Published online Oct 18, 2016. doi: 10.4254/wjh.v8.i29.1205
Peer-review started: March 14, 2016
First decision: April 20, 2016
Revised: August 2, 2016
Accepted: August 17, 2016
Article in press: August 18, 2016
Published online: October 18, 2016
Processing time: 217 Days and 12 Hours
Protein-calorie malnutrition (PCM) is a common condition in cirrhotic patients, leading to a worse prognosis, complications, poor quality of life and lower survival rates. Among ways of assessing nutritional status, there are anthropometric methods such as the evaluation of the triceps skinfold, the arm circumference, the arm muscle circumference and the body mass index, and non-anthropometric methods such as the subjective global assessment, the handgrip strength of non-dominant hand, and the bioelectrical impedance analysis (BIA). PCM is frequently under-diagnosed in clinical settings in patients with cirrhosis due to the limitations of nutritional evaluation methods in this population. BIA is a useful method, but cannot be indicated in patients with abnormal body composition. In these situations, the phase angle (PA) has been used, and can become an important tool in assessing nutritional status in any situation. The PA is superior to anthropometric methods and might be considered as a nutritional indicator in cirrhosis. The early characterization of the nutritional status in patients with cirrhosis means an early nutritional intervention, with a positive impact on patients’ overall prognosis. Among the usually accepted methods for nutritional diagnosis, the PA provides information in a quick and objective manner.
Core tip: Malnutrition in cirrhotic patients is a common clinical condition, but there is currently no nutritional diagnosis method defined as the gold standard. Presently, the only nutritional indicator compatible with the clinical condition through the Child-Pugh score in cirrhosis is the phase angle (PA). The PA has been a reliable method and is free of influences regarding changes in body composition of cirrhotic patients at an advanced stage. The PA measured by bioelectrical impedance analysis promises to be a significant parameter for early nutritional intervention in patients with chronic liver disease.