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Leptin a new biological marker for evaluating malnutrition in elderly patients

European Journal of Clinical Nutrition volume 61, pages 647–654 (2007)Cite this article

Abstract

Background:

There is no single universally accepted biochemical marker of nutritional status in the elderly. Many markers are affected by non-nutritional factors.

Objective:

The purpose of this study was to determine the biological parameters best related to anthropometric markers of malnutrition in an elderly polypathological population, and determine cutoff values for these potential parameters to diagnose malnutrition.

Design:

This prospective study enrolled 116 elderly hospitalized patients and 76 elderly outpatients. Nutritional status (albumin, transthyretin, body mass index (BMI), skinfold thickness) and biological parameters (leptin, insulin-like growth factor-1 (IGF-1), IGF binding protein-1 (IGFBP-1), IGFBP-3, C-reactive protein (CRP), orosomucoid) were assessed. We defined malnutrition according to the lowest quartile of BMI and skinfold thickness measured in a large healthy elderly French sample population.

Results:

In this sample of elderly patients (age: 85±7 years old), leptin concentration was the only biological parameter significantly related to nutrition status. Independent correlations were found between leptin concentration and BMI, skinfold thickness and sex. The relationship between nutritional status and leptin concentration is significantly different in each sex: the more the patients are undernourished, the lower the leptin concentration in both sexes. The optimal leptin cutoff value for the diagnosis of malnutrition in this population was 4 μg/l in men (sensitivity 0.89, specificity 0.82) and 6.48 μg/l in women (sensitivity 0.90, specificity 0.83).

Conclusion:

Leptin concentration is highly correlated with anthropometric data whereas albumin or transthyretin are known to be also influenced by morbidity and inflammatory conditions. Serum leptin concentration could be used for nutritional assessment in elderly patients with acute diseases.

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References

  • Baxter JP (1999). Problems of nutritional assessment in the acute setting. Proc Nutr Soc 58, 39–46.

    Article  CAS  Google Scholar 

  • Beck AM, Ovesen L (1998). At which body mass index and degree of weight loss should hospitalised elderly patients be considered at nutritional risk? Clin Nutr 17, 195–198.

    Article  CAS  Google Scholar 

  • Campillo B, Paillaud E, Bories PN, Noel M, Porquet D, Le Parco JC (2000). Serum levels of insulin-like growth factor-1 in the three months following surgery for a hip fracture in elderly: relationship with nutritional status and inflammatory reaction. Clin Nutr 19, 349–354.

    Article  CAS  Google Scholar 

  • Cederholm T, Arner P, Palmblad J (1997). Low circulating leptin levels in protein-energy malnourished chronically ill elderly patients. J Intern Med 242, 377–382.

    Article  CAS  Google Scholar 

  • Chumlea WC, Roche AF, Steinbaugh ML (1985). Estimating stature from knee height for persons 60 to 90 years of age. J Am Geriatr Soc 33, 116–120.

    Article  CAS  Google Scholar 

  • Delarue J, Constans T, Malvy D, Pradignac A, Couet C, Lamisse F (1994). Anthropometric values in an elderly French population. Br J Nutr 71, 295–302.

    Article  CAS  Google Scholar 

  • Friedman JM, Halaos JL (1998). Leptin and the regulation of body weight in mammals. Nature 395, 763–770.

    Article  CAS  Google Scholar 

  • Gallagher D, Kovera AJ, Clay-Williams G, Agin D, Leone P, Albu J et al. (2000). Weight loss in postmenopausal obesity: no adverse alterations in body composition and protein metabolism. Am J Physiol Endocrinol Metab 279, E124–E131.

    Article  CAS  Google Scholar 

  • Giannopoulou I, Ploutz-Snyder LL, Carhart R, Weinstock RS, Fernhall B, Goulopoulou S et al. (2005). Exercise is required for visceral fat loss in postmenopausal women with type 2 diabetes. J Clin Endocrinol Metab 90, 1511–1518.

    Article  CAS  Google Scholar 

  • Gower BA, Nagy TR, Goran MI, Smith A, Kent E (2000). Leptin in postmenopausal women: influence of hormone therapy, insulin and fat distribution. J Clin Endocr Soc 85, 1770–1775.

    CAS  Google Scholar 

  • Haluzik M, Kabrt J, Nedvidkova J, Svobodova J, Kotrlikova E, Papezova H (1999). Relationship of serum leptin levels and selected nutritional parameters in patients with protein–caloric malnutrition. Nutrition 15, 829–833.

    Article  CAS  Google Scholar 

  • Hasselmann M, Alix E (2003). Tools and procedures for screening for malnutrition and its associated in risks in hospital. Nutr Clin Metab 17, 218–226.

    Article  Google Scholar 

  • Isidori AM, Strollo F, More M, Caprio M, Aversa A, Moretti C et al. (2000). Leptin and aging: correlation with endocrine changes in male and female healthy adult populations of different body weights. J Clin Endocrinol Metab 85, 1954–1962.

    Article  CAS  Google Scholar 

  • Janssen JAMJL, Stolk RP, Pols HAP, Grobbee DE, Lamberts SWJ (1998). Serum total IGF-1, free IGF-1, and IGFBP-1 levels in an elderly population. Relation to cardiovascular risk factors and disease. Arteriolscler Thromb Vasc Biol 18, 277–282.

    Article  CAS  Google Scholar 

  • Kalme T, Seppälä M, Qiao Q, Koistinen R, Nissinen A, Harrela M et al. (2004). Sex hormone binding globulin and insulin-like growth factor binding protein-1 as indicators of metabolic syndrome, cardiovascular risk and mortality in elderly men. J Clin Endocrinol Metab 90, 1550–1556.

