PEDIATRIC MALNUTRITION INDICATORS


LABORATORY ASSAYS FOR VITAMIN AND MINERAL STATUS VITAMIN/MINERAL


Biotin Biotin


3-hydroxyisovaleric acid (3-HIA) Biotin


Vitamin C Ascorbic Acid


Chromium (Cr) Chromium


59 LABORATORY METHOD NORMAL 24-hour urine 75-195 μmol/d Serum or whole blood Serum or plasma >0.4 mg/dL INTERPRETATION DEFICIENCY TOXICITY <6 μg/d


>195 μmol/d <200 pg/mL


≤0.2 mg/dL


Low urine concentration of biotin and elevated excretion of 3-HIA are more reliable than serum or whole blood.


Blood levels can show daily fluctuations. Recommended at least 2 levels on 2 different days.


Deficiency usually diagnosed clinically with skin or gingival signs and those at risk of vitamin C deficiency.


Serum Erythrocyte Urine


Copper (Cu) Copper


Ceruloplasmin Copper


Iodine (I) Iodine


T3 (triiodothyronine)


Serum or plasma Serum 24-hour urine


Median urinary excretion Serum


<0.05-0.5 μg/L 20-36 μg/L 0.1-2.0 μg/L


70-140 μg/dL 20-35 mg/dL <60 μg/day


Peds >6 yo and adult: 100-199 μg/L


<50 μg/dL <20 mg/dL >60 μg/day


<20 μg/L


20-49 yo: >204 ng/dL 50-90 yo: >181 ng/dL


>140 μg/dL


Wilson disease: ceruloplasmin <10 mg/dL; urine copper >200 μg/day.


≥300 μg/dL


Urinary iodine measured in repeated 24-hour or random samples. Insufficient: 20 to <100 μg/L.


Thyroid-stimulating hormone increases with iodine intake <100 μg/day.


Difficult to determine status due to presence in blood in extremely low concentrations.


COMMENTS


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