Bülent SALMAN, MUSTAFA KEREM, TONGUÇ UTKU YILMAZ, Tevfik Tolga ŞAHİN, Abdulkadir BEDİRLİ, Mehmet OĞUZ, Gürsel BİBEROĞLU

The relation between nutritional status and age of surgical patients with the levels of vitamin A,C, E and beta-caroten

Anahtar Kelimeler:

Vitamin A, Vitamin E, Beslenme durumu, Askorbik asit, Beta karoten, Vücut kitle indeksi

The study aimed to investigate the effects of age, body mass index and nutritional assessment system score, levels of vitamins A, C, E and beta-carotene in surgical patients with different diagnosis. 163 patients hospitalized at Gazi University Medical School, Department of General Surgery were prospectively analyzed. Patients were grouped as younger (Group 1, n=110), and older (Group 2, n=53) than 60 years. Nutritional statuses were classified as normal, moderately malnourished, and severely malnourished. The serum vitamin levels were investigated with comparisons of age, gender, primary surgical disease (benign or malign), and BMI. Correlations between BMI, age and vitamin levels were evaluated. Group 2 had significantly worse nutritional status and more malign diseases than group 1. Vitamin A, C, E and beta carotene levels was found low in 20 %, 39%, %6, and 7 % of the patients in group 1 and 60%, 81%, 15%, 30% of patients in group 2 respectively. Vitamin levels were low in malnourished patients. BMI of the patients were in correlation with the vitamin levels. Body mass index was in correlation with the serum vitamin levels. Supplementation of vitamins A and C can be beneficial in elderly patients.

Keywords:

Vitamin A, Vitamin E, Nutritional Status, Ascorbic Acid, beta Carotene, Body Mass Index,

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1. Edington J, Boorman J, Durrant ER, Perkins A, Giffin CV, James R et al. Prevalence of malnutrition on admission to four hospitals in England. The Malnutrition Prevalence Group. Clin Nutr 2000;19: 191-5.

2. Bruun Ll, Bosaeus I, Nygaard K. Prevalence of malnutrition in surgical patients: evaluation of nutritional support and documentation. Clin Nutr 1999;18: 141-7.

3. Chima CS, Barco K, Dewitt ML, Maeda M, Teran JC, Mullen KD. Relationship of nutritional status to length of stay, hospital cost, and discharge status of the patients hospitalized in the medicine service. J Am Diet Assoc 1997;97: 975-8.

4. Correia MI, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr 2003;22: 235-9.

5. Schneider SM, Veyres P, Pivot X, Soummer AM, Jambou P, Filippi J et al. Malnutrition is an independent factor associated with nosocomial infections. Br J Nutr 2004;92: 105-11.

6. Messner RL, Stevens N, Wheeler WE, Hawes MC. Effect of admission nutritional status on length of hospital stay. Gastroenterol Nurs 1991;13: 202-5.

7. Velanovich V. The value of routine preoperative laboratory testing in predicting preoperative complications: a multivariate analysis. Surgery 1991;109: 235-43.

8. McWhirter JP, Pennington CR. Incidence and recognition of malnutrition in hospital. BMJ 1994;308: 945-8.

9. Selberg O, Sel S. The adjunctive value of routine biochemistry in nutritional assessment of hospitalized patients. Clin Nutr 2001;20: 477-85.

10. Planas M, Audivert S, Pérez-Portabella C, Burgos R, Puiggrós C, Casanelles JM et al. Nutritional status among adult patients admitted to an university-affiliated hospital in Spain at the time of genoma. Clin Nutr 2004;23: 1016-24.

11. Chiplonkar SA, Agte VV, Mengale SS, Tarwadi KW. Are lifestyle factors good predictors of retinol and vitamin C deficiency in apparently healthy adults? Eur J Clin Nutr 2002;56: 96-104.

12. Baker JP, Detsky AS, Wesson DE, Wolman SL, Stewart S, Whitewell J et al. Nutritional assessment: a comparison of clinical judgement and objective measurements. New Eng J Med 1982;306: 969-72.

13. Baker H, DeAngelis B, Baker E, Khalil M, Frank O. Human plasma pattens during 14 days ingestion of vitamin E, beta-caroten, ascorbic acid and their various combinations. J Am Coll Nutr 1996;15: 159-63.

14. Blee HT, Cogbill HT, Lambert P. Hemorrhage associated with vitamin C deficiency in surgical patients. Surg 2002;131: 408-12.

15. Lansey S, Waslien C, Mulvihill M, Fillit H. The role of anthropometry in the assessment of malnutrition in the hospitalized frail elderly. Gerontology 1993;39: 346-53.

