NUTRITIONAL-STATUS IN CIRRHOSIS

Malnutrition frequently occurs in patients with chronic liver disease and may represent a risk factor influencing both short- and long-term survival in these patients. Previously published studies have tended t o be confined to alcoholic patients and there are few data on the prev alence of nutritional abnormalities in patients with cirrhosis not of alcoholic origin. Anthropometric measurements and a clinical evaluatio n of the nutritional status of 1402 patients with cirrhosis (883 males and 519 females) were recorded between January 1988 and 1989 by the I talian Multicentre Cooperative project on Nutrition in Liver Cirrhosis . The origin of liver disease was alcohol-related in 37% of patients. Child-Pugh criteria were used to establish the severity of the liver d isease. Patients with cirrhosis exhibited a wide range of nutritional abnormalities. While 29% of females and 18% of males appeared to be ov ernourished, a significant reduction in fat stores, as estimated by th e mid-arm fat area, and/or muscle mass, as estimated by mid-arm muscle area, was observed in 30% of patients with cirrhosis. The prevalence of signs of nutritional depletion increased in both sexes as liver fun ction deteriorated. Mean values for mid-arm fat area decreased by 30% in males and by 40% in females with moderate to severe liver failure ( Child-Pugh Classes B and C). The reduction in mid-arm muscle area was more evident in males (17% decrease) than in females (9% decrease). Pa tients with alcohol-related cirrhosis showed a higher prevalence of ma lnutrition and had more frequent severe liver impairment (Child-Pugh C lasses B and C). Overall, the clinical judgement differed from the ant hropometric assessment in 23% of patients, suggesting the need to intr oduce some simple anthropometric measurements in the evaluation of the nutritional status in patients with cirrhosis. (C) Journal of Hepatol ogy.