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Serum Prealbumin
Aka: Serum Prealbumin, Prealbumin
- See Also
- Malnutrition Labs
- Indications
- Malnutrition Evaluation (See Malnutrition Labs)
- Monitoring of nutritional improvement
- Efficacy
- Correlates with clinical outcomes
- Prealbumin is the best marker of Malnutrition
- Short serum half-life
- Less affect by liver disease than other proteins
- Not affected by hydration status
- Not affected by Vitamin Deficiency (except zinc)
- Pathophysiology
- Serum half-life: 2 days
- High essential to nonessential amino acid ratio
- Production
- Liver is primary source
- Other sites of production
- Choroid plexus
- Enterochromaffin cells in gastrointestinal mucosa
- Normal
- Prealbumin: 16 to 35 mg/dl
- Increased Serum Prealbumin
- Alcohol Abuse (especially binge drinking)
- Prealbumin returns to baseline after 7 days
- Medications
- Corticosteroids (e.g. Prednisone)
- Progesterone and related agents
- Decreased Serum Prealbumin
- Protein Malnutrition
- Other Causes
- Zinc Deficiency
- Negative acute phase reactant
- Decreases with inflammation or post-surgery
- Interpretation in Malnutrition
- Protein Malnutrition Diagnosis
- Prealbumin <5 mg/dl: Predicts poor prognosis
- Prealbumin <11 mg/dl: High risk
- Requires aggressive Nutritional Supplementation
- Prealbumin <15: Increased risk of Malnutrition
- Monitoring recommended twice weekly
- Reference
- Bernstein (1995) Nutrition 11:170 [PubMed]
- Protein Malnutrition Monitoring
- Findings suggestive of adequate nutritional support
- Prealbumin level rising 2 mg/dl per day
- Prealbumin level returns to normal by 8 days
- Findings requiring intense nutritional (e.g. TPN)
- Prealbumin level rises <4 mg/dl in 8 days
- References
- Beck (2002) Am Fam Physician 65:1575-8 [PubMed]