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Serum zinc

RBC metallothionein

RDR, relative dose-response; MRDR, modified relative dose-response; RBP, retinol binding protein; TTR, transthyretin; ETK, erythrocyte transketolase; RBC, red blood cell; TPP, thiamin pyrophosphate; EGR, erythrocyte glutathione reductase; PLP, pyridoxal-5'-phosphate; EAST, erythrocyte aspartate aminotransferase; MMA, methylmalonic acid; GSHPx, platelet glutathione peroxidase; SOD, superoxide dismutase.Adapted with permission from van den Berg H, Heseker H, Lamand M, Sandstrom B and Thurnham D (1993) Flair Concerted Action No 10 Status Papers—Introduction, Conclusions and Recommandations. International Journal for Vitamin and Nutrition Research 63: 247-251, with changes suggested by D. Thurnham (personal communication).

RDR, relative dose-response; MRDR, modified relative dose-response; RBP, retinol binding protein; TTR, transthyretin; ETK, erythrocyte transketolase; RBC, red blood cell; TPP, thiamin pyrophosphate; EGR, erythrocyte glutathione reductase; PLP, pyridoxal-5'-phosphate; EAST, erythrocyte aspartate aminotransferase; MMA, methylmalonic acid; GSHPx, platelet glutathione peroxidase; SOD, superoxide dismutase.Adapted with permission from van den Berg H, Heseker H, Lamand M, Sandstrom B and Thurnham D (1993) Flair Concerted Action No 10 Status Papers—Introduction, Conclusions and Recommandations. International Journal for Vitamin and Nutrition Research 63: 247-251, with changes suggested by D. Thurnham (personal communication).

the interest in recent intake or long-term status. In association with this test, serum cholesterol and triacylglycerols and also lipoprotein fractions are measured. The selection of micronutrient tests can be determined by the suspected deficiencies from previous dietary surveys; in the absence of dietary data, several tests should be measured because preclinical deficiencies are common in developed societies. A sensible selection can be found in Table 1. In the US Third Nutritional Health and Nutrition Examination Survey, most of the recommended and best available methods were used. This is also the case for vitamin status analysis in the recent UK government diet and nutrition surveys of specific population groups.

In a hospital setting, the selection of laboratory tests depends on the clinical conditions of patients on admission and during the subsequent course of injury or illness. Because protein-energy malnutrition can be present in some cases, protein status should be assessed using laboratory tests for serum albumin, plasma transport proteins, and urinary creatinine and 3-methylhistidine, and also for acute phase proteins. Using some of the previous values associated with other variables (immunological functions and anthropometric measurements), indices relating nutritional status to clinical outcome can be computed. Among hospital patients, vitamin and trace element deficiencies are also common; the determination of deficient variables suspected on the basis of history and physical examination is suggested.

Because on various occasions major differences in interlaboratory comparisons and ring tests have been observed, it is essential in the selection of laboratory tests to favor definitive reference methods or, in their absence, standardized and validated methods for which careful collection and handling of samples is compulsory and also appropriate quality control. Commercial-quality control samples or external quality assurance schemes are available only in some cases. For quality control of in-house samples, it is suggested to prepare one sample with low or deficient content and one with normal or high content. Interlaboratory cross-comparison is highly recommended.

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