Low folate levels associated with malnutrition in hospital patients

Low folate levels associated with malnutrition in hospital patients

About 10% of patients who come to complex care hospitals may have low levels of folate and other indicators of malnutrition, investigators say. To ensure those patients are identified and helped, those who present with gastrointestinal problems, chronic kidney disease or sepsis -- all associated with malnutrition -- need to have their folate levels tested on admission, they report in the journal Laboratory Medicine . We looked at people who had low levels and relatively normal folate levels. The people with low levels had a higher incidence of gastrointestinal disorders like chronic diarrhea as well as sepsis and kidney disease. The other piece was that people who had low levels also had other markers of malnutrition." Dr. Gurmukh Singh, vice chair of pathology at the Medical College of Georgia at Augusta University Singh and his colleagues were trying to come up with a recommendation for whose folate levels should be tested because of testing inconsistencies he was finding at AU Medical Center, the Augusta-based adult teaching hospital for MCG, including what happened when a low folate level was found. The investigators compared 1,019 patients with a serum folate level of less than seven nanograms per milliliter, which they considered low, to a group of 300 patients with an intermediate level of at least 15 nanograms per milliliter. A nanogram is one billionth of a gram, and a milliliter is one thousandth of a liter. Evidence of malnutrition they found in those with low folate levels included 25% with a lower serum albumin, the main protein of the liquid portion of blood that's made by the liver; 55% with low levels of prealbumin, a short-lived protein made by the liver which decreases in supply when the liver isn't getting adequate nutrition; and 11% with a deficiency in vitamin B12, which often works synergistically with folate, which is also a B vitamin. More than 62% of those with low serum folate were deficient in one or more of these malnutrition markers, the investigators say. Their findings led them to suggest that patients with a folate level of less than seven nanograms per milliliter be evaluated for malnutrition. A state of overweight or obesity should not preclude malnutrition evaluation, they say. The low folate group also had a significantly higher prevalence of gastrointestinal disorders, sepsis and abnormal serum creatinine. Creatinine is a breakdown product of muscle and protein that is typically eliminated by the kidneys, and high blood levels indicate kidney problems. Related Stories



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