Clinical Information

Prealbumin is synthesized in the liver and is involved in triiodothyronine (T₃), thyroxine (T₄) and Vitamin A transport. Each tetrameric prealbumin molecule binds one molecule of retinol-binding protein (which complexes with vitamin A) at one site and up to two molecules of T₃ or T₄ at another site. Prealbumin is secondary to thyroxine-binding globulin for T₃ and T₄ transport. Prealbumin has an extremely short half-life and can provide a more timely and sensitive assessment of protein malnutrition or liver dysfunction than transferrin or albumin.

Prealbumin is a very sensitive negative acute phase protein. Decreased levels are associated with inflammation, malignancy, liver cirrhosis, and protein diseases of the gut or kidneys. Prealbumin levels also fall during periods of calorie/protein malnutrition. Therefore, during inflammatory processes with concomitant malnutrition, prealbumin levels fall rapidly. Decreased levels of prealbumin are also associated with cystic fibrosis, chronic illness, and some forms of hereditary amyloidosis.

Prealbumin can be a useful marker for assessing protein-energy nutritional status of maintenance dialysis patients. Elevated prealbumin levels are associated with high dose of corticosteroids, high levels of endogenous steroids secondary to adrenal hyperactivity, high dose nonsteroidal anti-inflammatory medication, and Hodgkin’s disease.