Ranasinghe RN, Biswas M, Vincent RP.  Ann Clin Biochem. 2022 Jan;59(1):7-14. doi: 10.1177/0004563220931885. Epub 2020 Jun 11. PMID: 32429677.

Abstract : Prealbumin is a small protein which has been widely evaluated as a nutritional and a prognostic marker. The small size and concentration of prealbumin in blood proposes challenges on measuring it with high sensitivity and specificity. Over the years, a number of analytical methodologies have been developed, which may help establish prealbumin as a useful biomarker in routine clinical practice.

The aim of the short review was to explore the current literature on the clinical utility of prealbumin and the advances made in the analytical methodologies of prealbumin. We searched MEDLINE, EMBASE and the Cochrane Library for articles published between January 1980 and July 2019, with the general search terms of 'prealbumin', 'prognostic marker', 'nutritional marker', 'analytical methodologies' and 'malnutrition'. Additionally, we selected relevant articles and comprehensive overviews from reference lists of identified studies. The routine use of prealbumin in clinical practice remains debatable; however; it can complement clinical history, anthropometric assessment and physical examination to assess malnutrition with more certainty. Consensus on the clinical applications of prealbumin in the management of malnutrition is warranted.

Schweighofer N, Colantonio C, Haudum CW, Hutz B, Kolesnik E, Mursic I, Pilz S, Schmidt A, Stadlbauer V, Zirlik A, Pieber TR, Verheyen N, Obermayer-Pietsch B. Nutrients. 2021 Dec 31;14(1):186. doi: 10.3390/nu14010186. PMID: 35011061; PMCID: PMC8747660.

Abstract: Sarcopenia is linked with increased risk of falls, osteoporosis and mortality. No consensus exists about a gold standard “dual-energy X-ray absorptiometry (DXA) index for muscle mass determination” in sarcopenia diagnosis. Thus, many indices exist, but data on sarcopenia diagnosis agreement are scarce. Regarding sarcopenia diagnosis reliability, the impact of influencing factors on sarcopenia prevalence, diagnosis agreement and reliability are almost completely missing. For nine DXA-derived muscle mass indices, we aimed to evaluate sarcopenia prevalence, diagnosis agreement and diagnosis reliability, and investigate the effects of underlying parameters, presence or type of adjustment and cut-off values on all three outcomes.

The indices were analysed in the BioPersMed cohort (58 ± 9 years), including 1022 asymptomatic subjects at moderate cardiovascular risk. DXA data from 792 baselines and 684 follow-up measurements (for diagnosis agreement and reliability determination) were available. Depending on the index and cut-off values, sarcopenia prevalence varied from 0.6 to 36.3%. Height-adjusted parameters, independent of underlying parameters, showed a relatively high level of diagnosis agreement, whereas unadjusted and adjusted indices showed low diagnosis agreement. The adjustment type defines which individuals are recognised as sarcopenic in terms of BMI and sex. The investigated indices showed comparable diagnosis reliability in follow-up examinations.

Blanquet M, Ducher G, Sauvage A, Dadet S, Guiyedi V, Farigon N, Guiguet-Auclair C, Berland P, Bohatier J, Boirie Y, Gerbaud L. Eur J Clin Nutr. 2022 Jan;76(1):56-64. doi: 10.1038/s41430-021-00906-5. Epub 2021 Apr 13. PMID: 33850314.

Background/objectives: Sarcopenia is an age-related muscle disease associated with higher mortality, morbidity risk and health costs. An easy and convenient sarcopenia screening test would be hugely valuable for clinical critical care. The study aimed to assess handgrip strength (HGS) as a screening tool for sarcopenia in acute care-unit inpatients, using the EWGSOP 1 reference-standard definition.

Subjects/methods: Inpatients, aged 75 years old or above, of two acute care wards—a multidisciplinary care unit (MCU) and a geriatric care unit (GCU), were included between September 2017 and June 2018 in a cross-sectional study. HGS, sarcopenia, nutritional status, functional status, number of medications and sociodemographic data were collected. The accuracy of HGS as a screening test for sarcopenia was assessed by gender using receiver operating characteristic (ROC) curves and area under the curve (AUC) in a population of older patients (n = 223; age: 85.8 yrs; BMI: 26.7 kg/m²).

Ruiz-García I, Contreras-Bolívar V, Sánchez-Torralvo FJ, Ulloa-Díaz O, Ruiz-Vico M, Abuín-Fernández J, Barrios-García M, Alba-Conejo E, Olveira G. Clin Nutr. 2022 Jan;41(1):186-191. doi: 10.1016/j.clnu.2021.11.028. Epub 2021 Nov 24. PMID: 34891021.

Background & aims: Disease-related malnutrition (DRM) coding rate is usually low in hospitalised patients. The objective of our study was to estimate the percentage of correct DRM coding in cancer inpatients and to calculate the economic losses caused by such lack of coding.

Methods: This was an observational, prospective study that was conducted in patients hospitalised in the Medical Oncology Unit of our hospital. A nutritional assessment was performed through subjective global assessment (SGA). The all patient refined-diagnosis related group (APR-DRG) weights were obtained at the moment of discharge; moreover, recalculation was done after including the diagnosis of malnutrition in the medical record of those patients in whom it had not been initially coded. The associated cost reimbursement were calculated based on the weight before and after revising the diagnosis of DRM.