The inflammatory stress of hospitalyzed patients was quantified according to their plasma levels of acute-phase proteins (APP). The data from 54 adult (48 ± 20 yrs) patients were retrospectively (1994-1998) analysed along with other 12 healthy controls. The major pathologies were peripheral vascular disease (22) , penphigus pholiaceos (7), inflammatory bowel disease (7), trauma (6) and orthognatic post surgery (3). Samples of fasting venous blood were drawn and their plasma used for positive (+) and negative (-) APP by nephelometric assays. Among assayed APP+ were C-reactive protein (CRP), acid alpha-1-glycoprotein (AAG), alpha-1-antitrypsin (AAT) and ceruloplasmim (CER) while albumin (Alb), transthyretin (TTR), transferrin (TF) and retinol-binding protein (RBP) were the APP- representatives. A significant relationship (Spearman test) was found between the variables CRP <FONT FACE=Symbol>´</FONT> AAG (r = 0.49), Alb <FONT FACE=Symbol>´</FONT> TTR (r = 0.60), Alb <FONT FACE=Symbol>´</FONT> RBP (0.58), Alb <FONT FACE=Symbol>´</FONT> TF (r = 0.39), TTR <FONT FACE=Symbol>´</FONT> RBP (r = 0.56) and TTR <FONT FACE=Symbol>´</FONT>TF (r = 0.43). The stronger relationships between APP+ <FONT FACE=Symbol>´</FONT> APP- were found for CRP <FONT FACE=Symbol>´</FONT> Alb (r = - 0.71), CRP <FONT FACE=Symbol>´</FONT> TTR (- 0.54), CRP <FONT FACE=Symbol>´</FONT> TF (r = - 0.39) and AAG <FONT FACE=Symbol>´</FONT> Alb (r = - 0.35). By assembling the APP according to the prognostic inflammatory nutritional index (PINI) proposed by Ingenbleek & Carpentier (Int. J. Vitam. Nutr. Res., 55: 91, 1985) the obtained data allowed a group distribution as healthy controls (G1), patients without (PINI < 1,G2) or with risk (PINI >1, G3). The later was split as lower (G3A, n =16) medium (G3B, n =10) and high (G3C, n = 6) risk and mortality-risk (G3D, n =11). The PINI values differentiated (non-parametric Kruskall-Wallis test) G3 > (G1= G2) and G3 > G3A. Among all assayed proteins only CRP, Alb and TTR discriminated groups as G3 > (G1= G2) for CRP or G3< (G1= G2) for Alb and TTR. Only CRP, TTR and TF discriminated the morbidity severity with G3D > G3A (for CRP) and G3D < G3A (for TTR and TF). The correlation coeficient allowed only APP-- substitutions at the PINI formula whereas CRP/Alb was the best PINI simplification form keeping its power of group discrimination.
Critical patients; Acute-phase proteins; Inflammatory-stress index; Nutritional markers
