Pharmacology Book

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Lab Markers of Malnutrition

Aka: Lab Markers of Malnutrition, Malnutrition Labs
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  1. Indications
    1. Unintentional Weight Loss
    2. Suspected Protein and Calorie Malnutrition
    3. Hospitalized patients with malnutrition risk factors
      1. No eating within 5 days
      2. Nutrient losses (e.g. Protein-losing Enteropathy)
      3. Serum Albumin <3.2 g/dl
      4. Chronic debilitating condition
        1. Alcoholism
        2. Cancer
        3. Diabetes Mellitus
        4. Renal disease
        5. Advanced age
  2. Pathophysiology: Protein-Calorie Malnutrition Consequence
    1. Malnutrition alters metabolic function
      1. Insulin levels
      2. Growth Hormone levels
      3. Cortisol levels
      4. Decreases hepatic function
      5. Diminishes mineral stores
    2. Malnutrition predisposes to poor clinical outcomes
      1. Associated with higher rate of mortality
      2. Associated with prolonged hospitalization
      3. Associated with slower clinical improvement
  3. Lab Indicators of Malnutrition in Adults
    1. Serum Prealbumin <15 mg/dl
      1. Best marker for malnutrition
      2. See Prealbumin for interpretation and monitoring
    2. Serum Albumin <3.4 mg/dl
    3. Serum Transferrin <200 mg/dl
    4. Total Lymphocyte Count <1500/mm3
    5. Total Cholesterol <160 mg/dl
  4. References
    1. Beck (2002) Am Fam Physician 65(8):1575-8
    2. Grazewood (1998) J Fam Pract 47(1): 19-25

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