Plasma levels of transthyretin and retinol-binding protein in Child-A cirrhotic patients in relation to protein-calorie status and plasma amino acids, zinc, vitamin A and plasma thyroid hormones.
Transthyretin and retinol-binding protein are sensitive markers of acute protein-calorie malnutrition both for early diagnosis and dietary evaluation. A preliminary study showed that retinol-binding protein is the most sensitive marker of protein-calorie malnutrition in cirrhotic patients, even those with the mild form of the disease (Child A). However, in addition to being affected by protein-calorie malnutrition, the levels of these short half-life-liver-produced proteins are also influenced by other factors of a nutritional (zinc, tryptophan, vitamin A, etc) and non-nutritional (sex, aging, hormones, renal and liver functions and inflammatory activity) nature. These interactions were investigated in 11 adult male patients (49.9 +/- 9.2 years of age) with alcoholic cirrhosis (Child-Pugh grade A) and with normal renal function. Both transthyretin and retinol binding protein were reduced below normal levels in 55% of the patients, in close agreement with their plasma levels of retinol. In 67% of the patients (4/6), the reduced levels of transthyretin and retinol-binding protein were caused by altered liver function and in 50% (3/6) they were caused by protein-calorie malnutrition. Thus, the present data, taken as a whole, indicate that reduced transthyretin and retinol-binding protein levels in mild cirrhosis of the liver are mainly due to liver failure and/or vitamin A status rather than representing an isolated protein-calorie malnutrition indicator.
Calamita
Z
Z
Laboratory of Nutritional and Metabolic Biochemistry, Faculty of Medicine of Botucatu, Ribeirão Preto, SP, Brazil.
Dichi
I
I
Papini-Berto
S J
SJ
Dichi
J B
JB
Angeleli
A Y
AY
Vannucchi
H
H
Caramori
C
C
Burini
R C
RC
D000328:Adult; D000596:Amino Acids / Q000097:blood*; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000378:metabolism*; D017093:Liver Failure; D008297:Male; D008875:Middle Aged; D011228:Prealbumin / Q000032:analysis*; D011502:Protein-Energy Malnutrition / Q000097:blood*; D012177:Retinol-Binding Proteins / Q000032:analysis*; D054839:Retinol-Binding Proteins, Plasma; D013963:Thyroid Hormones / Q000097:blood*; D014801:Vitamin A / Q000097:blood*; D015032:Zinc / Q000097:blood*
D000596:Amino Acids; D011228:Prealbumin; D012177:Retinol-Binding Proteins; D054839:Retinol-Binding Proteins, Plasma; D013963:Thyroid Hormones; D014801:Vitamin A; D015032:Zinc