Document Detail

High rate of deficiency in the amino acids tryptophan and histidine in people with wounds: implication for nutrient targeting in wound management--a pilot study.
MedLine Citation:
PMID:  19155712     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Malnutrition resulting from inadequate protein, energy, or micronutrient intake has been identified as an independent risk factor for the development of pressure ulcers in older adult patients and is associated with increased morbidity and death. OBJECTIVE: To assess the relationship between albumin, the standard biochemical marker of nutritional adequacy, and amino acid status in people with wounds. METHODS: The authors performed tests for serum albumin, prealbumin, and amino acid profiles on 18 consecutive hospital patients with wounds and 7 patients without wounds. RESULTS: A low level of the essential amino acids tryptophan and histidine was a common finding in older people with wounds. Of the 18 consecutive wound cases, 16 (88.9%) were found to be deficient in tryptophan, histidine, or both. Moreover, levels were generally found to be lower than those in the group without wounds. The levels of all other amino acids were essentially normal for all patients. Finally, although serum albumin is often used as a surrogate marker of amino acid adequacy or nutritional status, clinically abnormal albumin had poor specificity (63.2%), poor sensitivity (60.7%), and low positive predictive value (70.8%) for the identification of a low tryptophan or histidine level. CONCLUSIONS: People with wounds are a relatively at-risk group and are likely to be overlooked in terms of micronutrient deficiencies, and these findings have important implications in terms of potential specific targeting of nutrient supplementation.
Beryl Dawson; Emmanuel J Favaloro
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Advances in skin & wound care     Volume:  22     ISSN:  1538-8654     ISO Abbreviation:  Adv Skin Wound Care     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-01-21     Completed Date:  2009-05-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100911021     Medline TA:  Adv Skin Wound Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  79-82     Citation Subset:  N    
Department of Nutrition and Dietetics, Balmain Hospital, Balmain NSW, Australia.
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MeSH Terms
Aged, 80 and over
Antidepressive Agents, Second-Generation*
Biological Markers
Case-Control Studies
Dietary Supplements
Histidine / deficiency*
Middle Aged
Nutritional Status*
Pilot Projects
Risk Assessment
Tryptophan / deficiency*
Wound Healing*
Wounds and Injuries / diet therapy*
Reg. No./Substance:
0/Albumins; 0/Antidepressive Agents, Second-Generation; 0/Biological Markers; 71-00-1/Histidine; 73-22-3/Tryptophan

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