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      Nutrition and somatomedin. XIII. Usefulness of somatomedin-C in nutritional assessment.

      The American Journal of Medicine

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          Abstract

          Malnutrition is common in hospitalized patients, but current measures of nutritional status are limited. Because levels of somatomedins are regulated by nutrition, the utility of somatomedin-C measurement in nutritional assessment was studied. Thirty-seven malnourished patients had measurement of somatomedin-C and conventional nutritional indexes. In 28 patients seen before therapy, the somatomedin-C level was reduced (38 percent of normal) and was lower than the albumin level (66 percent, p less than 0.01), transferrin level (59 percent, p less than 0.05), and lymphocyte count (43 percent, p = NS). Somatomedin-C level was lowest with combined "kwashiorkor-marasmus" (25 percent of normal) and also reduced with "kwashiorkor" (51 percent) or "marasmus" (57 percent) alone. Somatomedin-C was correlated with albumin, transferrin, and lymphocyte count (p less than 0.02 for each). In six patients given nutritional therapy, somatomedin-C levels rose by more than 70 percent in each (mean increase 181 percent), whereas lymphocyte counts rose in four (increase 78 percent for all patients), transferrin levels rose in four (increase 33 percent), and albumin levels rose in one (-6 percent). In 20 patients with detailed dietary analysis, only somatomedin-C was correlated with intake of protein and calories (p less than 0.005 for each). Somatomedin-C may be a sensitive marker of malnutrition and the response to nutritional therapy.

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          Most cited references 27

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          Nutritional assessment: a comparison of clinical judgement and objective measurements.

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            Prognostic nutritional index in gastrointestinal surgery

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              Prevalence of malnutrition in general medical patients.

              Three, single-day nutritional surveys at weekly intervals were conducted in the general medical wards of an urban municipal teaching hospital. The techniques of nutritional assessment included anthropometric measures (weight/height, triceps skin fold, arm-muscle circumference, serum albumin, and hematocrit). The prevalence of protein-calorie malnutrition was 44% or greater by these criteria (weight/height, 45%; triceps skin fold, 76%; arm-muscle circumference, 55%; serum albumin, 44%; and hematocrit, 48%). These results were reproducible without significant variation between surveys. In 34% of patients, a lymphopenia of 1,200 cells/cu mm or less was found, a level likely to be associated with diminished cell-mediated immunity. Compared with a similar survey among surgical patients, the medical patients were more depleted calorically (weight/height, triceps skin fold) but had better protein status (arm-muscle circumference, serum albumin). Significant protein-calorie malnutrition occurs commonly in municipal hospitals in both medical and surgical services.
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                Author and article information

                Journal
                3918442
                10.1016/0002-9343(85)90431-0

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