PDF(Pubmed)
Abstract：
OBJECTIVE: Correctly characterizing malnutrition is a challenge. Transthyretin (TTR) rapidly responds to adequate protein intake/infusion, which could be used as a marker to identify malnutrition. Nutritional therapy is used to prevent malnutrition. Parenteral nutrition (PN) requires daily monitoring to determine whether what is being offered is adequate. This article aims to investigate whether the practice of measuring TTR is justified.
METHODS: Data from patients admitted to the ward or intensive care unit (ICU) were collected at three different times: within the first 72 h (T1) of PN use, on the 7th day (T2), and the 14th day (T3) after the initial assessment.
RESULTS: 302 patients were included; the average age was 48.3 years old; the prevalence of death was 22.2%, and 61.6% of the sample were male. TTR values and the effectiveness of nutritional support in these patients were not associated with the outcome; however, meeting caloric needs was related to the outcome (p = 0.047). No association was found when TTR values were compared to the nutritional status. Thus, TTR was not a good indicator of nutritional risk or nutritional status in hospitalized patients.
CONCLUSIONS: Undoubtedly, the TTR measurement was inversely proportional to CRP measurements. It was possible to conclude in this follow-up cohort of hospitalized patients that TTR values were not useful for determining whether the patient was malnourished, predicting death or effectiveness of nutritional support, yet based upon our analyses, a decrease in TTR greater than 0.024 units for every 1 unit increase in CRP might be due to ineffective nutritional supply.
METHODS: Data from patients admitted to the ward or intensive care unit (ICU) were collected at three different times: within the first 72 h (T1) of PN use, on the 7th day (T2), and the 14th day (T3) after the initial assessment.
RESULTS: 302 patients were included; the average age was 48.3 years old; the prevalence of death was 22.2%, and 61.6% of the sample were male. TTR values and the effectiveness of nutritional support in these patients were not associated with the outcome; however, meeting caloric needs was related to the outcome (p = 0.047). No association was found when TTR values were compared to the nutritional status. Thus, TTR was not a good indicator of nutritional risk or nutritional status in hospitalized patients.
CONCLUSIONS: Undoubtedly, the TTR measurement was inversely proportional to CRP measurements. It was possible to conclude in this follow-up cohort of hospitalized patients that TTR values were not useful for determining whether the patient was malnourished, predicting death or effectiveness of nutritional support, yet based upon our analyses, a decrease in TTR greater than 0.024 units for every 1 unit increase in CRP might be due to ineffective nutritional supply.
摘要：
目的：正确描述营养不良的特征是一个挑战。甲状腺素运载蛋白（TTR）对足够的蛋白质摄入/输注迅速反应，可以用作识别营养不良的标记。营养疗法用于预防营养不良。肠胃外营养（PN）需要每日监测，以确定所提供的营养是否足够。本文旨在探讨测量TTR的做法是否合理。
方法：在三个不同的时间收集进入病房或重症监护病房（ICU）的患者的数据：在使用PN的最初72小时（T1）内，在第7天（T2），以及初始评估后的第14天（T3）。
结果：共纳入302例患者，平均年龄48.3岁，死亡率为22.2%，61.6%的样本为男性。这些患者的TTR值和营养支持的有效性与结局无关；然而，满足热量需求与结局相关(p=0.047).当将TTR值与营养状况进行比较时,未发现关联。因此，TTR不是住院患者营养风险或营养状况的良好指标。
结论：毫无疑问，TTR测量值与CRP测量值成反比.在这个住院患者的随访队列中可以得出结论，TTR值对确定患者是否营养不良没有帮助。预测死亡或营养支持的有效性，然而根据我们的分析，CRP每增加1个单位,TTR降低大于0.024个单位可能是由于营养供应无效.
方法：在三个不同的时间收集进入病房或重症监护病房（ICU）的患者的数据：在使用PN的最初72小时（T1）内，在第7天（T2），以及初始评估后的第14天（T3）。
结果：共纳入302例患者，平均年龄48.3岁，死亡率为22.2%，61.6%的样本为男性。这些患者的TTR值和营养支持的有效性与结局无关；然而，满足热量需求与结局相关(p=0.047).当将TTR值与营养状况进行比较时,未发现关联。因此，TTR不是住院患者营养风险或营养状况的良好指标。
结论：毫无疑问，TTR测量值与CRP测量值成反比.在这个住院患者的随访队列中可以得出结论，TTR值对确定患者是否营养不良没有帮助。预测死亡或营养支持的有效性，然而根据我们的分析，CRP每增加1个单位,TTR降低大于0.024个单位可能是由于营养供应无效.
