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
Processing time: 114 Days and 20.1 Hours
ARTICLE HIGHLIGHTS
Research background

Chronic liver disease with advanced fibrosis and cirrhosis may be accompanied by progressive malnutrition. Early diagnosis of malnutrition in patients with advanced stages of chronic liver disease and implementation of appropriate nutritional treatment for malnourished patients should be an integral part of the therapeutic process.

Research motivation

Among the numerous methods of assessing nutritional status, it is important to determine which one is the most appropriate for patients with liver fibrosis given the specific complications of progressive organ failure.

Research objectives

The aim was to assess the nutritional status of patients diagnosed with advanced liver fibrosis at the cirrhosis stage using various methods of nutritional status assessment. We tried to find out which methods of assessing nutritional status are the most appropriate for patients with advanced liver fibrosis.

Research methods

The study group contained 88 patients with advanced liver fibrosis. Patients were classified into three groups according to the Child-Pugh scale. The nutritional status was assessed using many methods: Electrical bioimpedance method, albumin concentration, mid-armmuscle circumference, body mass index (BMI), subjective global assessment (SGA) of nutritional status scale, and hand grip strength. To draw conclusions, proper statistical analyzes were performed.

Research results

There was a strong correlation between the Child-Pugh classification and SGA 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 the Child-Pugh classification and fat mass index. The indicators decreased with disease progression.

Research conclusions

Malnutrition among patients worsens with the progression of liver fibrosis, and the level of deterioration of this organ is indicated by the Child-Pugh scores. We found that serum albumin concentration, arm circumference, lean body mass, skeletal muscle mass, phase angle, hand grip strength, and SGA score were useful parameters for assessing the nutritional status of patients with liver cirrhosis.

Research perspectives

Another important step in the study of the nutritional status of patients with advanced liver fibrosis seems to be the analysis of patients' diets to prepare individualized recommendations, adequate to progressive malnutrition.