Study of lipid-related markers for nutritional assessment unaffected by inflammation

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Nutrition support team (NST) assesses nutritional state of malnourished patients for nutritional intervention as well as evaluation of its effectiveness. Clinically, many variables such as albumin, total cholesterol (TC), transthyretin (TTR), retinol binding protein (RBP), and transferrin (Tf). Among them, TTR, RBP, and Tf are known as rapid turnover proteins because their half lives are only within a few days in human plasma. However, they decrease markedly in inflammation. This study clearly demonstrates that (1) serum albumin decreases in inflammation but albumin concentrations measured by bromocresol green (BCG) method exhibits positive bias, (2) LDL-C reflects cholesterol absorption in the small intestine rather than de novo cholesterol synthesis in the liver, and (3) LDL-C does not decrease in the patients with inflammation. These results strongly suggest that LDL-C may enable us to evaluate nutritional state more precisely free of influence from inflammation. (664)