Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 27, 2023; 15(7): 914-924
Published online Jul 27, 2023. doi: 10.4254/wjh.v15.i7.914
Evaluation of the nutritional status of patients with liver cirrhosis
Barbara Janota, Aneta Krupowicz, Kinga Noras, Ewa Janczewska
Barbara Janota, Ewa Janczewska, Department of Basic Medical Sciences, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, Bytom 41-902, Poland
Aneta Krupowicz, ID Clinic, Mysłowice 41-400, Poland
Kinga Noras, Department of Biometry, Warsaw University of Life Sciences, Warsaw 02-787, Poland
Author contributions: Janota B designed research and wrote the paper; Krupowicz A collected data and wrote the paper; Noras K performed statistical analysis; Janczewska E designed research and supervised the paper.
Institutional review board statement: The study was reviewed and approved by the Hospital Review Board. Planning, conduct, and reporting of the study were in line with the tenets outlined in the Declaration of Helsinki.
Informed consent statement: All study participants provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Data sharing statement: Data will be available by contacting the corresponding author.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ewa Janczewska, DSc, MD, PhD, Adjunct Professor, Department of Basic Medical Sciences, Faculty of Public Health in Bytom, Medical University of Silesia in Katowice, Piekarska 18 Street, Bytom 41-902, Poland. ejanczewska@sum.edu.pl
Received: March 28, 2023
Peer-review started: March 28, 2023
First decision: May 16, 2023
Revised: May 30, 2023
Accepted: July 4, 2023
Article in press: July 4, 2023
Published online: July 27, 2023
Abstract
BACKGROUND

Progressive malnutrition coexists with liver diseases, particularly in patients with cirrhosis. Early diagnosis of malnutrition in patients with advanced stages of chronic liver disease and the implementation of appropriate nutritional treatment for malnourished patients should be an integral part of the therapeutic process.

AIM

To evaluate the nutritional status of patients with various severities of advanced liver fibrosis, using various nutritional status parameters.

METHODS

This study involved 118 patients with liver cirrhosis who were classified into three groups according to their Child-Pugh score. The nutritional status of the patients in each group was assessed using different methods. The average values obtained from the measurements were calculated for each research group. The influence of disease stage on the examined parameters of nutritional status was determined using one-way analysis of variance. To investigate the relationship between the parameters determining nutritional status and the stage of disease advancement, a correlation analysis was performed.

RESULTS

The Child-Pugh A group had the highest mean body weight (76.42 kg), highest mean body mass index (BMI) (26.72 kg/m²), and largest mean arm circumference (27.64 cm). In the Child-Pugh B group, the mean scores of all examined variables were lower than those of the Child-Pugh A group, whereas the mean body weight and BMI of the Child-Pugh C group were higher than those of the Child-Pugh B group. There was a very strong correlation between the Child-Pugh classification and subjective global assessment score; a very strong correlation between the Child-Pugh classification and arm circumference; a strong correlation between the Child-Pugh classification and body weight, albumin concentration, fat-free mass index, muscle mass index, phase angle, and BMI; and an average correlation between Child-Pugh classification and fat mass index. Notably, these indicators deteriorated with disease progression.

CONCLUSION

Advanced liver fibrosis leads to the deterioration of many nutritional status parameters. The extent of malnutrition increases with the progression of liver fibrosis. The Child-Pugh score reflects the nutritional status.

Keywords: Liver cirrhosis, Fibrosis, Nutritional status, Malnourishment, Sarcopenia

Core Tip: Early diagnosis of malnutrition in patients with advanced stages of chronic liver disease and the implementation of appropriate nutritional treatments for malnourishment should be an integral part of the therapeutic process. It is important to properly assess the nutritional status of these patients as this can be the basis for therapeutic plans. It is advisable to determine which method of assessing nutritional status is appropriate for patients with cirrhosis since they usually develop specific complications of progressive organ failure.