Malavé I, Vethencourt M A, Pirela M, Cordero R
Instituto Venezolano de Investigaciones Científicas (IVIC), Venezuela.
J Trop Pediatr. 1998 Oct;44(5):256-62. doi: 10.1093/tropej/44.5.256.
We measured the levels of thyroxine-binding prealbumin (TBPA), C-reactive protein (CRP), and interleukin-6 (IL-6) in sera from protein-energy undernourished and control children either without or with associated clinical infections. Levels of TBPA were significantly lower in undernourished than in control children without clinical infections. Mean serum TBPA concentration was also significantly lower in both clinically infected undernourished and control children than in those of the same nutritional status but without overt infections. Significant positive correlations were observed between the concentration of TBPA and the Z-scores of weight for age, height for age, and weight for height in all children without clinical infections, which disappeared in clinically infected children. CRP and IL-6 increased to approximately similar levels in sera from undernourished and control children with overt infections. An inverse correlation between the levels of TBPA and CRP and a significant positive correlation between the concentration of CRP and IL-6 were observed in children with associated clinical infections. Serum IL-6 and TBPA showed a small negative relationship in patients with overt infections. Thus, TBPA is a sensitive marker of undernutrition only in the absence of clinical infections, and the capacity to increase production of IL-6 and CRP during infections is preserved in protein-energy undernutrition.
我们检测了蛋白质能量营养不良儿童和对照儿童血清中甲状腺素结合前白蛋白（TBPA）、C反应蛋白（CRP）和白细胞介素-6（IL-6）的水平，这些儿童有无相关临床感染。在无临床感染的情况下，营养不良儿童的TBPA水平显著低于对照儿童。在有临床感染的营养不良儿童和对照儿童中，血清TBPA平均浓度也显著低于相同营养状况但无明显感染的儿童。在所有无临床感染的儿童中，TBPA浓度与年龄别体重、年龄别身高和身高别体重的Z评分之间存在显著正相关，而在有临床感染的儿童中这种相关性消失。在有明显感染的营养不良儿童和对照儿童血清中，CRP和IL-6升高至大致相似的水平。在有相关临床感染的儿童中，观察到TBPA水平与CRP之间呈负相关，CRP浓度与IL-6之间呈显著正相关。在有明显感染的患者中，血清IL-6和TBPA呈微弱负相关。因此,TBPA仅在无临床感染时是营养不良的敏感标志物，在蛋白质能量营养不良时，感染期间增加IL-6和CRP产生的能力得以保留。
