| Albumin |
- Easy and inexpensive to measure
- Covered by most reimbursement programs
|
- Extremely long half-life (~20 days); insensitive
to short-term changes
- Insensitive to trauma- or stress-induced
malnutrition (see section on the hypermetabolic
state)
- Affected by over-hydration and dehydration;
Often given as part of therapy
- Affected by non-nutritional factors (including
liver and kidney disease)
|
| Transferrin |
- Shorter half-life (~8 days) than albumin
- Decreased level in severe malnutrition
|
- Half-life still too long for ongoing assessment
(evaluating response to therapy)
- Strongly affected by iron deficiency (transferrin
is an iron-support protein)
- Sensitive to hormones and medications (particularly
antibiotics affecting protein synthesis)
- Affected by chronic infection or inflammatory
disease
- Strongly depressed in patients with liver
disease; Depressed by infection/inflammation
|
| Prealbumin (Transthryretin) |
-
Short half-life (~2 days)
-
Excellent sensitivity to nutritional
status
-
Very useful for classification/triage
-
High proportion of essential
amino acids
|
|
| Retinol-Binding Protein (RBP) |
- Very short half-life (~10 hours)
- Excellent sensitivity to nutritional status
- Helps "fill in the gaps" when used
with prealbumin
|
- Strongly affected by kidney disease
- Compromised by infection/inflammation
- Very sensitive to cancer-induced cachexia
|
