C-Reactive Protein-to-Prealbumin and C-Reactive Protein-to-Albumin Ratios as Nutritional and Prognostic Markers in Hospitalized Patients—An Observational Study
Open accessAbstract
This study aimed to evaluate the role of the C-reactive protein-to-prealbumin (CP) ratio and the C-reactive protein-to-albumin (CA) ratio as nutritional and prognostic markers. A retrospective study was conducted on hospitalized patients who underwent a nutritional assessment and the measurement of C-reactive protein, prealbumin, and albumin (n = 274). Receiver operating characteristic (ROC) curve analysis was used. The area under the curve (AUC) of the CP ratio for predicting mortality was 0.644, 95%CI (0.571 to 0.717), and the CA ratio had an AUC of 0.593, 95%CI (0.518 to 0.669). The AUC of the CP ratio for the differential diagnosis between severe and moderate disease-related malnutrition (DRM) was 0.643, 95%CI (0.564 to 0.722), and the CA ratio had an AUC of 0.650, 95%CI (0.572 to 0.728). The CP and CA ratios showed greater accuracy in predicting mortality compared to C-reactive protein as an isolated marker (p = 0.011 and p = 0.006, respectively). Both ratios also improved the ability of prealbumin and albumin to identify severe DRM (p = 0.002 and p = 0.044, respectively). In conclusion, these results suggest that the CP and CA ratios may have a limited role in predicting mortality and identifying severe DRM by outperforming isolated protein markers.
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Current research supports the integration of inflammatory and protein markers such as CRP, albumin, and prealbumin to improve sensitivity in detecting protein-energy malnutrition and systemic inflammation.
“Current research supports the integration of inflammatory and protein markerssuch as CRP, albumin, and prealbumin-to improve sensitivity in detecting protein-energy malnutrition and systemic inflammation [21,152].”
From The Seven Methods for the Evaluation of Nutritional Status—ABCDEFG: Narrative Review (2026) · cites this paper as [152]
The Results (§3.2.2; page not supplied) report that CRP-to-prealbumin and CRP-to-albumin ratios detected severe versus moderate disease-related malnutrition more accurately than the isolated protein markers, but had poor accuracy for diagnosing malnutrition overall. The paper does not show improved sensitivity for detecting protein-energy malnutrition generally or improved detection of systemic inflammation; the Methods (§2.2) define inflammation using CRP alone. (LLM, conf=0.87)
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Cites
What is subjective global assessment of nutritional status?
Detsky, A., McLaughlin, Baker, J., Johnston, N., Whittaker, S., Mendelson, R., & Jeejeebhoy, K. (1987) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/014860718701100108 · Cited by 3,252 · see citing works
Jensen, G. L., Cederholm, T., Correia, M. I. T. D., Gonzalez, M. C., Fukushima, R., Higashiguchi, T., de Baptista, G. A., Barazzoni, R., Blaauw, R., Coats, A. J. S., et al. (2019) · Journal of Parenteral and Enteral Nutrition · doi:10.1002/jpen.1440 · Cited by 1,442 · see citing works
CONUT: a tool for controlling nutritional status. First validation in a hospital population.
de Ulíbarri, J. I., González-Madroño, A., de Villar, N. G. P., González, P., González, B., Mancha, A., Rodríguez, F., & Fernández, G. (2005) · PubMed · Cited by 1,383 · see citing works
Hospital Malnutrition: Prevalence, Identification and Impact on Patients and the Healthcare System
Barker, L. A., Gout, B. S., & Crowe, T. C. (2011) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph8020514 · Cited by 985 · see citing works
Nutritional Laboratory Markers in Malnutrition
Keller, U. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8060775 · Cited by 753 · see citing works
Management of disease-related malnutrition for patients being treated in hospital
Schuetz, P., Seres, D., Lobo, D. N., Gomes, F., Kaegi-Braun, N., & Stanga, Z. (2021) · The Lancet · doi:10.1016/s0140-6736(21)01451-3 · Cited by 355 · see citing works
Hospital malnutrition in Latin America: A systematic review.
Correia, M., Perman, M., & Waitzberg, D. (2017) · Clinical Nutrition · doi:10.1016/j.clnu.2016.06.025 · Cited by 279 · see citing works
Predictive value of C-reactive protein/albumin ratio in acute pancreatitis
Kaplan, M., Ateş, İ., Akpinar, M. Y., Yüksel, M., Kuzu, U. B., Kaçar, S., Çoşkun, O., & Kayaçeti̇n, E. (2017) · Hepatobiliary & pancreatic diseases international · doi:10.1016/s1499-3872(17)60007-9 · Cited by 171 · see citing works
Is transthyretin a good marker of nutritional status?
