Plasma proteins as indices of response to nutritional therapy in cancer patients

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Abstract
The use of plasma albumin (ALB), transferrin (TFN), prealbumin (TBPA), retinol-binding protein (RBP), triceps skin fold (TSF), and midarm muscle circumference (MAMC) as determinants of response to nutritional therapy (TPN) was investigated in 40 cancer patients during preoperative TPN. Thirty-one patients received 90% or more of their anabolic caloric requirement (Harris-Benedict equation) by means of TPN. During this study period (average 11.1 ± 4.7 days) nutritional assessments were completed before TPN and on the last day of TPN before surgery. Average weight loss based on usual body wt (UBW) and ideal body wt (IBW) was 19 ± 11% and 9 ± 15%, respectively (not significant, NS). Weight loss (UBW) correlated with ALB (P < 0.001), TBPA (P < 0.005) and RBP (P < 0.02) but did not correlate with TFN (P < 0.06), TSF, and MAMC. Weight loss (IBW) correlated with TSF (P < 0.01) and MAMC (P < 0.03) but did not correlate with plasma protein (PP). During TPN the average percent increases for PP were 0.1% (ALB, NS), 20% (TFN, NS), 60% (TBPA, P < 0.02), and 116% (RBP, P < 0.005). These results suggest that plasma TBPA and RBP are significant parameters of response to short-term nutritional therapy in cancer patients.