II. Indications

  1. Malnutrition Evaluation (See Malnutrition Labs)
  2. Monitoring of nutritional improvement

III. Efficacy

  1. Correlates with clinical outcomes
  2. Prealbumin is the best marker of Malnutrition
    1. Short serum Half-Life
    2. Less affect by liver disease than other Proteins
    3. Not affected by hydration status
    4. Not affected by Vitamin Deficiency (except zinc)

IV. Pathophysiology

  1. Serum Half-Life: 2 days
  2. High essential to Nonessential Amino Acid ratio
  3. Production
    1. Liver is primary source
    2. Other sites of production
      1. Choroid plexus
      2. Enterochromaffin cells in gastrointestinal mucosa

V. Normal

  1. Prealbumin: 16 to 35 mg/dl

VI. Increased Serum Prealbumin

  1. Alcohol Abuse (especially binge drinking)
    1. Prealbumin returns to baseline after 7 days
  2. Medications
    1. Corticosteroids (e.g. Prednisone)
    2. Progesterone and related agents

VII. Decreased Serum Prealbumin

  1. Protein Malnutrition
  2. Other Causes
    1. Zinc Deficiency
    2. Negative acute phase reactant
      1. Decreases with inflammation or post-surgery

VIII. Interpretation in Malnutrition

  1. Protein Malnutrition Diagnosis
    1. Prealbumin <5 mg/dl: Predicts poor prognosis
    2. Prealbumin <11 mg/dl: High risk
      1. Requires aggressive Nutritional Supplementation
    3. Prealbumin <15: Increased risk of Malnutrition
      1. Monitoring recommended twice weekly
    4. Reference
      1. Bernstein (1995) Nutrition 11:170 [PubMed]
  2. Protein Malnutrition Monitoring
    1. Findings suggestive of adequate Nutritional Support
      1. Prealbumin level rising 2 mg/dl per day
      2. Prealbumin level returns to normal by 8 days
    2. Findings requiring intense nutritional (e.g. TPN)
      1. Prealbumin level rises <4 mg/dl in 8 days

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Related Studies

Ontology: Prealbumin (C0032923)

Definition (NCI) Transthyretin (147 aa, ~16 kDa) is encoded by the human TTR gene. This protein is involved in both the binding and transport of retinol and thyroxine.
Definition (MSH) A tetrameric protein, molecular weight between 50,000 and 70,000, consisting of 4 equal chains, and migrating on electrophoresis in 3 fractions more mobile than serum albumin. Its concentration ranges from 7 to 33 per cent in the serum, but levels decrease in liver disease.
Concepts Biologically Active Substance (T123) , Amino Acid, Peptide, or Protein (T116)
MSH D011228
SnomedCT 37959007
LNC LP15837-5, LP32135-3, MTHU004200
English Prealbumin, Proalbumin, Transthyretin, transthyretin, TTR, ATTR, TBPA, Prealbumin [Chemical/Ingredient], proalbumin, prealbumin, Prealbumin (substance)
Swedish Prealbumin
Czech prealbumin
Finnish Prealbumiini
French Proalbumine, Transthyrétine, Préalbumine
Italian Pro-albumina, Transtiretina, Prealbumina
Portuguese Transtirretina, Prealbumina, Proalbumina
Polish Prealbumina
Japanese 高トリプトファンプレアルブミン, トランスサイレチン, プレアルブミン, プロアルブミン, 前単純蛋白質
Spanish prealbúmina (sustancia), prealbúmina, transtirretina, Transtiretina, Prealbúmina, Proalbúmina
German Proalbumin, Transthyretin, Präalbumin