Evaluation of nutritional markers less affected by inflammation

Abstract

As nutritional markers, albumin, transthyretin, retinol-binding protein, and transferrin are used. However, their concentrations decrease markedly during inflammation. In recent years, it has been reported that apolipoprotein (Apo) C-II and ApoC-III can be nutritional markers that are less affected by inflammation. We investigated whether apolipoproteins including ApoC-II and ApoC-III are useful as nutritional markers unaffected by inflammation, and we analyzed the effects of renal injury and hypertriglyceridemia on their measured concentrations. The subjects were 51 patients with malnutrition, 28 healthy volunteers, 19 patients with renal injury, and 24 patients with hypertriglyceridemia. The malnutrition group was divided into two: the low-CRP-concentration group of 19 patients and the high-CRP-concentration group of 32 patients. The concentrations of apolipoproteins were measured and compared among the groups. The ApoA-I concentration was significantly lower in the malnutrition group than in the healthy group. Additionally, a significantly larger reduction was observed in the high-CRP-concentration group than in the low-CRP-concentration group. The ApoC-II concentration showed a small difference between the healthy and malnutrition groups and especially no difference between the high-CRP-concentration and healthy groups. The ApoC-III concentration was significantly lower in the malnutrition group than in the healthy group, but there was no significant difference between the low-CRP- and high-CRP-concentration groups. In addition, the ApoC-III concentration was significantly higher in the renal injury and hypertriglyceridemia groups than in the healthy group. As mentioned above, ApoC-III may be a nutritional marker that is not affected by inflammation. However, the concentration of ApoC-III tends to be high in the presence of renal injury and hypertriglyceridemia, so the interpretation of the results requires caution.