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Hepatic proteins and nutrition assessment.

Abstract

Serum hepatic protein (albumin, transferrin, and prealbumin) levels have historically been linked in clinical practice to nutritional status. This paradigm can be traced to two conventional categories of malnutrition: kwashiorkor and marasmus. Explanations for both of these conditions evolved before knowledge of the inflammatory processes of acute and chronic illness were known. Substantial literature on the inflammatory process and its effects on hepatic protein metabolism has replaced previous reports suggesting that nutritional status and protein intake are the significant correlates with serum hepatic protein levels. Compelling evidence suggests that serum hepatic protein levels correlate with morbidity and mortality. Thus, serum hepatic protein levels are useful indicators of severity of illness. They help identify those who are the most likely to develop malnutrition, even if well nourished prior to trauma or the onset of illness. Furthermore, hepatic protein levels do not accurately measure nutritional repletion. Low serum levels indicate that a patient is very ill and probably requires aggressive and closely monitored medical nutrition therapy.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Coram Health Care, St. Louis, MO, USA. fuhrmanp@coramhc.com

    ,

    Source

    MeSH

    Biomarkers
    Humans
    Inflammation
    Kwashiorkor
    Liver
    Nutrition Assessment
    Nutritional Status
    Prealbumin
    Protein-Energy Malnutrition
    Serum Albumin
    Severity of Illness Index
    Transferrin

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    15281044

    Citation

    Fuhrman, M Patricia, et al. "Hepatic Proteins and Nutrition Assessment." Journal of the American Dietetic Association, vol. 104, no. 8, 2004, pp. 1258-64.
    Fuhrman MP, Charney P, Mueller CM. Hepatic proteins and nutrition assessment. J Am Diet Assoc. 2004;104(8):1258-64.
    Fuhrman, M. P., Charney, P., & Mueller, C. M. (2004). Hepatic proteins and nutrition assessment. Journal of the American Dietetic Association, 104(8), pp. 1258-64.
    Fuhrman MP, Charney P, Mueller CM. Hepatic Proteins and Nutrition Assessment. J Am Diet Assoc. 2004;104(8):1258-64. PubMed PMID: 15281044.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Hepatic proteins and nutrition assessment. AU - Fuhrman,M Patricia, AU - Charney,Pamela, AU - Mueller,Charles M, PY - 2004/7/29/pubmed PY - 2004/9/1/medline PY - 2004/7/29/entrez SP - 1258 EP - 64 JF - Journal of the American Dietetic Association JO - J Am Diet Assoc VL - 104 IS - 8 N2 - Serum hepatic protein (albumin, transferrin, and prealbumin) levels have historically been linked in clinical practice to nutritional status. This paradigm can be traced to two conventional categories of malnutrition: kwashiorkor and marasmus. Explanations for both of these conditions evolved before knowledge of the inflammatory processes of acute and chronic illness were known. Substantial literature on the inflammatory process and its effects on hepatic protein metabolism has replaced previous reports suggesting that nutritional status and protein intake are the significant correlates with serum hepatic protein levels. Compelling evidence suggests that serum hepatic protein levels correlate with morbidity and mortality. Thus, serum hepatic protein levels are useful indicators of severity of illness. They help identify those who are the most likely to develop malnutrition, even if well nourished prior to trauma or the onset of illness. Furthermore, hepatic protein levels do not accurately measure nutritional repletion. Low serum levels indicate that a patient is very ill and probably requires aggressive and closely monitored medical nutrition therapy. SN - 0002-8223 UR - https://www.unboundmedicine.com/medline/citation/15281044/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002822304009162 DB - PRIME DP - Unbound Medicine ER -