RAPID TURNOVER PROTEIN AND FAT-SOLUBLE VITAMINS IN CIRRHOTIC PATIENTS

Abstract

Serum albumin (Alb), prealbumin (PA), retinol binding protein (RBP) and transferrin (Tf) were measured in fifteen patients who underwent the direct operations for esophageal varices and intraoperative liver biopsies revealed cirrhosis in 13, fibrosis in 2. Correlation between these preoperative values and the values of ICG R15 and Ch-E were studied. And correlations between the postoperative values in these rapid turnover proteins and enegy intakes, amino acid intakes during postoperative parenteral nutrition (PN) were also studied. Serum fat-soluble vitamin levels were monitored similazly. 1) Preoperative Alb levels were well related with ICG R15 and Ch-E, but postoperatively these levels were significantly related with the infusional dose of exogenous albumin. 2) Preoperative PA, RBP levels were also well related with ICG R15 and Ch-E, and postoperatively these levels were well related with energy intakes in postoperative PN and body weight losses. 3) Preoperative PA, RBP values tended to be lower in patients with postoperative complication compared with in patients without postoperative complication. 4) Preoperative Vit. A. Vit. E levels were near the lowest limit of, or below the normal range. Postoperative those levels in patients without the infusion with fat-soluble vitamins were lower than those in patients who were administered fat-soluble vitamins. From these results, PA and RBP are considered to be useful to estimate the severity of liver damage, and seems to be one of the valuable parameters for the nutritional assesment and risk factors for operative intervension. During postoperative PN, fat-soluble vitamins have to be administered in patients with liver cirrhosis, even if the period of PN is short.