Clinical and Laboratory Markers of Body Wasting and Malnutrition in Long-Livers

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BACKGROUND . Malnutrition is a prevalent and clinically significant condition among long-livers, associated with increased vulnerability, functional decline, and adverse health outcomes. Conventional screening tools, such as questionnaires, may be limited in individuals aged 90 and older due to cognitive and physical impairments. This highlights the importance of objective laboratory-based assessment in this population. OBJECTIVE : to identify laboratory biomarkers associated with malnutrition and weight loss in long-livers MATERIALS AND METHODS. This study included 3,869 long-livers aged 90 and above. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), and a comprehensive laboratory panel included markers of inflammation, protein metabolism, hormonal status, and micronutrients. A subset of participants underwent follow-up to assess changes in body weight. Non-parametric tests and the Boruta algorithm were used to identify key predictors. The ethics committee (№ 30 24.12.2019) reviewed the study. The statistical analysis was performed using R version 4.4.0. RESULTS . Malnutrition or its risk (MNA ≤ 11) was identified in 78.6% of long-livers. These individuals exhibited significant changes in laboratory parameters: lower levels of albumin, total protein, hemoglobin, leptin, 25(OH) D, and IGF-1, and higher levels of C-reactive protein (CRP), NT-proBNP, and ferritin (p < 0.001). Boruta analysis highlighted albumin, total protein, hemoglobin, and leptin as the strongest predictors of malnutrition. A change in IGF-1 was consistently observed both in malnourished participants and those with progressive weight loss, regardless of initial nutritional status. CONCLUSIONS . Laboratory screening provides valuable insights into the metabolic profile of malnutrition in long-livers, reflecting systemic inflammation, protein-energy deficiency, and diminished anabolic reserve. IGF-1 may serve as a sensitive indicator of early catabolic processes. Laboratory-based assessment is an effective and practical tool when questionnaire-based methods are limited or inapplicable.

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