Nutritional assessment in hepatic cirrhosis; clinical, anthropometric, biochemical and hematological parameters.

INTRODUCTION

Since malnutrition is common in patients with hepatic cirrhosis (HC) is necessary to investigate the interference of the pathophysiological changes of liver in the methods of diagnosis of the nutritional status.

OBJECTIVE

To evaluate the frequency of malnutrition among patients with HC outpatients, using different assessment methods of the nutritional state.

METHODS

Nutritional state was determined by subjective global assessment (SGA); body mass index (BMI); percentage of ideal body weight (%BW); triceps skinfold thickness (%TST), mid-arm circumference (%MAC) and of the ideal mid-arm muscle circumference (%MAMC); serum albumin (ALB) and total lymphocyte count (TLC).

RESULTS

Seventy-eight patients were evaluated, 56.4% were male and mean age were 53.0 ± 7.7 years. The HC etiology was alcoholic in 56.4% of the cases. According to the classification of Child-Pugh, 48.7% were A, 26.9% were B and 24.4% were C. Variable degrees of malnutrition were diagnosed in 61.5% (SGA), 16.7% (BMI), 17.9% (%BW), 93.6% (%TST), 62.8% (%MAC) and 38.5% (%MAMC) of the patients. The levels of ALB and TLC were compatible with malnutrition diagnosis in 43.6% and 69.2% of the patients, respectively. The frequency of diagnosis of malnutrition increased according to the severity of HC and it also increased in patients with alcoholic etiology. A greater depletion of adipose tissue in women and of muscular tissue in men was demonstrated.

CONCLUSIONS

The diagnostic frequency of malnutrition in ambulatory-treated patients varies according to the nutritional evaluation method used. The prevalence of malnutrition is greater in the more advanced stages of HC and in alcoholic etiology.