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Clinical indications for plasma protein assays: transthyretin (prealbumin) in inflammation and malnutrition: International Federation of Clinical Chemistry and Laboratory Medicine (IFCC): IFCC Scientific Division Committee on Plasma Proteins (C-PP)

  • A. Myron Johnson , Giampaolo Merlini , Joanna Sheldon and Kiyoshi Ichihara
Published/Copyright: March 22, 2007
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Volume 45 Issue 3

Abstract

A large number of circumstances are associated with reduced serum concentrations of transthyretin (TTR), or prealbumin. The most common of these is the acute phase response, which may be due to inflammation, malignancy, trauma, or many other disorders. Some studies have shown a decrease in hospital stay with nutritional therapy based on TTR concentrations, but many recent studies have shown that concentrations of albumin, transferrin, and transthyretin correlate with severity of the underlying disease rather than with anthropometric indicators of hypo- or malnutrition.

There are few if any conditions in which the concentration of this protein by itself is more helpful in diagnosis, prognosis, or follow up than are other clinical findings. In the majority of cases, the serum concentration of C-reactive protein is adequate for detection and monitoring of acute phase responses and for prognosis. Although over diagnosis and treatment of presumed protein energy malnutrition is probably not detrimental to most patients, the failure to detect other causes of decreased concentrations (such as serious bacterial infections or malignancy) of the so-called visceral or hepatic proteins could possibly result in increased morbidity or even mortality. In addition to these caveats, assays for TTR have a relatively high level of uncertainty (“imprecision”). Clinical evaluation – history and physical examination – should remain the mainstay of nutritional assessment.

Clin Chem Lab Med 2007;45:419–26.

Keywords: inflammation; malnutrition; prealbumin; transthyretin
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Corresponding author: Andrew Myron Johnson, MD, 610 Bruton Place South, Greensboro, NC 27410-4660, USA Phone: +1-336-292-2072; Fax: +1-919-966-1999,

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Published Online: 2007-03-22
Published in Print: 2007-03-01

©2007 by Walter de Gruyter Berlin New York

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  27. Meeting Report: From human genetic variations to prediction of risks and responses to drugs and the environment
https://doi.org/10.1515/CCLM.2007.051
Keywords for this article
inflammation; malnutrition; prealbumin; transthyretin

Articles in the same Issue

  1. From human genetic variations to prediction of risks and responses to drugs and the environment
  2. Nutrigenomics – 2006 update
  3. How to comprehensively analyse proteins and how this influences nutritional research
  4. Genotypes, obesity and type 2 diabetes – can genetic information motivate weight loss? A review
  5. The Gene-Diet Attica Investigation on childhood obesity (GENDAI): overview of the study design
  6. Polymorphisms in the APOA1/C3/A4/A5 gene cluster and cholesterol responsiveness to dietary change
  7. Nutri-epigenomics: lifelong remodelling of our epigenomes by nutritional and metabolic factors and beyond
  8. Emerging role of cathepsin S in obesity and its associated diseases
  9. Association analysis of hepatitis virus B infection with haplotypes of the TBX21 gene promoter region in the Chinese population
  10. Multiplex polymerase chain reaction on FTA cards vs. flow cytometry for B-lymphocyte clonality
  11. Real-time multiplex PCR assay for genotyping of three apolipoprotein E alleles and two choline acetyltransferase alleles with three hybridization probes
  12. Immunomagnetic CD45 depletion does not improve cytokeratin 20 RT-PCR in colorectal cancer
  13. Analysis of the components of hypertransaminasemia after liver resection
  14. Fine characterization of mitral valve glycosaminoglycans and their modification with degenerative disease
  15. Oxidative stress evaluated using an automated method for hydroperoxide estimation in patients with coronary artery disease
  16. Secretory phospholipase A2 activity and release kinetics of vascular tissue remodelling biomarkers after coronary artery bypass grafting with and without cardiopulmonary bypass
  17. Clustered components of the metabolic syndrome and platelet counts in Japanese females
  18. International Standard for serum vitamin B12 and serum folate: international collaborative study to evaluate a batch of lyophilised serum for B12 and folate content
  19. Multicentre physiological reference intervals for serum concentrations of immunoglobulins A, G and M, complement C3c and C4 measured with Tina-Quant® reagents systems
  20. In vivo and in vitro allergy diagnostics: it's time to reappraise the costs
  21. Experience with post-market surveillance of in-vitro diagnostic medical devices for lay use in Germany
  22. Evaluation of the high-sensitivity, full-range Olympus CRP OSR6199 application on the Olympus AU640®
  23. How to improve the teaching of urine microscopy
  24. In vitro determination of allergen-specific serum IgE. Comparative analysis of three methods
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  26. Clinical indications for plasma protein assays: transthyretin (prealbumin) in inflammation and malnutrition: International Federation of Clinical Chemistry and Laboratory Medicine (IFCC): IFCC Scientific Division Committee on Plasma Proteins (C-PP)
  27. Meeting Report: From human genetic variations to prediction of risks and responses to drugs and the environment
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