title: Malnutrition: laboratory markers vs nutritional assessment.
abstract: Malnutrition is an independent risk factor for patient morbidity and mortality and is associated with increased healthcare-related costs. However, a major dilemma exists due to lack of a unified definition for the term. Furthermore, there are no standard methods for screening and diagnosing patients with malnutrition, leading to confusion and varying practices among physicians across the world. The role of inflammation as a risk factor for malnutrition has also been recently recognized. Historically, serum proteins such as albumin and prealbumin (PAB) have been widely used by physicians to determine patient nutritional status. However, recent focus has been on an appropriate nutrition-focused physical examination (NFPE) for diagnosing malnutrition. The current consensus is that laboratory markers are not reliable by themselves but could be used as a complement to a thorough physical examination. Future studies are needed to identify serum biomarkers in order to diagnose malnutrition unaffected by inflammatory states and have the advantage of being noninvasive and relatively cost-effective. However, a thorough NFPE has an unprecedented role in diagnosing malnutrition.
authors.affiliation: Department of Gastroenterology/Hepatology, McMaster University, Hamilton, Ontario, Canada reachshishira@gmail.com.
authors.forename: Shishira
authors.initials: S
authors.lastname: Bharadwaj
authors.affiliation: Department of Gastroenterology/Hepatology, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Shaiva
authors.initials: S
authors.lastname: Ginoya
authors.affiliation: Department of Gastroenterology/Hepatology, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Parul
authors.initials: P
authors.lastname: Tandon
authors.affiliation: Department of Gastroenterology/Hepatology, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Tushar D
authors.initials: TD
authors.lastname: Gohel
authors.affiliation: Department of Gastroenterology/Hepatology, McMaster University, Hamilton, Ontario, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Guirguis
authors.affiliation: Department of Gastroenterology/Hepatology, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Hiren
authors.initials: H
authors.lastname: Vallabh
authors.affiliation: Department of Gastroenterology/Hepatology, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Jevenn
authors.affiliation: Department of Gastroenterology/Hepatology, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Hanouneh
keywords: malnutrition; physical examination; serum markers