Original Article
European Journal of Clinical Nutrition (2007) 61, 647–654. doi:10.1038/sj.ejcn.1602572; published online 6 December 2006
Leptin a new biological marker for evaluating malnutrition in elderly patients
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.
O Bouillanne1, J-L Golmard2, C Coussieu3, M Noël4, D Durand5, F Piette6 and V Nivet-Antoine5
- 1Service de Gérontologie 2, Hôpital Emile-Roux, Assistance Publique – Hôpitaux de Paris (AP-HP), Limeil-Brévannes, France
- 2Service de Biostatistiques, Université Paris 6, Paris, France
- 3Service de Biochimie médicale, Hôpital Hôtel-Dieu, AP-HP, Paris, France
- 4Service de Biochimie Endocrinienne, Hôpital Robert-Debré, AP-HP, Paris, France
- 5Service de Biochimie, Hôpital Charles-Foix, AP-HP, Université Paris 5, Ivry sur Seine, France
- 6Service de Médecine Interne et Gérontologie, Hôpital Charles-Foix, AP-HP, Université Paris 6, Ivry sur Seine, France
Correspondence: Dr O Bouillanne, Service de Gérontologie 2, CH Emile-Roux (Assistance Publique – Hôpitaux de Paris), 94456 Limeil-Brévannes, France. E-mail: olivier.bouillanne@erx.aphp.fr
Received 19 January 2006; Revised 9 August 2006; Accepted 1 October 2006; Published online 6 December 2006.
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 
g/l in men (sensitivity 0.89, specificity 0.82) and 6.48 g/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.
Keywords:
leptin, body mass index, skinfold thickness, elderly, malnutrition
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