Rapid-Turnover Transport Proteins: An Index of Subclinical Protein-Energy Malnutrition

Ps, Shetty; Jung, R. T.; Watrasiewicz, K.E.; James, W. P. T.

doi:10.1016/s0140-6736(79)90241-1

Cited by 303 publications

(76 citation statements)

References 13 publications

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“…RBP4 is a clinically useful marker because it has a short half-life. In that respect, the decrease of plasma RBP4 levels during VLCD is in full agreement with earlier studies (21,22). Moreover, this study shows that RBP4 gene expression in adipose tissue is subject to regulation by VLCD.…”

Section: Discussionsupporting

confidence: 93%

Plasma Levels and Adipose Tissue Messenger Ribonucleic Acid Expression of Retinol-Binding Protein 4 Are Reduced during Calorie Restriction in Obese Subjects but Are Not Related to Diet-Induced Changes in Insulin Sensitivity

Vítková

Klimčáková

Kováčiková

et al. 2007

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context: Retinol-binding protein 4 (RBP4) may play a role in the development of insulin resistance. Objective:We investigated whether RBP4 adipose tissue mRNA expression and plasma level are related to insulin sensitivity during a diet-induced weight loss.Design, Setting, Patients, and Intervention: Obese women followed a dietary intervention composed of a 4-wk very low-calorie diet (VLCD), a 2-month low-calorie diet, and 3-4 months of a weight maintenance (WM) phase. Main Outcome Measures:Clinical investigation was performed before and at the end of each phase. Insulin sensitivity was assessed with the euglycemic hyperinsulinemic clamp. Adipose tissue mRNA and plasma levels of RBP4 were determined using reverse transcription-quantitative PCR and ELISA, respectively.Results: Weight and fat mass decreased during VLCD and were stabilized during WM. Glucose disposal rate increased during VLCD and remained elevated thereafter. Plasma levels of RBP4 decreased after VLCD and, although increasing at subsequent phases, remained lower than prediet values. Adipose tissue mRNA levels were diminished after VLCD, and increased during low-calorie diet and WM to reach basal values. Basal RBP4 levels or diet-induced variations of RBP4 were not different in lean women and two groups of obese women with high-and low-insulin sensitivity. Conclusions:Severe calorie restriction promotes a reduction in adipose tissue and plasma levels of RBP4. The study does not bring evidence for a role for RBP4 in the regulation of diet-induced changes in insulin sensitivity.

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Section: Discussionsupporting

confidence: 93%

Plasma Levels and Adipose Tissue Messenger Ribonucleic Acid Expression of Retinol-Binding Protein 4 Are Reduced during Calorie Restriction in Obese Subjects but Are Not Related to Diet-Induced Changes in Insulin Sensitivity

Vítková

Klimčáková

Kováčiková

et al. 2007

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…1) may represent a confounding factor in the interpretation of the results. Plasma PAB concentrations change rapidly; a decrease of up to 50% in PAB concentration is expected after few days of inadequate nutrient intake and/or diseases with an acute phase response, conditions that often coexist in severely ill patients (24 ). Conversely, a rapid increase of PAB concentration is seen when adequate nutritional intake is restored (21 ) or CRP stabilizes (25 ); therefore rapid changes of CRP can induce an overestimation of malnutrition.…”

Section: Discussionmentioning

confidence: 99%

Prealbumin Serum Concentrations as a Useful Tool in the Assessment of Malnutrition in Hospitalized Patients

et al. 2006

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Background: Protein-energy malnutrition (PEM) is a common condition among patients admitted to hospitals, and it is associated with a worse prognosis and increased mortality. Although several screening systems have been developed, PEM is still poorly recognized, and there is no consensus on which test is more reliable and feasible in clinical practice. Prealbumin (PAB) is a potential useful PEM marker because its serum concentrations are closely related to early changes in nutritional status. Methods: We studied PEM prevalence and PAB serum concentrations in 108 hospitalized patients. The Detailed Nutritional Assessment (DNA) was used as the reference method to determine PEM. PAB performance was compared with that of 2 other methods, the Subjective Global Assessment (SGA) and the Prognostic Inflammatory and Nutritional Index score (PINI). Results: According to the DNA reference method, 41% of patients were classified with mild malnutrition and 19% with severe malnutrition. PAB showed the best concordance with the standard DNA method (concordance index, 76.8%) and a good sensitivity/specificity profile (83.1%/76.7%) compared with SGA and PINI. Conclusions: We conclude that PAB could represent a feasible and reliable tool in the evaluation of malnutrition, especially in settings where it is difficult to obtain

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“…Serum albumin was determined by the bromocresolgreen assay. Prealbumin and transferrin were measured by radial immunodiffusion [15][16][17].…”

Section: Methodsmentioning

confidence: 99%

The Prognostic Significance of Protein-energy Malnutrition in Geriatric Patients

et al. 1995

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SummaryAlthough it has been shown that protein-energy malnutrition is a predictor of adverse outcome in geriatric patients, it is unclear whether this is due to underlying disease or disability, or whether malnutrition is an independent outcome predictor. To clarify the predictive role of malnutrition, we analysed the 4.5-year mortality and living location follow-ups of 219 geriatric patients admitted to a geriatric assessment unit. Prevalence of anthropometric and serological malnutrition indicators were between 13.7% and 39.8% at hospital admission. In bivariate models, prealbumin, subnormal arm muscle area, and subnormal body weight were predictors of mortality and survival at home. On the other hand, albumin, transferrin, and triceps skin-fold thickness did not predict these outcomes. In multivariate models the hazard ratio (HR) of 4.5-year mortality remained significant with an HR of 1.8 (95% CI 1.3-2.6) for subnormal arm muscle area, and 1.6 (95% CI 1.0-2.6) for subnormal body weight. Prealbumin was the strongest serological outcome predictor (multivariate mortality HR 1.9, 95% CI, 1.3-2.8). In these models, subnormal cognitive function, impaired physical function, and creatinine clearance < 30 ml/min were also associated with increased mortality. Malnutrition did not predict hospital discharge location, but among patients discharged home, those with initial malnutrition had a decreased length of survival at home.Our findings indicate that certain protein-energy malnutrition indicators are independent risk factors predicting decreased length of overall survival and survival at home in geriatric patients. Physicians should screen actively for this often unrecognized problem and initiate appropriate treatment strategies.

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Rapid-Turnover Transport Proteins: An Index of Subclinical Protein-Energy Malnutrition

Cited by 303 publications

References 13 publications

Plasma Levels and Adipose Tissue Messenger Ribonucleic Acid Expression of Retinol-Binding Protein 4 Are Reduced during Calorie Restriction in Obese Subjects but Are Not Related to Diet-Induced Changes in Insulin Sensitivity

Plasma Levels and Adipose Tissue Messenger Ribonucleic Acid Expression of Retinol-Binding Protein 4 Are Reduced during Calorie Restriction in Obese Subjects but Are Not Related to Diet-Induced Changes in Insulin Sensitivity

Prealbumin Serum Concentrations as a Useful Tool in the Assessment of Malnutrition in Hospitalized Patients

The Prognostic Significance of Protein-energy Malnutrition in Geriatric Patients

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