Nutritional Status Assessment in Adults Laboratory Medicine

Updated: Sep 22, 2015
  • Author: W Aaron Hood, DO; Chief Editor: Vikram Kate, MBBS, MS, PhD, FACS, FACG, FRCS, FRCS(Edin), FRCS(Glasg), FIMSA, MAMS, MASCRS  more...
  • Print
Laboratory Medicine

Laboratory Medicine Summary

Serum proteins (albumin, transferrin, prealbumin, retinol-binding protein) are perhaps the most widely used laboratory measures of nutritional status. They are hepatically produced negative acute-phase reactants with reduced levels during systemic inflammation. However, in the absence of inflammation, a low concentration of these proteins correlates strongly with malnutrition. [3] Details of these proteins can be found in Table 3.

Table 3: Serum Proteins Used for Assessment of Nutritional Status [3, 26, 27] (Open Table in a new window)

Protein Half-life, days Function Comment
Albumin 14-20 Maintenance of plasma oncotic pressure; carrier protein levels increase with dehydration, blood and albumin transfusion, and anabolic steroids



levels decrease in liver failure, inflammation, volume overload states (cirrhosis, congestive heart failure, renal failure), zinc deficiency, protein-losing states (nephrotic syndrome, enteropathy), corticosteroid use, and bedrest



Transferrin 8-9 Iron transport levels increase during dehydration, iron deficiency, pregnancy, estrogen therapy, and acute hepatitis



levels decrease in liver and renal failure, inflammation, anemia due to chronic disease and vitamin B12 and folate deficiency, corticosteroids, zinc deficiency, and protein-losing states (nephrotic syndrome, enteropathy)



Often measured indirectly as total iron-binding capacity (TIBC)



Prealbumin (transthyretin) 2-3 Binds thyroxine; carrier for retinol-binding protein levels increase in renal failure (degraded by the kidney) and corticosteroid and oral contraceptive use



levels decrease in liver failure, inflammation, and hyperthyroidism



Retinol-binding protein (RBP) 12-24 Vitamin A transport; binds to prealbumin levels increase in renal failure (degraded by the kidney)



levels decrease in cirrhosis, inflammation, vitamin A and zinc deficiency, and hyperthyroidism