16. Özden Y, Irmak V, Erten H. Meme kanserli ve sağlıklı beta-karoten, A vitamini ve E vitamini düzeylerinin üç ayrı parametresiz test aracılığı ile karşılaştırılması. Cerrahpaşa Tıp Dergisi 2004;35: 23-27

17. Salman B, Oğuz M, Emre AU, Hasanoğlu A, Biberoğlu G, Tekin E. Malnutrisyonlu ve malnütrisyonsuz hastalarda vitamin A, E ve beta karoten düzeyleri. Demet Sağlık Tıp Dergisi 2003;1: 30-4.

18. Öcal A, Çaken A, Özsöz A, Gülerçe i. Kronik obstrüktif hastalığında C ve E vitaminlerinin serum düzeyleri. Solunum Hastalıkları 2001;12: 184-9. 19. Uzunoğlu N, Sunguroğlu K. Mide kanserinde serum retinol, betakaroten, çinko, bakr, bakr/çinko de?erleri. Medical Network Klinik Bilimler ve Doktor 2000;6: 694-9.

20. Papila Ç, Ünal T, ipek T. Premenopozal dönemde fibrokistik meme hastalarında E vitamininin hormonal değerler üzerine etkisi. Endokrinolojide Yönelişler 1999;8: 2-4.

21. Morley JE, Silver AJ. Nutritional issues in nursing home care. Ann Inter Med 1995; 123: 850-9.

22. Azais B, Moriniere C, Guesne A. Vitamin A status in the institutionalized elderly. Int J Vitam Nutr Res 1995;65: 151-61.

23. Marazzi MC, Mancinelli S, Palombi L. Vitamin C and nutritional status of institutionalized and noninstitutionalized elderly women in Rome. Int J Vitam Nutr Res 1990;60: 351-9.

24. Vannucchi H, da Cunha DF, Bernardes MM, Unamuno MR. Serum levels of vitamin A, E, C and B2, carotenoid and zinc in hospitalized elderly patients. Rev Saude Publica 1994; 28:121-6.

25. Constans T, Bacq Y, Bréchot JF, Guilmot JL, Choutet P, Lamisse F. Protein-energy malnutrition in elderly medical patients. J Am Geriatr Soc 1992; 40: 263-8.

26. Lares-Asseff I, López Hernández Mdel C, Santiago Porras P, Ramírez López E, Pérez Guillé G, Cravioto J. Nutritional state of betacarotene and retinol in institutionalized elderly individuals of Mexico City. Int J Vitam Nutr Res 1995;65: 236-9.

27. Fifty-eight World Health Assembly 2005. Strengtining active and healthy aging. WHO Report- WHA58.16 page 91. (http://www.who.int/ nmh/ a 5819/en/index.html).

28. Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and recommendations for vitamin C intake. JAMA 1999;281:1425-33.

29. Brin M, Batuernfeind J C. Vitamin needs of the elderly. Postgrad Med 1978; 63: 969-81.

30. James WP, Ferro-Luzzi A, Waterlow JC. Definition of chronic energy deficiency in adults. Report of a working party of the International Dietary Energy Consultative Group. Eur J Clin Nutr 1988;42: 969-81.

31. Campillo B, Paillaud E, Uzan I, Merlier I, Abdellaoui M, Perennec J et al. Value of body mass index in the detection of severe malnutrition: influence of the pathology and changes in the anthropometric parameters. Clin Nutr 2004;23: 551-9.

32. Kondrup J, Johansen N, Plum LM, Bak L, Larsen IH, Martinsen A et al. Incidence of nutritional risk and causes of inadequate nutritional care in hospitals. Clin Nutr 2002;21: 461-8.

33. Mandal SK, Rya AK. Vitamin C status of elderly patients on admission into an assessment geriatric ward. J Int Med Res 1987;15: 96-8.

34. Cunha DF, Cunha SF, Unamuno MR, Vannucchi H. Serum levels assessment of vitamin A, E, C, B2 and carotenoids in malnourished and nonmalnourished hospitalized elderly patients. Clin Nutr 2001;20:167-70.

35. Campbell DR, Gross MD, Martini MC, Grandits GA, Slavin JL, Potter JD, et al. Plasma carotenoids as biomarkers of vegetable and fruit intake. Cancer Epidemiol Biomarkers Prev 1994;3: 493-500.

36. Porrini M, Simonetti P, Ciappellano S, Testolin G. Vitamin A, E, and C nutritive of elderly people in North Italy. Int J Vit Nutr Res 1987;57: 349-55.

37. Heseker H, Schneider R. Requirement and supply of vitamin C, E, and beta-carotene for elderly men and women. Eur J Clin Nutr 1994;48:118-27.