What is the best laboratory test for assessing an acute change in a patient’s nutritional status?

“Prealbumin is the single best laboratory test for assessing nutritional status in acutely ill patients because serum concentrations change relatively quickly in response to changes in nutritional status (SOR B). Prealbumin is a measure of hepatic protein synthesis and has a half-life of only 48 hours. It can be measured serially in hospitalized patients to help determine if and when parenteral nutritional support should be implemented. Low levels correlate with poor clinical outcomes in a variety of diseases including heart failure, stroke, and cancer. Albumin and transferrin levels have longer half-lives and are therefore not as sensitive to acute nutritional status changes. Prealbumin levels are also independent of the patient’s hydration status and are not affected by vitamin deficiencies. It should be noted that acute alcohol intoxication and corticosteroid therapy may artificially raise prealbumin levels, thereby limiting the utility of the test in some patients.” theabfm.org

Resources:
http://www.aafp.org/afp/2002/0415/p1575.html

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