PD287 - THE INFLAMMATION-NUTRITION NEXUS: PREALBUMIN AS AN INTEGRATIVE BIOMARKER OF METABOLIC BALANCE IN CRITICALLY ILL ELDERLY PATIENTS

PD287

THE INFLAMMATION-NUTRITION NEXUS: PREALBUMIN AS AN INTEGRATIVE BIOMARKER OF METABOLIC BALANCE IN CRITICALLY ILL ELDERLY PATIENTS

Y. C. Su^1,*, Y.-Y. Chen²

¹Department of Dietetics, ²Division of Pulmonology, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan, Province of China

Rationale: Systemic inflammation in critically ill elderly patients often confounds the interpretation of traditional nutritional markers. This study aims to investigate the association between inflammatory stress (hs-CRP) and visceral protein (prealbumin) to elucidate the metabolic profiles and protein balance of ICU patients.

Methods: This prospective observational study enrolled 65 patients aged >65 years with acute respiratory failure requiring mechanical ventilation at a medical ICU since January 2025. On the third day of admission, serum high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), albumin, prealbumin, zinc, vitamin D, and 24-hour urinary urea nitrogen (UUN) were measured. Exclusion criteria included hemodynamic instability, severe pulmonary complications (e.g., ECMO, iNO), or failure to meet standardized weaning protocols (e.g., the NTUH Yunlin protocol). Pearson’s correlation analysis was employed to evaluate the nexus between inflammatory and nutritional markers.

Results: Among 65 elderly patients, a significant inverse correlation was observed between prealbumin and hs-CRP (r = -0.347, p < 0.01), indicating that intensified inflammatory stress significantly suppresses prealbumin levels. Prealbumin demonstrated significant positive correlations with zinc (r = 0.322, p < 0.01), vitamin D3 (r = 0.301, p < 0.05), and UUN (r = 0.524, p < 0.01). Furthermore, a significant association was noted between hs-CRP and UUN (r = -0.44, p < 0.05), reflecting the metabolic impact of systemic inflammation on protein catabolism and overall metabolic balance.

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Conclusion: Prealbumin serves as a sensitive indicator reflecting the nexus between systemic inflammation, micronutrient status, and protein metabolism. Prealbumin is a critical determinant for monitoring metabolic balance and the trajectory of clinical recovery in critically ill elderly populations.

Disclosure of Interest: Y. C. Su Other: The authors declare no financial or non-financial conflicts of interest related to this work., Y.-Y. Chen Other: The authors declare no financial or non-financial conflicts of interest related to this work.