The Use of Visceral Proteins as Nutrition Markers: An ASPEN Position Paper
The Use of Visceral Proteins as Nutrition Markers: An ASPEN Position Paper
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DOI：
10.1002/ncp.10588
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发表时间：
2020-10-30
影响因子：
3.1
通讯作者：
Jensen, Gordon L.
中科院分区：
文献类型：
--
作者：
Evans, David C.;Corkins, Mark R.;Jensen, Gordon L.
血清白蛋白和前白蛋白是众所周知的内脏蛋白质，传统上被认为是营养评估中有用的生化实验室价值。然而，最近的文献对这一论点提出了异议。这份文件的目的是澄清这些蛋白质是炎症的特征，而不是描述营养状况或蛋白质-能量营养不良。危重病和慢性病都以炎症为特征，因此，肝脏蛋白质合成的优先顺序发生改变，导致血清白蛋白和前白蛋白浓度降低。此外，血清蛋白的重新分布是由于毛细血管通透性的增加。然而，炎症和营养不良之间存在关联，而营养不良和内脏蛋白质水平之间没有关联。这些蛋白质与患者的不良后果风险有很好的相关性，而不是与蛋白质-能量营养不良有关。因此，血清白蛋白和前白蛋白不应作为总蛋白质或总肌肉质量的替代指标，也不应作为营养标记物。这篇论文已经得到了美国肠外和肠内营养学会董事会的批准。
Serum albumin and prealbumin, well-known visceral proteins, have traditionally been considered useful biochemical laboratory values in a nutrition assessment. However, recent literature disputes this contention. The aim of this document is to clarify that these proteins characterize inflammation rather than describe nutrition status or protein-energy malnutrition. Both critical illness and chronic illness are characterized by inflammation and, as such, hepatic reprioritization of protein synthesis occurs, resulting in lower serum concentrations of albumin and prealbumin. In addition, the redistribution of serum proteins occurs because of an increase in capillary permeability. There is an association between inflammation and malnutrition, however, not between malnutrition and visceral-protein levels. These proteins correlate well with patients' risk for adverse outcomes rather than with protein-energy malnutrition. Therefore, serum albumin and prealbumin should not serve as proxy measures of total body protein or total muscle mass and should not be used as nutrition markers. This paper has been approved by the American Society for Parenteral and Enteral Nutrition Board of Directors.