Endocrine Abstracts

Introduction: Disease-related malnutrition (DRM) is characterized by the presence of an acute or chronic inflammatory response. The traditional parameters for diagnosis, such as albumin, have failed in their application, forcing a reconsideration of the criteria used for the diagnosis of DRM. The ratio of C-Reactive Protein to prealbumin (CP ratio) allows to assess nutritional changes in relation to the inflammatory environment. The objective of this study is to assess the diagnostic capacity for malnutrition of CP ratio, correlating it with GLIM criteria.

Material and Method: Cross-sectional pilot study in hospitalized patients, under follow-up by the Nutrition Unit of Hospital La Paz. Patients with inflammation, diagnosed by C-Reactive Protein (CRP)>0.5 mg/dl, were included. CP ratio was measured in the initial evaluation and compared with isolated prealbumin for the clinical assessment of malnutrition. ROC curves were used in the statistical analysis.

Results: 91 patients were included, 65 with DRM (28 with severe DRM) based on GLIM criteria. The CP ratio presented an area under the curve (AUC) =0.556 (95% CI: 0.420-0.691) for the diagnosis of malnutrition versus normally nourished; and AUC=0.552 (95% CI: 0.408-0.696) for the diagnosis of severe versus moderate DRM. Prealbumin presented an AUC=0.536 (95%CI: 0.402-0.671) for the diagnosis of malnutrition versus normally nourished and AUC=0.551 (95%CI:0.407-0.694) for severe versus moderate DRM. When comparing CP ratio with prealbumin alone, there were no significant differences in the ability to detect DRM(P=0.880) or severe DRM (P=0.992).

Conclusions: The CP ratio has poor diagnostic accuracy for DRM and the degree of malnutrition. It does not show superiority with respect to prealbumin in patients with inflammation.