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Erhebung des Ernährungszustandes — ein Bestandteil der klinischen Routine-Diagnostik: Cholinesterase-Aktivität als Ernährungsindikator

Assessment — A part of basic diagnostic procedures: Cholinesterase as nutritional indicator

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Summary

Nutritional assessment has not yet been established as integral part of basic clinical diagnostic procedures everywhere, eventhough the prognostic relevance of malnutrition is well known. One of the reasons is the the lack of nutritional indicators, which are specific of and sensitive for changes of the nutritional status on the one hand, and routinely analyzed on the other. We report on the utility of serum cholinesterase, which has the shortest half-life of all plasma proteins, to identify malnourished patients. 54 internal inpatients with malignant diseases or in septic state were followed up prospectively with respect to courses of cholinesterase (CHE), albumin (ALB), transferrin (TRA), and body weight over periods of 4 weeks. A correct correlation to malnutrition was defined as plasma concentrations < reference ranges or continuous concentr. fall >10%. Based on 132 observations (65 with continuous weight loss, mean: −5.5% of original w.; 54 w. gain, mean +4,6%, 13 constant w.), changes of CHE had the highest correlation to weight changes (r=0.79,p<0.001), compared to the courses of TRA-or ALB-levels (r=0.65/0.68). Incorrect positive results (conc. fall or conc. < ref. range without weight loss): absolute levels — CHE 4%, ALB 4%, TRA 22%; conc. courses — CHE 0%, ALB 0%, TRA 6%. Incorrect negative: absolute c. — CHE 63%, ALB 30%, TRA 28%; courses — CHE 15%, ALB 19%, TRA 17%. The common determination of CHE and ALB-courses allowed a correct identification of malnutrition in 96% of all observations, with the same result as the courses of ALB + TRA. Because of its wide ref. ranges, the absolute CHE activity is useless for nutritional screening in contrast to ALB and TRA, but the follow-up of CHE-levels allows an excellent discrimination between good and bad nutritional status. The use of the CHE-course can be recommended as nutritional indicator, if TRA-analysis is not available.

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Abbreviations

ALB:

Albumin

CHE:

Cholinesterase

GEW:

Körpergewicht

OKG:

Optimales Körpergewicht

TRA:

Transferrin

MW:

Mittelwert

SD:

Standardabweichung

m:

männlich

w:

weiblich

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Authors and Affiliations

  1. Aus der Klinik II und Poliklinik für Innere Medizin der Universität zu Köln, Germany

    G. Ollenschläger, M. Schrappe-Bächer, M. Steffen, B. Bürger & B. Allolio

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  1. G. Ollenschläger
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  2. M. Schrappe-Bächer
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  3. M. Steffen
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  4. B. Bürger
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  5. B. Allolio
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Herrn Prof. Dr. W. Kaufmann zur Vollendung des 65. Lebensjahres gewidmet.

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Ollenschläger, G., Schrappe-Bächer, M., Steffen, M. et al. Erhebung des Ernährungszustandes — ein Bestandteil der klinischen Routine-Diagnostik: Cholinesterase-Aktivität als Ernährungsindikator. Klin Wochenschr 67, 1101–1107 (1989). https://doi.org/10.1007/BF01741785

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  • DOI: https://doi.org/10.1007/BF01741785

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