Case 17.3
In addition to other labs, micronutrients and inflammatory markers were checked during his hospitalization. These were reviewed during his outpatient visit
| Component | Lab Value |
Vitamin D, 25-Hydroxy | 16 (L) |
| Ferritin | 638 (H) |
| Iron, Serum | 12 (L) |
| Transferrin | 131 (L) |
| % Saturation | 7 (L) |
| Erythrocyte Sedimentation Rate | 39 (H) |
| C-Reactive Protein | 16.2 (H) |
| Pre-Albumin | 16 (L) |
| Albumin | 2.9 (L) |
| White Blood Cell Count | 6.6 |
He has alterations in micronutrient levels as well as a decrease in albumin and prealbumin levels. Do these alterations alone indicate malnutrition?
Yes
No
There is no single biochemical marker to diagnosis malnutrition. Micronutrients can be positive or negative acute phase reactants. Alterations in micronutrient levels may also reflect disease activity versus depleted stores. Any deficiency found with micronutrients does not solely diagnose malnutrition. Altered visceral protein markers of albumin and prealbumin are both negative acute phase reactants and levels can decrease with inflammation due to reduced synthesis. Low levels of albumin and prealbumin in setting of inflammation are likely not reflective of nutrition status and should not be used to solely diagnose malnutrition.