NUTRITIONAL ASSESSMENT IN CHRONIC LIVER-DISEASE PATIENTS - A COMPARISON BETWEEN SKELETAL-MUSCLE FUNCTION AND STANDARD NUTRITIONAL PARAMETERS

To determine the validity of skeletal muscle function as a functional marker of nutritional status in patients with liver cirrhosis, 133 sub jects were studied. Seventy-four of them suffered from liver cirrhosis ; 17 were malnourished patients with gastrointestinal diseases, and 42 constituted normal controls. Adductor pollicis function was assessed. The force developed by this muscle at 10 Hz was expressed as the perc entage of the force at 20 Hz (F10/F20). Standard nutritional assessmen t was also performed and included the measurement of serum transport p roteins and of anthropometric parameters. Cirrhotic patients with norm al lean body mass, as measured either by arm muscle area or creatinine height index, had F10/F20 values which were not significantly differe nt from those measured in normal controls. Cirrhotic patients with red uced lean body mass had F10/F20 values which were not significantly di fferent from those observed in malnourished patients with gastrointest inal diseases. Finally, cirrhotic patients with normal arm muscle area had F10/F20 values which were significantly different from those in m alnourished patients with gastrointestinal diseases. Mean serum levels of total proteins, albumin, and transferrin were not correlated with any of the anthropometric measurements nor with skeletal muscle functi on. Indeed, we observed a decrease in the mean serum levels of albumin and transferrin which was related to the severity of liver disease. T his trend between the severity of liver disease and nutritional marker s has not been observed with triceps skinfold thickness, arm muscle ar ea or circumference, and skeletal muscle function. We conclude that, u nlike serum transport proteins, skeletal muscle function is not affect ed by chronic liver disease. Thus, it can be used as a functional meas urement of nutritional status in such patients.