Which of the following compounds is not synthesized predominantly by the liver?A) Albumin
The liver is the largest gland in the body, and responsible for synthesis of the majority of plasma proteins. The liver produces approximately 10 g of albumin per day, and albumin measurement can therefore be used as a surrogate for liver synthetic function. This must be interpreted with caution, as albumin levels can be influenced by a host of factors unrelated to hepatic function, and albumin's long half-life (15-20 days) makes it a poor marker for acute hepatic dysfunction. Most clotting factors are synthesized predominantly in the liver, except for factor VIII. Due to this fact the prothrombin time (PT) and international normalized ratio (INR) may also be used as markers of hepatic synthetic function. However, these too should be interpreted with caution as other conditions, including vitamin K deficiency and warfarin use, may prolong a patient's PT/INR.