Question

Current ICD definitions of malnutrition use biochemical markers as a component of the diagnostic criteria. Explain the effect of inflammation on visceral proteins and how that may impact the clinician’s ability to diagnose malnutrition. What laboratory values may confirm the presence of inflammation?

Answer 1

Malnutrition is an imbalanced nutritional status resulted from insufficient intake of nutrients to meet normal physiological requirement. Visceral proteins are considered as the viral marker of nutritional status of patients. One of the problem of diagnosing malnutrition is to the unified definition. In many malnourished patients there is an associated disease related inflammation influences both requirement and intake. It promote malnutrition. Visceral proteins are mostly synthesized in the liver. Poor protein and energy intake, impaired liver synthetic function as well as inflammatory status result in low circulating levels of visceral proteins. During inflammatory states and increased production of acute-phase proteins the liver reprioritizes protein synthesis, and lowers as a mirror visceral protein synthesis.

If a patient having inflammation certain type of extra proteins are often released and circulating through out the blood stream. Some ofthe laboratory values such as CRP(c-reactive protein), esr(erythrocytes sedimentation rate), pct(pro calcitonin). These values are more helpful to confirm the inflammation and physician can treat the patient according to that.