消瘦症
夸什约克
营养不良
医学
转甲状腺素
蛋白质营养不良
转铁蛋白
生理学
血清白蛋白
白蛋白
内科学
蛋白质-能量营养不良
蛋白质代谢
免疫学
胃肠病学
新陈代谢
作者
M. Patricia Fuhrman,Pamela Charney,Charles Mueller
出处
期刊:Journal of The American Dietetic Association
[Elsevier]
日期:2004-08-01
卷期号:104 (8): 1258-1264
被引量:484
标识
DOI:10.1016/j.jada.2004.05.213
摘要
Serum hepatic protein (albumin, transferrin, and prealbumin) levels have historically been linked in clinical practice to nutritional status. This paradigm can be traced to two conventional categories of malnutrition: kwashiorkor and marasmus. Explanations for both of these conditions evolved before knowledge of the inflammatory processes of acute and chronic illness were known. Substantial literature on the inflammatory process and its effects on hepatic protein metabolism has replaced previous reports suggesting that nutritional status and protein intake are the significant correlates with serum hepatic protein levels. Compelling evidence suggests that serum hepatic protein levels correlate with morbidity and mortality. Thus, serum hepatic protein levels are useful indicators of severity of illness. They help identify those who are the most likely to develop malnutrition, even if well nourished prior to trauma or the onset of illness. Furthermore, hepatic protein levels do not accurately measure nutritional repletion. Low serum levels indicate that a patient is very ill and probably requires aggressive and closely monitored medical nutrition therapy.
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