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Serum Protein Response to Surgery and Starvation

Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

Charles L. Hobbs, M.D.

Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

James L. Mullen, M.D.

Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

Ernest F. Rosato, M.D.

Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania

To investigate the effect of stress on the dynamics of serum protein response during starvation, serum albumin, prealbumin, and transferrin changes were studied in six chair-adapted macaques during two separate 7-day test periods: (1) Starvation—NPO + IV D5/W (100 cc/kg/day), and (2) Surgery/starvation—laparotomy and gastrostomy + NPO + IV D₅/W (100 cc/kg/day). During the starvation period, transferrin was the only protein that decreased from baseline values and did so at day 7 of the study period. In contrast, during the period of starvation following surgery, both prealbumin and transferrin were significantly decreased at both day 4 and day 7 of the study period, whereas albumin was only decreased at day 7 of this period. These findings indicate that the addition of a surgical stress to starvation results in a depression of serum protein levels that is not only of greater magnitude, but also more rapid in onset than observed with starvation alone. In addition, the differential response of prealbumin and transferrin to starvation and stress may provide a useful indicator of the presence and/or degree of stress in certain situations. The clinical utility of this finding remains to be ascertained.

Journal of Parenteral and Enteral Nutrition, Vol. 6, No. 5, 395-398 (1982)
DOI: 10.1177/0148607182006005395


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