[Clinico-biological evaluation of malnutrition]

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 in-take. 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) prognostic and (3) evaluation of nutritional supplementation efficiency.