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Évaluation clinico‐biologique de la dénutrition

Annales de Biologie Clinique. Volume 62, Number 4, 395-403, Juillet-Août 2004, Revue générale

Résumé

Summary

Author(s) : K. Bach‐Ngohou, A. Bettembourg, D. Le Carrer, D. Masson, M. Denis , Laboratoire de biochimie spécialisée, Centre hospitalier universitaire Hôtel‐Dieu, Nantes kalyane.bach chu‐nantes.fr .

Summary : Malnutrition is frequently observed at hospital, concerning 30 to 50% of hospitalised patients. Increased length of stay and cost of care has made of this problem a major economic stake. Indeed, malnutrition diagnosis and prevention has become, since 2001, one of major french government’s priority. Malnutrition results from unbalanced nutritional requirement and intake. It associates both weight, proteic and functional loss. Its diagnosis and evaluation of its gravity are first clinical and need body mass index determination. For biological diagnosis, nutritional markers have to be very sensitive to nutritional state. Nutritional profile can be made, associating two nutritional markers (albumin and transthyretin) and one inflammation protein (alpha 1‐acid‐glycoprotein). Various clinical, biological or clinico‐biological indexes can also be calculated. Altogether, both indexes and nutrition profile are excellent tools for (1) diagnosis and classification of malnutrition state, moderate or severe, (2) pronostic and (3) evaluation of nutritional supplementation efficiency.

Keywords : malnutrition, albumin, prealbumin, transthyretin, alpha 1‐acid‐glycoprotein

Pictures

Figure 1. Exemples de profils nutritionnels. a : dénutrition exogène débutante sans inflammation ; b : dénutrition exogène chronique sans inflammation ; c : dénutrition endogène isolée avec inflammation ; d : dénutrition mixte endogène avec inflammation et exogène ; e : profil nutritionnel en cas d’hyperandrogénie (exemple de l’anorexie mentale).