II. Indications
- Unintentional Weight Loss
- Suspected Protein and Calorie Malnutrition
- Hospitalized patients with Malnutrition risk factors
- No eating within 5 days
- Nutrient losses (e.g. Protein-losing Enteropathy)
- Serum Albumin <3.2 g/dl
- Chronic debilitating condition
- Alcoholism
- Cancer
- Diabetes Mellitus
- Renal disease
- Advanced age
III. Pathophysiology: Protein-Calorie Malnutrition Consequence
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Malnutrition alters metabolic function
- Insulin levels
- Growth Hormone levels
- Cortisol levels
- Decreases hepatic function
- Diminishes mineral stores
-
Malnutrition predisposes to poor clinical outcomes
- Associated with higher rate of mortality
- Associated with prolonged hospitalization
- Associated with slower clinical improvement
IV. Lab Indicators of Malnutrition in Adults
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Serum Prealbumin <15 mg/dl
- Best marker for Malnutrition
- See Prealbumin for interpretation and monitoring
- Serum Albumin <3.4 mg/dl
- Serum Transferrin <200 mg/dl
- Total Lymphocyte Count <1500/mm3
- Total Cholesterol <160 mg/dl