Service de Biochimie, Hôpital Cochin, APHP, Paris, France.
Service de Biochimie, Hôpital Cochin, APHP, Paris, France; Laboratoire de Biologie de la Nutrition, EA4466 PRETRAM, Faculté de Pharmacie de Paris, Université de Paris, Paris, France.
Clin Nutr. 2021 Mar;40(3):907-911. doi: 10.1016/j.clnu.2020.06.017. Epub 2020 Jun 25.
The use of transthyretin (TTR, prealbumin) as a marker of malnutrition and the definition of associated cut-offs are a matter of debate. In order to clarify this issue, we performed a retrospective study and then a prospective validation one. In the first study, data from 23,617 consecutive patients from our University hospital were analysed. Using the 0.11 and 0.05 g/L cut-off values defined by the French Health Authority, only 3.13% and 0.49% appeared malnourished or severely malnourished indicating that these cut-off values are clearly inappropriate. In the prospective study, consecutive patients were stratified for normal (≥0.2 g/L) or low (<0.2 g/L) TTR, and normal (<15 mg/L) or high (≥15 mg/L) C-reactive protein, hence defining 4 groups (n = 50 to 57/group), and data were analysed according to nutritional status estimated from patient files. Receiver operating characteristic (ROC) curve of TTR level associated with malnutrition allowed setting cut-off values at 0.17 and 0.12 g/L for malnutrition and severe malnutrition respectively.
转甲状腺素（TTR，前白蛋白）作为营养不良的标志物的使用以及相关截断值的定义一直存在争议。为了澄清这个问题，我们进行了一项回顾性研究和前瞻性验证研究。在第一项研究中，我们分析了来自我们大学医院的 23617 例连续患者的数据。使用法国卫生当局定义的 0.11 和 0.05 g/L 截断值，只有 3.13%和 0.49%的患者出现营养不良或严重营养不良，这表明这些截断值显然不合适。在前瞻性研究中，连续患者根据 TTR（≥0.2 g/L 或<0.2 g/L）和 C-反应蛋白（<15 mg/L 或≥15 mg/L）正常或升高进行分层，从而定义了 4 组（每组 50 至 57 例），并根据患者档案中估计的营养状况分析数据。与营养不良相关的 TTR 水平的受试者工作特征（ROC）曲线允许将营养不良和严重营养不良的截断值分别设置为 0.17 和 0.12 g/L。
