During inflammatory states, what happens to serum albumin and prealbumin?

• A. They decrease
• B. They increase
• C. They remain unchanged
• D. They vary unpredictably

Answer: (A)

During inflammation the liver shifts toward producing positive acute-phase proteins and downregulates the synthesis of negative acute-phase proteins. Serum albumin and prealbumin are negative acute-phase proteins, so their production decreases and their serum levels fall in inflammatory states. Cytokines like IL-6 drive this change, and prealbumin, with its short half-life, responds quickly while albumin declines more gradually. Therefore, both albumin and prealbumin decrease during inflammation.