Dellière, S., & Cynober, L. (2017) · Clinical Nutrition · doi:10.1016/j.clnu.2016.06.004 · Cited by 138 · see citing works
Liao, C., Yu, Y.-L., Lin, Y., Hsu, Y., Chern, Y., Chiang, J., & You, J. (2021) · World Journal of Surgical Oncology · doi:10.1186/s12957-021-02253-y · Cited by 127 · see citing works
Regulation of C-reactive protein conformation in inflammation
Yao, Z., Zhang, Y., & Wu, H. (2019) · Inflammation Research · doi:10.1007/s00011-019-01269-1 · Cited by 125 · see citing works
Reid, M. E., Badaloo, A. V., Forrester, T., Morlese, J. F., Heird, W. C., & Jahoor, F. (2002) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/76.6.1409 · Cited by 87 · see citing works
Acute-phase protein response is impaired in severely malnourished children
Doherty, J. F., Golden, M. H., Raynes, J. G., Griffin, G. E., & Mcadam, K. P. W. J. (1993) · Clinical Science · doi:10.1042/cs0840169 · Cited by 76 · see citing works
Talaverón, J. M. L., Tahull, M. B., & Badosa, E. L. (2017) · Clinical Nutrition · doi:10.1016/j.clnu.2017.08.013 · Cited by 54 · see citing works
Murillo, A. Z., Petrina-Jáuregui, M. E., Ripa-Ciáurriz, C., Sánchez, R. S., Villazón-González, F., Faes, Á. G.-D., Fernández-López, C., Calles-Romero, L., Martín-Palmero, Á., Riestra-Fernández, M., et al. (2021) · Nutrición Hospitalaria · doi:10.20960/nh.03638 · Cited by 49 · see citing works
GLIM criteria to identify malnutrition in patients in hospital settings: A systematic review
Alves, L. F., de Jesus, J. D. S., Britto, V. N. M., de Jesus, S. A., Santos, G. S., & de Oliveira, C. C. (2023) · Journal of Parenteral and Enteral Nutrition · doi:10.1002/jpen.2533 · Cited by 43 · see citing works
Predictive Value of the C-Reactive Protein-To-Prealbumin Ratio in Medical ICU Patients
Li, L., Dai, L., Wang, X. Q., Wang, Y., Zhou, L., Chen, M., & Wang, H. (2017) · Biomarkers in Medicine · doi:10.2217/bmm-2016-0266 · Cited by 43 · see citing works
MANARY, M. J., Yarasheski, K. E., Berger, R. A., Abrams, E. T., Hart, C. A., & Broadhead, R. (2004) · Pediatric Research · doi:10.1203/01.pdr.0000127017.44938.6d · Cited by 39 · see citing works
Yamada, T., Haruki, S., Minami, Y., 沼田まどか, & Hagiwara, N. (2021) · Journal of Cardiology · doi:10.1016/j.jjcc.2021.05.009 · Cited by 35 · see citing works
C reactive protein to albumin ratio (CAR) as predictor of anastomotic leakage in colorectal surgery
Paliogiannis, P., Deidda, S., Maslyankov, S., Paycheva, T., Farag, A. F. A., Mashhour, A. N., Misiakos, E., Papaconstantinou, D., Mik, M., Łosińska, J., et al. (2021) · Surgical Oncology · doi:10.1016/j.suronc.2021.101621 · Cited by 32 · see citing works
Prognostic Significance of C-reactive Protein-to-prealbumin Ratio in Patients with Esophageal Cancer
Matsunaga, T., Miyata, H., Sugimura, K., Motoori, M., Asukai, K., Yanagimoto, Y., Yamamoto, K., Akita, H., Nishimura, J., Wada, H., et al. (2019) · Yonago acta medica · doi:10.33160/yam.2020.02.002 · Cited by 30 · see citing works
Keevil, B. G., Nicholls, S. P., & Kilpatrick, E. S. (1998) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1177/000456329803500512 · Cited by 28 · see citing works
Lin, N., Li, J., Ke, Q., Wang, L., Cao, Y., & Liu, J. (2020) · Disease Markers · doi:10.1155/2020/4867974 · Cited by 27 · see citing works
Sonsöz, M. R. (2023) · Turk Kardiyoloji Dernegi Arsivi-Archives of the Turkish Society of Cardiology · doi:10.5543/tkda.2022.27741 · Cited by 23 · see citing works
Prognostic value of C-reactive protein/albumin ratio in hypertensive COVID-19 patients
Özdemir, İ. H., Özlek, B., Özen, M. B., Gündüz, R., Çetin, N., Özlek, E., Yıldız, B. S., & Bilge, A. R. (2021) · Clinical and Experimental Hypertension · doi:10.1080/10641963.2021.1937205 · Cited by 22 · see citing works
Kano, H., Midorikawa, Y., Song, P., Nakayama, H., Moriguchi, M., Higaki, T., Tsuji, S., & Takayama, T. (2020) · BioScience Trends · doi:10.5582/bst.2020.03167 · Cited by 16 · see citing works
de Valbuena, A. A., Pereira, N., Castillo, J. L., García, D., Núñez, J. R., Cayana, N., Morán, A., Parra, M. A., & Troconiz, C. (2004) · PubMed · Cited by 15 · see citing works
Turbidimetric determination of transthyretin (prealbumin) with a centrifugal analyzer.
