CHRONIC-ALCOHOLIC MYOPATHY AND NUTRITIONAL-STATUS

To investigate the prevalence of alcoholic myopathy and its relationsh ip to the nutritional status, we performed a muscle biopsy on the vast um lateralis of 60 consecutive hospitalized alcoholic patients using a Tru-Cut needle, processing it for light microscope and ultrastructura l analysis. The nutritional status was assessed by anthropometric meas urements such as midarm circumference, triceps skinfold and midarm mus cle area, and serum albumin. The hallmark of chronic alcoholic myopath y, fiber muscle atrophy, was present in 33% of the patients, necrosis scarcely being observed (1.5%). Ultrastructural alterations as lipid a nd glycogen accumulation or mitochondrial and myofibrillar alterations were nonspecific and observed in nearly all the cases where atrophy w as present. Malnutrition was frequent in our patients: 39% and 34% sho wed a triceps skinfold and a midarm muscle area, respectively, under t he fifth populational percentile. Patients with muscle fiber atrophy o r ultrastructural changes showed a worse nutritional status, not only regarding muscle protein (assessed by midarm muscle area or creatininu ria and explained by fiber atrophy), but also regarding fat stores ass essed by triceps skinfold. Toxic effect of ethanol and malnutrition ma y act synergistically leading to chronic alcoholic myopathy.