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Serum cobalamins and cobalamin-binding proteins during total parenteral nutrition. 1988

J P van Spreeuwel, and J J Verwimp, and N de Vos, and M Rouflart, and J A Flendrig
Department of Internal Medicine, University Hospital, Maastricht, The Netherlands.

Levels of serum cobalamin and both saturated and unsaturated serum cobalamin-binding proteins (transcobalamin II and R-binders) were determined prospectively in 43 patients before and after 2 weeks of total parenteral nutrition (TPN). Nine patients showed subnormal serum levels of cobalamin but none of them had clinical signs of cobalamin deficiency. Serum cobalamin levels significantly declined after 2 weeks of TPN as did both saturated and unsaturated R-binder levels whereas transcobalamin II levels remained constant. Since cobalamin in serum is entirely bound to proteins, of which R-binders comprise 80-90%, the changes in R-binder levels will markedly influence serum cobalamin levels, in fact they adequately explain the short time fluctuations of serum cobalamin levels observed. It is argued that the changes in serum cobalamin levels may reflect a changed distribution of cobalamins over the various body compartments rather than decreased or increased body stores. Moreover, only cobalamin bound to transcobalamin II is delivered to the tissues. Therefore, serum cobalamin levels alone may inadequately reflect cobalamin availability in patients receiving TPN.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010289 Parenteral Nutrition, Total The delivery of nutrients for assimilation and utilization by a patient whose sole source of nutrients is via solutions administered intravenously, subcutaneously, or by some other non-alimentary route. The basic components of TPN solutions are protein hydrolysates or free amino acid mixtures, monosaccharides, and electrolytes. Components are selected for their ability to reverse catabolism, promote anabolism, and build structural proteins. Hyperalimentation, Parenteral,Intravenous Hyperalimentation,Nutrition, Total Parenteral,Parenteral Hyperalimentation,Total Parenteral Nutrition,Hyperalimentation, Intravenous
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D014155 Transcobalamins A group of carrier proteins which bind with VITAMIN B12 in the BLOOD and aid in its transport. Transcobalamin I migrates electrophoretically as a beta-globulin, while transcobalamins II and III migrate as alpha-globulins. Cobalamin-Binding Protein,Transcobalamin,Transcobalamin II,Vitamin B 12-Binding Protein,Vitamin B 12-Binding Proteins,Vitamin B12-Binding Protein,Cobalamin-Binding Proteins,Cobalophilin,Haptocorrin,Holo-Transcobalamin II,R-Binder,Transcobalamin (I),Transcobalamin I,Transcobalamin III,Vitamin B 12 Binder,Vitamin B12-Binding Proteins,B12-Binding Protein, Vitamin,Cobalamin Binding Protein,Cobalamin Binding Proteins,Holo Transcobalamin II,Protein, Cobalamin-Binding,Protein, Vitamin B12-Binding,Proteins, Cobalamin-Binding,Proteins, Vitamin B12-Binding,R Binder,Vitamin B 12 Binding Protein,Vitamin B 12 Binding Proteins,Vitamin B12 Binding Protein,Vitamin B12 Binding Proteins

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