Hamlin, C. R., & Pankowsky, D. A. (1987) · Clinical Chemistry · doi:10.1093/clinchem/33.1.144 · Cited by 13 · see citing works
Liu, Z., Chen, L., Sun, F., Lv, B., Ge, X., Shao, L., & Liu, S. (2022) · Nutrition and Cancer · doi:10.1080/01635581.2022.2083190 · Cited by 8 · see citing works
Ren, H., Zhao, L., Liu, Y., Tan, Z. H., Luo, G., & Deng, X. (2021) · The Heart Surgery Forum · doi:10.1532/hsf.3307 · Cited by 8 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [16]Doumas B.T. Biggs HG Determination of Serum Albumin Standard Methods of Clinical Chemistry Cooper C.A. Academic Press, Inc. New York, NY, USA 1972 175
Cited by
Sorted by citations
The Seven Methods for the Evaluation of Nutritional Status—ABCDEFG: Narrative Review
Zambrano-Villacres, R., Arteaga-Pazmiño, C., Guevara Castillo, W. D., Herrera-Fontana, M. E., Domínguez Brito, L. D., Becerra Granados, L. M., Recoba-Obregón, P. E., Rodríguez-Veintimilla, D., Bressi, V., Andrade-Molina, D., et al. (2026) · Applied Sciences · doi:10.3390/app16020845 · Cited by 5 · see citing works
Okuyan, Ö., Durmuş, S., & Uzun, H. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1647870 · Cited by 3 · see citing works
Bao, J., Hu, J., & Lv, X. (2025) · Frontiers in Medicine · doi:10.3389/fmed.2025.1710430 · Cited by 1 · see citing works
Zhang, Q., Lu, C., Wu, Z., Wu, S., Jiang, L., Wang, H., He, J., Tang, B., Yang, B., Liao, S., et al. (2025) · Renal Failure · doi:10.1080/0886022x.2025.2512404 · Cited by 1 · see citing works
González, M. N. G., Hernández-González, M. A., Contreras, S. P. N., Carrillo, P. L. G., & Orozco, A. R. (2025) · BMC Anesthesiology · doi:10.1186/s12871-025-03308-3
Parkinson’s disease and nutrition
Carvalho, C. G. M., Tavares-Júnior, J. W. L., Gomes, A. B. F., Komuro, J. E., & Braga‐Neto, P. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-33841-0.00026-9
Zhong, X., Huang, D., Chen, Y., Chen, Z., Chen, X., Zhou, S., Lu, Y., Huang, N., Wu, X., Chen, H., et al. (2026) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1750904
Han, S., Chen, L., Shu, H., Zhao, G., Zhang, H., Li, J., Qiu, W., Cheng, J., Zheng, G., & Li, Q. (2026) · Medicine · doi:10.1097/md.0000000000049238
Xu, H. H., Dominguez, E., Mroueh, V., Duncan, A., Bottegal, M. T., Kim, S., & Solari, M. G. (2026) · Journal of Reconstructive Microsurgery · doi:10.1055/a-2903-1493
Alvarado‐Omenat, J. J., Fonseca‐Sánchez, E., Llamas‐Ramos, R., García-García, D., Correyero‐León, M., & Llamas‐Ramos, I. (2026) · Biomedicines · doi:10.3390/biomedicines14071504
Yang, H., Luo, G., & Zhao, H. (2026) · Research Square · doi:10.21203/rs.3.rs-10587093/v1
Prognostic Impact of Overhydration in Hospitalized Patients Receiving Parenteral Nutrition
Eguinoa, A. Z., Mucarzel, F., Cartiel-Vesperinas, R., Oliver‐Vila, C., Ricart-Viles, M., Andurell-Ferrandiz, L., Lluch-Romero, A., Puig-Pérez, A., Palmas-Candia, F. X., & Burgos-Peláez, R. (2026) · Nutrients · doi:10.3390/nu18213528
- Authors
- García-Moreno, R. M., Mola Reyes, L., López-Plaza, B., & Palma Milla, S.
- Affiliations
- Clinical Nutrition and Dietetics Unit, Department of Endocrinology and Nutrition, Hospital Universitario La Paz, Paseo de la Castellana, No. 261, 28046 Madrid, Spain
- Food, Nutrition and Health Platform, Hospital La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2024-08-08
- Volume
- 16
- Issue
- 16
- Pages
- 2610
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC11357292
- OpenAlex
- W4401418869
- Cited by
- 12
- References
- 30
- Citations by year
- 2026: 8 · 2025: 4
- FWCI
- 2.05
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Keywords
- C-reactive protein to albumin ratio, C-reactive protein, prealbumin, serum albumin, dietary biomarkers, prognostic factors, mortality prediction, disease-related malnutrition, hospitalized patients
- MeSH terms
- Aged, Aged, 80 and over, C-Reactive Protein, Female, Hospitalization, Humans, Male, Middle Aged, Nutritional Status, Prealbumin, Prognosis, Retrospective Studies, ROC Curve, Serum Albumin, Biomarkers, Nutrition Assessment, Malnutrition
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