Protein energy malnutrition laboratory tests

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

Overview

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

Laboratory findings consistent with the diagnosis of protein-energy malnutrition include:

• 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