Visceral proteins, serum

LBM can be assessed by measuring serum visceral proteins (Table 57-4). They are best for assessing uncomplicated semistarvation and recovery, and poor for assessing status during acute stress. Visceral proteins must be interpreted relative to overall clinical status because they are affected by factors other than nutrition. 

LBM can be assessed by measuring serum visceral proteins (Table 57-4). ... 

Additional smdies that are often useful include direct endoscopic examination of affected areas and/or radiocontrast smdies. For patients with acute disease, assessment of fluid and electrolyte stams is important, because these may be lost during diarrheal episodes. Other laboratory tests, such as serum albumin, transferrin, or other markers of visceral protein status, as well as markers of inflammation (erythrocyte sedimentation rate) may be used. 

LBM includes skeletal muscle, somatic protein, and functional proteins such as circulating proteins and the visceral proteins. Biochemically, LBM can be assessed by measuring the serum visceral proteins, albumin (ALB), transferrin (TFN), and prealbumin (thyroxine-binding prealbumin or transthyretin). Other serum proteins, such as retinol-binding protein, flbronectin (an opsonic protein), and somatomedin-C (insulin-like growth factor-1), that have a very short half-life (less than 12 to 24 hours), have been suggested as... 

These serum visceral proteins are of greatest value in assessing imcomplicated semistarvation and recovery. Dming severe acute stress (tramna, bmns, or sepsis), these proteins are relatively poor markers of nutrition status because their synthesis is downregulated as the liver increases the production of acute-phase reactants such as C-reactive protein, aj-acid glycoprotein, and aj-antitrypsin. 

Jia, W., Wu, H., Bao, Y. et al. 2007. Association of serum retinol-binding protein 4 and visceral adiposity in Chinese subjects with and without type 2 diabetes. J Clin Endocrinol Metab 92 3224-3229. 

Lee, J. W., Im, J. A., Lee, H. R. et al. 2007. Visceral adiposity is associated with serum retinol binding protein-4 levels in healthy women. Obesity 15 2225-2232. 

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