Serum Albumin and Prealbumin in Calorically Restricted, Nondiseased Individuals: AÂ Systematic Review

In these otherwise healthy subjects, serum albumin and prealbumin levels are not “markers of nutritional status.” The “markers” failed to identify subjects with severe protein-calorie malnutrition until extreme starvation. That is, they failed to identify healthy individuals who would benefit from nutrition support, becoming abnormal only when starvation was already obvious. In contrast, serum albumin and prealbumin levels are known to fall promptly with injury or illness regardless of nutrient intake. They are negative acute-phase reactants. When these measures are low in sick patients, this cannot be assumed to reflect nutritional deprivation. Decisions about nutrition support should be based on evidence of meaningful benefit from this treatment rather than on assessment of “nutritional markers.”