Usefulness of short-lived proteins as nutritional indicators surgical patients.
OBJECTIVE
Biochemical indicators are used to assess the adequacy of nutritional support given to postoperative patients. However, the metabolic alterations present in these patients diminish the efficiency of these indicators. The objective of this work is to determine the usefulness of short-lived proteins as indicators to assess the nutritional support administered to patients during the metabolic stress phase produced by surgery.


METHODS
The nitrogen balance and plasma concentrations of transthyretin, retinol binding protein, and insulin-like growth factor-1 were determined in 24 patients who received 4 different nutritional regimens during 7 days after surgery.


RESULTS
Transthyretin and retinol binding protein, although sensitive to nutritional intake (P<0.0005 and P<0.04 respectively), were strongly affected by the stress response (P<0.008 and P<0.0003 respectively), thus limiting their usefulness for nutrition assessment. Insulin-like growth factor-1 was not influenced by the stress response and was sensitive to the nutritional supply (P<0.0001). Insulin-like growth factor-1 was the only component that showed similar efficiency than nitrogen balance as nutritional indicator.


CONCLUSIONS
Transthyretin and retinol binding protein are not adequate to assess the nutritional supply during the stress phase after surgery, while insulin-like growth factor-1 is a suitable indicator of the adequacy of recent intake in this situation, similar in performance to nitrogen balance.
López-Hellin
J
J
Centre d'Investigacions en Bioquímica i Biologia Molecular, Vall d'Hebron, Barcelona, Spain.
Baena-Fustegueras
J A
JA
Schwartz-Riera
S
S
García-Arumí
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D001798:Blood Proteins / Q000032:analysis; D005260:Female; D006801:Humans; D007202:Indicators and Reagents; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D009584:Nitrogen / Q000378:metabolism; D015596:Nutrition Assessment; D009752:Nutritional Status; D018529:Nutritional Support / Q000592:standards; D011182:Postoperative Care / Q000592:standards; D011184:Postoperative Period; D011228:Prealbumin / Q000032:analysis*; D012177:Retinol-Binding Proteins / Q000032:analysis*; D054839:Retinol-Binding Proteins, Plasma; D012680:Sensitivity and Specificity; D013312:Stress, Physiological / Q000378:metabolism*
D015415:Biomarkers; D001798:Blood Proteins; D007202:Indicators and Reagents; D011228:Prealbumin; D012177:Retinol-Binding Proteins; D054839:Retinol-Binding Proteins, Plasma; D007334:Insulin-Like Growth Factor I; D009584:Nitrogen