How do different types of malnutrition affect function and outcome?
• Marasmus is protein-calorie undernutrition associated with significant physical wasting of energy stores (adipose tissue and somatic muscle protein) but preservation of visceral and serum proteins. Patients are not edematous and may have mild immune dysfunction.
• Hypoalbuminemic malnutrition occurs with stressed metabolism and is common in hospitalized patients. They may have adequate energy stores and body weight, but have expanded extracellular space, depleted intracellular mass, edema, altered serum protein levels, and immune dysfunction.
• A similar state of relative protein deficiency occurs in classic kwashiorkor, in which caloric provision is adequate but quantity and quality of protein are not.