MALNUTRITION IN ALCOHOLIC AND VIRUS-RELATED CIRRHOSIS

The study aimed to define the prevalence, characteristics, and clinica l importance of nutritional disorders in patients with liver cirrhosis . Nutritional status was evaluated in 120 hospitalized patients-77 wit h alcoholic and 43 with virus-related cirrhosis-by anthropometric, vis ceral, and immunologic measurements. Energy malnutrition, defined as t riceps skinfold thickness (TSF) and/or midarm muscle circumference (MA MC) below the 5th percentile of standard values, was found in 34% of t he study population. Patients below the 5th percentile for MAMC and/or TSF showed significantly lower survival rates at 3, 6, 12, and 24 mo compared with patients above the 5th percentile. Protein malnutrition (low albumin, transthyretin, transferrin, and retinol-binding-protein concentrations) and immunoincompetence (abnormal response to skin test s) were much more frequent (81% and 59%) than energy malnutrition (34% ). Serum proteins correlated with the degree of liver function impairm ent, but not with immunologic tests. The prevalence, characteristics, and severity of protein-energy malnutrition were comparable in alcohol ic and viral cirrhosis. Malnutrition was correlated with the clinical severity of the liver disease. The study shows that protein-energy mal nutrition is a common complication of liver cirrhosis. Nutritional dis orders appear to be related to the degree of liver injury rather than to its etiology. Compared with other methods, which have important lim itations in liver disease, anthropometry is currently the most reliabl e method for nutritional assessment in clinical practice and may be va luable for predicting survival in cirrhotic patients.