title: Assessment of nutritional status and prediction of postoperative liver function from serum apolioprotein A-1 levels with hepatectomy.
abstract: BACKGROUND
  We investigated the usefulness of apolipoprotein A-1 (apoA) as an indicator of nutritional status, and the correlation of the preoperative apoA level with changes in postoperative liver function following hepatectomy.
  
  
  METHODS
  One hundred patients underwent hepatectomy. Serum levels of apoA, prealbumin (prealb), retinol-binding protein (RBP), lectin-cholesterol acyltransferase (LCAT), hyarulonate (HA), indocyanine green dye retention at 15 minutes (ICG), and the receptor index of Tc-GSA scintigraphy (LHL15) were measured at preoperation and on postoperative days (POD) 7 and 14. Partial resection was carried out in 62 cases, segmentectomy in nine cases, and bisegmentectomy in 29 cases. Co-existent liver conditions were normal liver (NL) in 43 cases, chronic hepatitis (CH) in 29 cases, and liver cirrhosis (LC) in 28 cases.
  
  
  RESULTS
  In most cases the serum apoA level had decreased on POD 7, and recovered on POD 14. There were no significant differences in the changes of apoA between the individual operative procedures. Although preoperative apoA had almost the same value in the NL, CH, and LC cases, apoA in LC cases on POD 14 was the lowest of all cases. The apoA level showed significant correlations with prealb, LCAT, and HA on POD 14. All cases were divided into two groups (group N: apoA over 91 mg/dl; group L: apoA under 90 mg/dl) based on the preoperative serum apoA level. On POD 14, the ICG, LHL15, and HA of group L were significantly deteriorated compared with those of group L.
  
  
  CONCLUSIONS
  The serum level of apoA reflects the changes in hepatic protein synthetic ability after hepatectomy; therefore, it may be possible to estimate recovery of nutritional status after hepatectomy from serum apoA. Moreover, we can predict postoperative deterioration of liver function from the preoperative apoA level.
authors.affiliation: First Department of Surgery, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, Japan. katsuram@sapmed.ac.jp
authors.forename: Tadashi
authors.initials: T
authors.lastname: Katsuramaki
authors.forename: Toru
authors.initials: T
authors.lastname: Mizuguchi
authors.forename: Masaki
authors.initials: M
authors.lastname: Kawamoto
authors.forename: Kouji
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Makoto
authors.initials: M
authors.lastname: Meguro
authors.forename: Minoru
authors.initials: M
authors.lastname: Nagayama
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nobuoka
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Kimura
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Furuhata
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D000328:Adult; D000368:Aged; D016632:Apolipoprotein A-I / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008107:Liver Diseases / Q000097:blood* / Q000601:surgery*; D008111:Liver Function Tests; D008115:Liver Regeneration / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology*; D011184:Postoperative Period; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D016632:Apolipoprotein A-I; D015415:Biomarkers