED ELDERLY PATIENTS.
Nivet-Antoine V, Golmard JL, Coussieu C, Piette F, Cynober L, Bouillanne O.
SourceFrom 1Service de Biochimie, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Charles-Foix, Ivry-sur-Seine EA 4466, Université Paris Descartes, Faculté de Pharmacie, Paris Service de Biostatistiques, Université Paris 6, Paris Service de Biochimie Endocrinienne et Oncologique, AP-HP, Hôpital Pitié-Salpêtrière, Paris Service de Médecine Interne et Gérontologie, AP-HP, Hôpital Charles-Foix, Ivry-sur-Seine Service de Biochimie, AP-HP, Hôpitaux Cochin et Hôtel-Dieu, Paris Service de Gérontologie 2, AP-HP, Hôpital Emile-Roux, Limeil-Brévannes, France.

Abstract
Objective:  Despite malnutrition being a major problem in hospitalized elderly patients, there is a lack of studies focusing on the comparative value of biological parameters for monitoring re-nutrition. The aim of this study was to determine which biological parameter(s) could best monitor successful re-nutrition in hospitalized malnourished elderly patients. Design:  The objective of the study was to explore the impact of a 6-week re-nutrition process on anthropometric and biological parameters in elderly patients, and to define the biological parameters associated with weight regain. Patients:  72 hospitalised malnourished elderly patients admitted to a hospital-based geriatric rehabilitation unit. Measurements:  Patients were evaluated at admission and at six weeks for anthropometric measurements of weight, sum of the four subcutaneous skinfold thicknesses, calf circumference and biological serum parameters including albumin, transthyretin, leptin, IGF-1, IGFBP-1 and IGFBP-3. Re-nutrition was considered successful if a patient gained at least 5% of body weight over 6 weeks. Results:  Leptin was the only biological parameter that increased at 6 weeks in successful re-nutrition. Leptin variations were not influenced by CRP variations, in contrast to transthyretin which can be modified by the inflammatory states frequently encountered in geriatric patients. Conclusions:  Serum leptin is a more appropriate parameter than transthyretin for monitoring re-nutrition.

Clin Endocrinol (oxf), 2011 Mar.17.doi:10.1111/j,1365-2265