title: 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.
abstract: 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.
authors.affiliation: Laboratory of Nutritional and Metabolic Biochemistry, Faculty of Medicine of Botucatu, Ribeirão Preto, SP, Brazil.
authors.forename: Z
authors.initials: Z
authors.lastname: Calamita
authors.forename: I
authors.initials: I
authors.lastname: Dichi
authors.forename: S J
authors.initials: SJ
authors.lastname: Papini-Berto
authors.forename: J B
authors.initials: JB
authors.lastname: Dichi
authors.forename: A Y
authors.initials: AY
authors.lastname: Angeleli
authors.forename: H
authors.initials: H
authors.lastname: Vannucchi
authors.forename: C
authors.initials: C
authors.lastname: Caramori
authors.forename: R C
authors.initials: RC
authors.lastname: Burini
mesh_terms: 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*
chemical_list: D000596:Amino Acids; D011228:Prealbumin; D012177:Retinol-Binding Proteins; D054839:Retinol-Binding Proteins, Plasma; D013963:Thyroid Hormones; D014801:Vitamin A; D015032:Zinc