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

营养支持小组(NST)评估营养不良患者的营养状况，以进行营养干预并评估其有效性。临床上，白蛋白、总胆固醇(TC)、转甲状腺素(TTR)、视黄醇结合蛋白(RBP)、转铁蛋白(Tf)等多项指标均存在异常。其中，TTR、RBP和Tf被称为快速周转蛋白，因为它们在人血浆中的半衰期只有几天。然而，它们在炎症中显著减少。本研究清楚地表明：(1)炎症时血清白蛋白降低，但溴甲酚绿(BCG)法测得的白蛋白浓度呈正偏；(2)低密度脂蛋白-C反映的是小肠对胆固醇的吸收，而不是肝脏胆固醇的新合成；(3)炎症患者的低密度脂蛋白-C不降低。这些结果有力地表明，低密度脂蛋白-C可能使我们能够更准确地评估营养状态，而不受炎症的影响。(664)

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)