J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://www.jocmr.org

Original Article

Volume 15, Number 2, February 2023, pages 109-115

Positive Correlation Between Changes in Serum Albumin Levels and Breakfast Non-Protein Calorie/Nitrogen Ratio in Geriatric Patients

**Table 1.** Demographics (n = 36)
	At admission	At discharge	P-value
Data are expressed as mean ± standard deviation. Paired t-test. The main diseases for admission included chronic heart failure, bronchial pneumonia, chronic obstructive pulmonary disease, and type 2 diabetes; however, these conditions had been treated in the acute care hospital, and thus, patients’ condition became stable. BI: Barthel index; Alb: serum albumin; TC: total cholesterol; TLC: total lymphocyte count; CRP: C-reactive protein; AST: aspartate aminotransferase; ALT: alanine aminotransferase; NPC/N: non-protein calorie/nitrogen ratio.
Number of patients (male/female)	36 (20/16)
Age (years)	81.7 ± 7.7
Duration of hospitalization (days)	74.0 ± 43.7
Charlson co-morbidity index (score)	2.5 ± 1.2
BI (score)	50.8 ± 41.6
Body mass index (kg/m²)	19.9 ± 3.2	19.9 ± 3.0	0.953
Alb (g/dL)	3.5 ± 0.4	3.4 ± 0.4	0.227
25-75%	3.3 - 3.7	3.3 - 3.7
TC (mg/dL)	173 ± 38	175 ± 35	0.635
25-75%	145 - 195	147 - 198
TLC (/mm³)	1,422 ± 471	1,588 ± 536	0.133
25-75%	1,129 - 1,718	1,278 - 1,817
CRP (mg/dL)	0.29 ± 0.42	0.4 ± 0.52	0.283
25-75%	0.03 - 0.33	0.07 - 0.52
AST (IU/L)	22 ± 8	21 ± 6	0.128
25-75%	16 - 25	18 - 23
ALT (IU/L)	17 ± 9	16 ± 10	0.801
25-75%	12 - 19	10 - 19
Nutrition intake
Energy intake (kcal/BW kg/day)	29.8 ± 6.5
Breakfast	9.5 ± 2.4
Lunch	10.3 ± 2.4
Dinner	10.0 ± 2.4
Protein intake (g/BW kg/day)	1.17 ± 0.28
Breakfast	0.32 ± 0.08
Lunch	0.42 ± 0.12
Dinner	0.43 ± 0.11
NPC/N mean	136 ± 22
Breakfast	167 ± 37
Lunch	140 ± 30
Dinner	130 ± 30

Table 1. Demographics (n = 36)

At admission

At discharge

P-value

Data are expressed as mean ± standard deviation. Paired t-test. The main diseases for admission included chronic heart failure, bronchial pneumonia, chronic obstructive pulmonary disease, and type 2 diabetes; however, these conditions had been treated in the acute care hospital, and thus, patients’ condition became stable. BI: Barthel index; Alb: serum albumin; TC: total cholesterol; TLC: total lymphocyte count; CRP: C-reactive protein; AST: aspartate aminotransferase; ALT: alanine aminotransferase; NPC/N: non-protein calorie/nitrogen ratio.

Number of patients (male/female)

36 (20/16)

Age (years)

81.7 ± 7.7

Duration of hospitalization (days)

74.0 ± 43.7

Charlson co-morbidity index (score)

2.5 ± 1.2

BI (score)

50.8 ± 41.6

Body mass index (kg/m²)

19.9 ± 3.2

19.9 ± 3.0

0.953

Alb (g/dL)

3.5 ± 0.4

3.4 ± 0.4

0.227

25-75%

3.3 - 3.7

TC (mg/dL)

173 ± 38

175 ± 35

0.635

25-75%

145 - 195

147 - 198

TLC (/mm³)

1,422 ± 471

1,588 ± 536

0.133

25-75%

1,129 - 1,718

1,278 - 1,817

CRP (mg/dL)

0.29 ± 0.42

0.4 ± 0.52

0.283

25-75%

0.03 - 0.33

0.07 - 0.52

AST (IU/L)

22 ± 8

21 ± 6

0.128

25-75%

16 - 25

18 - 23

ALT (IU/L)

17 ± 9

16 ± 10

0.801

25-75%

12 - 19

10 - 19

Nutrition intake

Energy intake (kcal/BW kg/day)

29.8 ± 6.5

Breakfast

9.5 ± 2.4

Lunch

10.3 ± 2.4

Dinner

10.0 ± 2.4

Protein intake (g/BW kg/day)

