Prealbumin

Definition

Plasma protein synthesized by the liver and retinol-binding protein transporter, reflecting protein nutritional status in the short term. It is more sensitive to rapid nutritional changes than albumin.

How it works

Prealbumin (transthyretin) has a short 2-3 day half-life, making it highly sensitive to rapid changes in nutritional intake. It increases rapidly with refeeding and decreases with fasting or malnutrition. A level below 20 mg/L indicates malnutrition, while a level below 11 mg/L suggests severe malnutrition. Unlike albumin, it is less affected by moderate acute inflammation, making it more specific to nutritional status. Prealbumin is particularly useful for rapid short-term follow-up of nutritional intervention efficacy.

Role

Sensitive and early nutritional status marker allowing rapid follow-up of nutritional interventions.

Examples

• Monitoring of rapid realimentation efficacy
• Rapid postoperative evaluation
• Parenteral nutrition monitoring
• Early detection of malnutrition

Recommendations

Measure prealbumin upon initiation of nutritional support to assess intervention efficacy. Perform follow-up measurements every 3-5 days to adjust nutritional intake based on response.

Key takeaway

Prealbumin is the most sensitive biological marker to rapidly follow changes in protein nutritional status.

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