CLINICAL AND NUTRITIONAL FACTORS PREDICTIVE OF PLASMA-LIPID UNSATURATION DEFICIENCY IN ADVANCED LIVER-CIRRHOSIS - A LOGISTIC-REGRESSION ANALYSIS

Aim: To identify those clinical and nutritional factors associated wit h plasma lipid unsaturation deficiency in cirrhosis. Methods: Fatty ac id profiles of plasma phospholipids (PL) and cholesteryl esters (CE) w ere measured in 101 inpatients with advanced cirrhosis and in 44 age- and sex-matched healthy controls. Double-bond index (DBI) was calculat ed for each fraction and binarily categorized in each patient using th e 5th percentile of the control group as the cut-off limit. The associ ation of 12 routine clinical, biological, and nutritional variables wi th derangement of each DBI was multivariately assessed by means of ste pwise logistic regression analysis. Results: The DBI of PL and CE were below the 5th percentile of the control group in 60 and 68 of 101 cir rhotic patients, respectively. After multivariate analyses, the variab les found to be independent predictors of impaired unsaturation were: 1) The presence of moderate/severe malnutrition (odds ratio: 1.3-8.0 ( 95% CI); p < 0.05) and serum tau-GT > 1 mukat/L (odds ratio: 0.2-1.0; NS) for plasma PL, and 2) the presence of moderate/severe malnutrition (odds ratio: 1.8-17.4; p < 0.05), serum bilirubin > 50 mumol/L (odds ratio 1.7-14.5; p < 0.05) and serum tau-GT > 1 mukat/L (odds ratio 0.1 -1.1; NS) for CE. Conclusion: Malnutrition appears to be a major facto r for impaired lipid unsaturation in advanced cirrhosis. Thus, the pos sibility of improving plasma lipid unsaturation in these patients by m eans of nutritional support should be further investigated.