[Practical application of nutritional assessment protein and inflammatory marker in the nutrition support team (NST)].
Recently nutrition support team (NST) has been established for the purpose of prevention of complications which are caused by nutrition disorders and reduction of the medical expenses. Although physical examinations and blood biochemical data had been used as the indexes evaluating nutritional of patients, they were not suitable for the evaluation for the short-term in-patient. On the contrary, serum albumin (ALB) has been wildly used as a nutritional marker. However, it is impossible to evaluate nutrition state for the short-term in-patient and acute phase disease patient accurately, because the plasma half-life is 21 days and it takes long time to detect the change in nutritional state by its value. Rapid turnover proteins (RTP), whose plasma half-life is shorter, has paid attention to evaluate nutritional state for the short-term in-patients and acute phase disease patients. Although, prognostic inflammatory and nutritional index (PINI) was considered as a useful maker for evaluating inflammatory and nutritional states using the concentrations of transthyretin (TTR), a RTP, alpha1-acid glycoprotein (alpha1-AG), a chronic inflammation marker, C reactive protein (CRP), a acute inflammation marker, and ALB, However, it has several pitfalls. We newly made serum amyloid A (SAA) index using SAA instead of CRP. When we compared SAA index with PINI in many diseases, it turned out that SAA index became a more effective index which reflected the patient condition than did PINI. As for this index, it is expected to be used by NST while further alternation may be needed.
Tateishi
Takiko
T
Department of Diagnostic Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8556.
Nakamura
Masaaki
M
Ueda
Mitsuharu
M
Himeno
Shingo
S
Yamashita
Taro
T
Yamauchi
Tsuyuko
T
Nishi
Kazuhiko
K
Mori
Kuniko
K
Asonuma
Katsuhiro
K
Inomata
Yukihiro
Y
Ando
Yukio
Y
D002097:C-Reactive Protein / Q000032:analysis; D006801:Humans; D015596:Nutrition Assessment; D018529:Nutritional Support; D011228:Prealbumin / Q000032:analysis; D012709:Serum Albumin / Q000032:analysis
D011228:Prealbumin; D012709:Serum Albumin; D002097:C-Reactive Protein