Protein energy malnutrition laboratory tests

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omodamola Aje B.Sc, M.D. [2]

There are no specific laboratory tests, group of tests, or indices that are satisfactory for the assessment of protein energy malnutrition. However, laboratory findings consistent with the diagnosis of protein-energy malnutrition include abnormally low blood glucose, hypoalbuminemia (10-25 g/L), hypoproteinemia (transferrin, essential amino acids, lipoprotein) and hypoglycemia.

Laboratory findings consistent with the diagnosis of protein-energy malnutrition include:^[1]

• Abnormally low blood glucose
• Abnormal blood smears by microscopy or direct detection testing
• Decreased serum hemoglobin
• Abnormal urinalysis and culture

Specific laboratory findings in patients with kwashiorkor include:

• Hypoalbuminemia (10-25 g/L)
• Hypoproteinemia (transferrin, essential amino acids, lipoprotein)
• Hypoglycemia
• Elevated plasma cortisol and growth hormone levels
• Decreased insulin secretion and insulin-like growth factor
• Increased percentage of body water and extracellular water
• Depletion of electrolytes, especially potassium and magnesium
• Decreased levels of some enzymes (including lactase)
• Iron deficiency anemia and metabolic acidosis

Specific laboratory findings in patients with marasmus include:

• Increased urinary 3-methylhistidine, a reflection of muscle breakdown
• Urinary excretion of hydroxyproline is diminished, reflecting impaired growth and wound healing
• Iron deficiency anemia
• Metabolic acidosis