    Article  Google Scholar 

  • Kondrup J, Allison SP, Elia M, Vellas B, Plauth M (2003). ESPEN guidelines for nutrition screening 2002. Clin Nutr 22, 415–421.

    Article  CAS  Google Scholar 

  • Kuczmarski MF, Kuczmarski RJ, Najjar M (2001). Effects of age on validity of self-reported height, weight, and body mass index: findings from the Third National Health and Nutrition Examination Survey, 1988-1994. J Am Diet Assoc 101, 35–36.

    Article  Google Scholar 

  • Laughlin GA, Barrettt-Connor E, Criqui MH, Kritz-Silverstein D (2004). The prospective association of serum insulin-like growth factor I (IGF-I) and IGF-binding protein-1 levels with all cause and cardiovascular disease mortality in older adults: the Rancho Bernardo study. J Clin Endocrinol Metab 89, 114–120.

    Article  CAS  Google Scholar 

  • Lo HC, Yang CS, Tsai LJ (2003). Simultaneous measurements of serum insulin-like growth factor-1 and leptin reflect the postoperative nutrition status of oral tumor patients. Nutrition 19, 327–331.

    Article  CAS  Google Scholar 

  • National Kidney Foundation (2002). K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis 39, S1–266.

  • Ponzer S, Tidermark J, Brismar K, Söderqvist A, Cederholm T (1999). Nutritional status, insulin-like growth factor-1 and quality of life in elderly women with hip fractures. Clin Nutr 18, 241–246.

    Article  CAS  Google Scholar 

  • Robbins LJ (1989). Evaluation of weight loss in the elderly. Geriatrics 44, 31–37.

    CAS  PubMed  Google Scholar 

  • Schulze PC, Kratzsch J, Linke A, Schoene N, Adams V, Gielen S et al. (2003). Elevated serum levels of leptin and soluble leptin receptor in patients with advanced chronic heart failure. Eur J Heart Fail 5, 33–40.

    Article  Google Scholar 

  • Smirnoff P, Almiral-Seliger D, Schwartz B (2001). Serum leptin levels in the elderly: relationship with gender and nutritional status. J Nutr Health Aging 5, 29–32.

    CAS  PubMed  Google Scholar 

  • Soderberg S, Ahren B, Eliasson M, Dinesen B, Brismar K, Olsson T (2001). Circulating IGF binding protein-1 is inversely associated with leptin in non-obese men and obese postmenopausal women. Eur J Endocrinol 144, 283–290.

    Article  CAS  Google Scholar 

  • Sullivan DH, Patch GA, Walis RC, Lipschitz DA (1990). Impact of nutritional status on morbidity and mortality in a select population of geriatric patients. Am J Clin Nutr 51, 749–758.

    Article  CAS  Google Scholar 

  • Van den Saffele J, Goemaere S, de Bacquer D, Kaufman JM (1999). Serum leptin levels in healthy ageing men: are decreased serum testosterone and increased adiposity in elderly men the consequence of leptin deficiency? Clin Endocrinol 5, 81–88.

    Article  Google Scholar 

  • Van Harmelen V, Reynisdottir S, Eriksson P, Hoffstedt J, Lönnqvist F, Arner P (1998). Leptin secretion from subcutaneous and visceral adipose tissue in women. Diabetes 47, 913–917.

    Article  CAS  Google Scholar 

  • Villareal DT, Banks M, Sinacore DR, Siener C, Klein S (2006). Effect of weight loss and exercise on frailty in obese older adults. Arch Intern Med 166, 860–866.

    Article  Google Scholar 

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Acknowledgements

This study was supported by a DRRC AP-HP grant, number 94.42.27.

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Authors and Affiliations

  1. Service de Gérontologie 2, Hôpital Emile-Roux, Assistance Publique – Hôpitaux de Paris (AP-HP), Limeil-Brévannes, France

    O Bouillanne

  2. Service de Biostatistiques, Université Paris 6, Paris, France

    J-L Golmard

  3. Service de Biochimie médicale, Hôpital Hôtel-Dieu, AP-HP, Paris, France

    C Coussieu

  4. Service de Biochimie Endocrinienne, Hôpital Robert-Debré, AP-HP, Paris, France

    M Noël

  5. Service de Biochimie, Hôpital Charles-Foix, AP-HP, Université Paris 5, Ivry sur Seine, France

    D Durand & V Nivet-Antoine

  6. Service de Médecine Interne et Gérontologie, Hôpital Charles-Foix, AP-HP, Université Paris 6, Ivry sur Seine, France

    F Piette

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  1. O Bouillanne
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  2. J-L Golmard
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  3. C Coussieu
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  4. M Noël
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  5. D Durand
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  6. F Piette
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  7. V Nivet-Antoine
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Corresponding author

Correspondence to O Bouillanne.

Additional information

Contributors: OB, VN-A and FP contributed to the design of the experiment. OB, VN-A contributed to the collection of data. J-LG contributed to the analysis of data. OB, VN-A, FP contributed to the writing of the manuscript. CC, MN, DD provided significant advice.

Conflict of interest statement

All authors have disclosed any financial and personal relationships with other people or organizations that could inappropriately influence their work. The corresponding author states that he had full access to all the data in the study and had final responsibility for the decision to submit for publication.

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Bouillanne, O., Golmard, JL., Coussieu, C. et al. Leptin a new biological marker for evaluating malnutrition in elderly patients. Eur J Clin Nutr 61, 647–654 (2007). https://doi.org/10.1038/sj.ejcn.1602572

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  • DOI: https://doi.org/10.1038/sj.ejcn.1602572

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