1.17 ± 0.28

Breakfast

0.32 ± 0.08

Lunch

0.42 ± 0.12

Dinner

0.43 ± 0.11

NPC/N mean

136 ± 22

Breakfast

167 ± 37

Lunch

140 ± 30

Dinner

130 ± 30

**Table 2.** Dietary Pattern (n = 36)
Nutrient intake ratio	Dietary pattern
^a\|load\| > 0.500 were considered as an important factor (in module).
Breakfast
Energy intake	0.317	0.551^a	0.134
Protein intake	0.285	-0.016	0.760^a
Non-protein energy intake	0.305	0.607^a	0.032
Lunch
Energy intake	0.359	-0.075	-0.241
Protein intake	0.328	-0.395	0.217
Non-protein energy intake	0.351	0.000	-0.334
Dinner
Energy intake	0.357	-0.128	-0.236
Protein intake	0.337	-0.381	0.174
Non-protein energy intake	0.351	-0.071	-0.316
Variance explained by each factor (eigenvalue)	2.666	0.940	0.809
Proportion of variance (%)	79.0	9.8	7.3
Cumulative proportion (%)	79.0	88.8	96.1

Table 2. Dietary Pattern (n = 36)

Nutrient intake ratio

Dietary pattern

First factor

Second factor

Third factor

^a|load| > 0.500 were considered as an important factor (in module).

Breakfast

Energy intake

0.317

0.551^a

0.134

Protein intake

0.285

-0.016

0.760^a

Non-protein energy intake

0.305

0.607^a

0.032

Lunch

Energy intake

0.359

-0.075

-0.241

Protein intake

0.328

-0.395

0.217

Non-protein energy intake

0.351

0.000

-0.334

Dinner

Energy intake

0.357

-0.128

-0.236

Protein intake

0.337

-0.381

0.174

Non-protein energy intake

0.351

-0.071

-0.316

Variance explained by each factor (eigenvalue)

2.666

0.940

0.809

Proportion of variance (%)

79.0

9.8

7.3

Cumulative proportion (%)

79.0

88.8

96.1

**Table 3.** Examination of Factors for Change Rate of Albumin (n = 36)
	Regression of coefficient	Standard error	t value	P-value
*P < 0.05, n = 36. Multiple regression analysis. ^aStepwise method. NPC/N: non-protein calorie/nitrogen ratio.
Model 1
Sex	0.078	0.042	1.846	0.075
First factor	0.002	0.008	0.255	0.801
Second factor	0.008	0.022	0.354	0.726
Third factor	-0.055	0.025	-2.164	0.038*
Model 2^a
Breakfast NPC/N	0.043	0.019	2.282	0.029*

Table 3. Examination of Factors for Change Rate of Albumin (n = 36)

Regression of coefficient

Standard error

t value

P-value

*P < 0.05, n = 36. Multiple regression analysis. ^aStepwise method. NPC/N: non-protein calorie/nitrogen ratio.

Model 1

Sex

0.078

0.042

1.846

0.075

First factor

0.002

0.008

0.255

0.801

Second factor

0.008

0.022

0.354

0.726

Third factor

-0.055

0.025

-2.164

0.038*

Model 2^a

Breakfast NPC/N

0.043

0.019

2.282

0.029*

**Table 4.** Comparison Between the Upper Group and the Lower Group of Change Rate of Albumin (n = 24)
	Lower group	Upper group	P value
Data are expressed as mean ± standard deviation. Mann-Whitney U test. ^aFisher’s exact test. Alb: serum albumin; NPC/N: non-protein calorie/nitrogen ratio.
Number of patients (male/female)	12 (8/4)	12 (5/7)	0.414
Age (years)	83 ± 4.5	79.6 ± 10.1	0.296
At discharge Alb/at admission Alb	0.85 ± 0.08	1.11 ± 0.09	< 0.001
Breakfast NPC/N	-0.35 ± 0.91	0.54 ± 1.23	0.058
Breakfast (bread/porridge)^a	11/1	6/6	0.069

Table 4. Comparison Between the Upper Group and the Lower Group of Change Rate of Albumin (n = 24)

Lower group

Upper group

P value

Data are expressed as mean ± standard deviation. Mann-Whitney U test. ^aFisher’s exact test. Alb: serum albumin; NPC/N: non-protein calorie/nitrogen ratio.

Number of patients (male/female)

12 (8/4)

12 (5/7)

0.414

Age (years)

83 ± 4.5

79.6 ± 10.1

0.296

At discharge Alb/at admission Alb

0.85 ± 0.08

1.11 ± 0.09

< 0.001

Breakfast NPC/N

-0.35 ± 0.91

0.54 ± 1.23

0.058

Breakfast (bread/porridge)^a

11/1

6/6

0.069