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Cited by 753Clinical Nutrition and GastroenterologyNutrition and Health in AgingBody Composition Measurement Techniques

Nutritional Laboratory Markers in Malnutrition

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Keller, Ulrich·2019·Journal of Clinical Medicine
DOI 10.3390/jcm8060775PMC PMC6616535
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Abstract

Serum visceral proteins such as albumin and prealbumin have traditionally been used as markers of the nutritional status of patients. Prealbumin is nowadays often preferred over albumin due to its shorter half live, reflecting more rapid changes of the nutritional state. However, recent focus has been on an appropriate nutrition-focused physical examination and on the patient’s history for diagnosing malnutrition, and the role of inflammation as a risk factor for malnutrition has been more and more recognized. Inflammatory signals are potent inhibitors of visceral protein synthesis, and the use of these proteins as biomarkers of the nutritional status has been debated since they are strongly influenced by inflammation and less so by protein energy stores. The current consensus is that laboratory markers could be used as a complement to a thorough physical examination. Other markers of the nutritional status such as urinary creatinine or 3-methylhistidine as indicators of muscle protein breakdown have not found widespread use. Serum IGF-1 is less influenced by inflammation and falls during malnutrition. However, its concentration changes are not sufficiently specific to be useful clinically as a marker of malnutrition, and serum IGF-1 has less been used in clinical trials. Nevertheless, biomarkers of malnutrition such as prealbumin may be of interest as easily measurable predictors of the prognosis for surgical outcomes and of mortality in severe illnesses.

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  • Prealbumin is a more sensitive indicator of nutritional status, useful to evaluate recent changes in protein intake.

    “Prealbumin (15-36 mg/dL) More sensitive indicator of nutritional status, useful to evaluate recent changes in protein intake.[20]”

    From The Seven Methods for the Evaluation of Nutritional Status—ABCDEFG: Narrative Review (2026) · cites this paper as [20]

    Section 3.2 says prealbumin’s shorter half-life makes it more favorable than albumin for tracking acute changes in nutritional state. It does not establish that prealbumin measures recent changes in protein intake or give the cited 15–36 mg/dL range. Section 3.3 further cautions that prealbumin can remain unchanged despite substantial nutritional deprivation. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Low albumin levels may suggest malnutrition, inflammation or liver disease.

    “Albumin (3.5-5.0 g/dL) Indicator of long-term protein status.Low levels may suggest malnutrition, inflammation or liver disease.[20]”

    From The Seven Methods for the Evaluation of Nutritional Status—ABCDEFG: Narrative Review (2026) · cites this paper as [20]

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Authors
Keller, U.
Affiliations
University Hospital of Basel (CH)
Corresponding author
Keller, Ulrich
ORCID
Keller, Ulrich
Venue
Journal of Clinical Medicine
Publisher
MDPI AG
Published
2019-05-31
Volume
8
Issue
6
Pages
775
ISSN
2077-0383 (ISSN-L)
DOI
10.3390/jcm8060775
PMC
PMC6616535
OpenAlex
W2948541676
Cited by
753
References
3
Citations by year
2026: 88 · 2025: 125 · 2024: 156 · 2023: 117 · 2022: 112 · 2021: 96 · 2020: 51 · 2019: 4 · 2018: 3
FWCI
8.93
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Clinical Medicine (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
Keywords
malnutrition, dietary biomarkers, prealbumin, serum albumin, inflammation, insulin-like growth factor I, 3-methylhistidine, urinary creatinine, muscle protein degradation, visceral proteins, nutritional assessment

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