Abstract
We thank Agilli et al. for their interest in our article and their comments on prealbumin. Agilli et al. emphasized the importance of the differential effects on prealbumin and acknowledged that certain accompanying conditions and medications may influence our results. They mentioned that certain diseases especially the chronic ones such as chronic liver diseases, chronic kidney disease, etc. may affect serum prealbumin levels. However, all the participants in our study had adjuvant chemotherapy, and this means that they did not have these mentioned chronic diseases. Because, if they had, they could not be treated with such toxic chemotherapeutics in the adjuvant setting. Besides, 81.7% of the patients had no comorbid diseases as we had defined both in the manuscript text and in Table 1. The remainder had various chronic diseases such as diabetes mellitus (6.7%), hypertension (8.7%), gastric ulcer (1.9%), and osteoporosis (1%). In addition, our inclusion criteria were Eastern Cooperative Oncology Group performance status <2 and adequate organ function, and we excluded the patients with morbid obesity (body mass index >40 kg/m2) and a known family history of dyslipidemia.
In our study, none of the patients received hormone replacement therapy including estrogens and progestational agents and any anabolic steroids. Our patients were early stage breast cancer patients with good performance status, and therefore, no dietary food supplements and vitamins were prescribed to them. Additionally, in literature search, we could not find any interactions between serum prealbumin levels and various drugs in patients with malignant diseases. 1 Studies concerning prealbumin and malignancy were all investigating the role of prealbumin as a biomarker for predicting nutritional status of the patients or cancer diagnosis.2–5 So, despite its interactions, prealbumin can be one of the indicators of nutritional status and is indicated especially as a biochemical nutritional parameter used in the monitoring of nutrition applications in ESPEN guidelines. 6
In order to measure serum hormonal (estradiol, follicle stimulating hormone, luteinizing hormone, free T3 and T4, thyroid stimulating hormone) and metabolic parameters related with metabolic syndrome (serum glucose, triglyceride, total cholesterol, high-density lipoprotein, low-density lipoprotein, apolipoprotein A-1, lipoprotein A-1) and nutritional status (transferrin, albumin, prealbumin), blood samples were analyzed in fasting state. Blood samples for measuring serum proteins were taken in the sitting position as these patients were evaluated in outpatient clinic.
Footnotes
Funding
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Conflict of interest
The authors declare no conflicts of interest.