Clinical significance of serum prealbumin in gynecologic malignancy / 대한산부인과학회지

OBJECTIVE: The prognosis of gynecologic malignancies was closely related to the nutritional status of patients as well as clinical or surgical staing at the time of diagnosis. The serum prealbumin has relatively short half-life among the nutritional parameters and could be used to detect immediate postoperative change of nutritional state in surgical patients. The purpose of this study was to evaluate the clinical impact of serum prealbumin and the validity of prealbumin in prediction and detection of postoperative complications in high risk patients with gynecologic malignancy. METHODS: 153 gynecologic malignant patients and 68 non-malignant patients operated from January 1999 to May 2003 were studied retrospectively. The serum albumin, total lymphocyte count (TLC), prealbumin were compared between the malignant and non-malignant patients, early and advanced stage cancer group, and complicated and uncomplicated group. Prealbumin was defined as the difference between preoperative and postoperative prealbumin concentrations. The correlation was statistically analyzed by Student's t-test, one way ANOVA test, and x2-test (SPSS ver. 11.0). RESULTS: There was significant difference in prealbumin between non-malignant patients and malignant patients (p=0.049). There was also significant difference in prealbumin between carcinoma in situ of uterine cervix and cervical cancer group (p=0.049). However there were no significant differences in prealbumin between early and advanced stage ovarian cancer and uterine cancer (p=0.48, p=0.67, respectively). There were no significant differneces between complicated and uncomplicated groups in prealbumin and delta prealbumin. CONCLUSION: Serum prealbumin was not useful in prediction and detection of high risk group of postoperative complications in gynecologic cancer patients.

Evaluation of Nutritional Parameters in Gynecologic Patients Undergoing Laparotomic Surgery / 대한산부인과학회잡지

OBJECTIVE: The serum prealbumin has relatively short half-life among the nutritional parameters and therefore could be used to detect immediate postoperative change of nutritional state in surgical patients. This study was proposed to evaluate the validity of delta prealbumin in prediction and detection of high risk patients through the analysis of the correlation between delta prealbumin and postoperative complication. METHODS AND MATERIALS: One hundred sixteen patients were retrospectively studied. The serum albumin, TLC, prealbumin were compared between the complicated (N=30) and controlled group (N=86). The correlation between delta prealbumin and postoperative complication, underlying disease, malignancy and operative procedures were statistically analyzed by Student's t-test. RESULTS: There were no significant differences in serum albumin, TLC, prealbumin between the complicted and controlled group but there was a significant difference in delta prealbumin (98.5+/-50.9 vs 75.2+/-37.3 mg/dL, p=0.03). The associations were found between delta prealbumin and underlying disease, malignancy and operative procedures. However, it was not statistically significant. CONCLUSION: This study demonstrates that the surgical patients with high risk of postoperative complications can be detected early in immediate postoperative period by nutritional assessment as well as in preoperative period and can be supported enterally or parenterally. The evaluation of delta prealbumin will contribute to the decrease of postoperative morbidity and mortality.

RELATIONSHIP BETWEEN BLOOD AND URINE NUTRITIONAL PARAMETERS AND BLOOD PRESSURE AMONG FIVE POPULATION GROUPS IN CHINA / 营养学报

Five population groups, including farmers living in Veining (a cold hilly southern county), farmers and labourers in Shijiazhuang (a northern district), coastal fishermen in Zhoushan and "Yi" nationality farmers in Veining (where the incidence of hypertension is very low in China) were selected randomly (467 male subjects, 40-59 years old) to explore nutritional parameters-BP relationships. The results showed; (1) Pulse rate, QI and BP were lowest in Veining "Han" and "Yi" nationality groups. (2) Values of blood and urine nutritional parameters were in close accord with the diet customs of the different population groups. (3) Urine Na, Ca, Ca/Mg, urea nitrogen and serum cholesterol, total protein, albumin, uric acid were higher, while urine K was lower in hypertensives. (4) Urine Na, Na/K, Ca/ Mg and serum albumin, total protein, cholesterol, triglyceride, uric acid levels correlated positively, while K inversely with BP on multivariate stepwise regression and/or discrimination analyses. These results suggested high Na (Ca)-intake might be hypertensive, while high K(Mg)-intake an-tihypertensive, the serum protein - BP relationship could not be ascribed as a secondary effect of hemoconcentration in hypertension; a high protein intake, regardless of nature, could be hypertensionogenic; hyperlipidemia seemed to be a risk factor of hypertension, not being the secondary consequence to high BP. In designing a strategic protocol for primary prevention of hypertension, the above should be given due consideration.