A decrease in hepatic synthesis would most directly lead to which change in plasma proteins?

• A. Albumin and globulin levels decrease
• B. Albumin levels increase while globulins decrease
• C. No change in levels
• D. Unrelated changes

Answer: (A)

The liver makes most plasma proteins, so when its synthetic function declines, the levels of those proteins in blood fall. Albumin is the main plasma protein produced by the liver and is crucial for maintaining oncotic (colloid osmotic) pressure; less albumin lowers this pressure and can lead to fluid leakage into tissues. Many globulins are also produced by the liver (such as transferrin, haptoglobin, ceruloplasmin, and various components of the coagulation and transport systems). If hepatic synthesis drops, these liver-derived globulins decrease as well. Immunoglobulins (antibodies), on the other hand, are mainly made by plasma cells, not the liver, so they’re not as directly affected by hepatic biosynthesis. Therefore, a decrease in hepatic synthesis would most directly reduce both albumin and globulin levels, matching the given answer.