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Title: Nutritional investigation of undernourished hospital patients with particular reference to serum proteins and metallothionein
Author: Robertson, A.
Awarding Body: University of Aberdeen
Current Institution: University of Aberdeen
Date of Award: 1992
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Reliable methods are needed to diagnose undernourished patients, to identify metabolic complications from infections or other stresses and to assess if there is a more immediate response to nutritional therapy than that detected by a relatively slow change in body mass. Metallothionein levels in blood cells of rats decreased when their food intake was restricted. Although these metallothionein levels were initially measured by radioimmunoassay, more recently enzyme-linked immunosorbent assays (ELISAs) have been developed. Attempts were made to improve the precision of one of these ELISAs so that metallothionein levels could be measured in humans, particularly 18 undernourished hospital patients. Although metallothionein levels did not appear helpful in diagnosing undernourished patients, the surrogates for body composition, such as body mass index (BMI) or arm circumference, provided simple, reliable measurements for diagnosing patients at risk. In addition the metallothionein levels in these undernourished patients did not respond to nutritional stimuli, whereas serum insulin-like growth factor I (IGF-I) did increase after feeding. Indeed IGF-I levels increased within 3 days of feeding in all patients regardless of the degree of acute phase response. The presence of acute phase response was established by the increase in serum C-reactive protein (CRP) levels. Thus simple, reliable criteria are recommended to specify chronic energy deficiency (namely BMI and arm circumferences); to discriminate acute phase response (namely serum CRP levels) and to monitor the response to nutritional support (namely serum IGF-I levels).
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available