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. 2021 Feb;36(1):22-28.
doi: 10.1002/ncp.10588. Epub 2020 Oct 30.

The Use of Visceral Proteins as Nutrition Markers: An ASPEN Position Paper

David C Evans  1 , Mark R Corkins  2 , Ainsley Malone  3   4 , Sarah Miller  5 , Kris M Mogensen  6 , Peggi Guenter  7 , Gordon L Jensen  8 ; ASPEN Malnutrition Committee  4
Affiliations

The Use of Visceral Proteins as Nutrition Markers: An ASPEN Position Paper

David C Evans et al. Nutr Clin Pract. 2021 Feb.

Erratum in

Abstract

Serum albumin and prealbumin, well-known visceral proteins, have traditionally been considered useful biochemical laboratory values in a nutrition assessment. However, recent literature disputes this contention. The aim of this document is to clarify that these proteins characterize inflammation rather than describe nutrition status or protein-energy malnutrition. Both critical illness and chronic illness are characterized by inflammation and, as such, hepatic reprioritization of protein synthesis occurs, resulting in lower serum concentrations of albumin and prealbumin. In addition, the redistribution of serum proteins occurs because of an increase in capillary permeability. There is an association between inflammation and malnutrition, however, not between malnutrition and visceral-protein levels. These proteins correlate well with patients' risk for adverse outcomes rather than with protein-energy malnutrition. Therefore, serum albumin and prealbumin should not serve as proxy measures of total body protein or total muscle mass and should not be used as nutrition markers. This paper has been approved by the American Society for Parenteral and Enteral Nutrition Board of Directors.

Keywords: adverse outcomes; albumin; critical care; inflammation; nutrition assessment; prealbumin; risk; visceral proteins.

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References

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