The Challenges of Nutritional Assessment in Cirrhosis

被引:16
作者
Molfino A. [1 ]
Johnson S. [2 ]
Medici V. [2 ]
机构
[1] Department of Internal Medicine, Universita’ La Sapienza, Viale dell’Università 37, Rome
[2] Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of California Davis, 4150 V Street, PSSB Suite 3500, Sacramento, 95817, CA
关键词
Assessment; Cirrhosis; Liver; Malnutrition; Nutrition;
D O I
10.1007/s13668-017-0216-8
中图分类号
学科分类号
摘要
Purpose of Review: Nutritional status in patients with cirrhosis is very frequently associated with macro- and micronutrient deficiencies. Cirrhosis itself is the cause of malnutrition and nutritional deficiencies but these conditions have to be identified and addressed properly as they can worsen the prognosis of cirrhosis. The goals of this review are to (1) identify and describe the challenges associated with nutritional assessment in cirrhosis and (2) describe recent advancements when using clinical, laboratory, and instrumental tools in the evaluation of malnourished patients with liver diseases. Recent Findings: The most promising tools for nutritional assessment in cirrhosis include the evaluation of body composition with phase angle obtained by bioelectrical impedance analysis, computed tomography transverse images at the level of third lumbar vertebra. The Royal Free Hospital global assessment algorithm appears to be helpful but needs further validation. Summary: Nutritional assessment in cirrhosis is challenging as several factors, including edema, can interfere with it and because of lack of a validated gold standard. Regardless, nutritional assessment methods have been developed in recent years and should gain relevance in the clinical practice. © 2017, Springer Science+Business Media, LLC.
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收藏
页码:274 / 280
页数:6
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共 64 条
  • [1] Merli M., Giusto M., Gentili F., Novelli G., Ferretti G., Riggio O., Et al., Nutritional status: its influence on the outcome of patients undergoing liver transplantation, Liver Int, 30, 2, pp. 208-214, (2010)
  • [2] Carvalho L., Parise E.R., Evaluation of nutritional status of nonhospitalized patients with liver cirrhosis, Arq Gastroenterol, 43, 4, pp. 269-274, (2006)
  • [3] Merli M., Riggio O., Dally L., Does malnutrition affect survival in cirrhosis? PINC (Policentrica Italiana Nutrizione Cirrosi), Hepatology, 23, 5, pp. 1041-1046, (1996)
  • [4] Mendenhall C.L., Moritz T.E., Roselle G.A., Morgan T.R., Nemchausky B.A., Tamburro C.H., Et al., A study of oral nutritional support with oxandrolone in malnourished patients with alcoholic hepatitis: results of a Department of Veterans Affairs cooperative study, Hepatology, 17, 4, pp. 564-576, (1993)
  • [5] Sam J., Nguyen G.C., Protein-calorie malnutrition as a prognostic indicator of mortality among patients hospitalized with cirrhosis and portal hypertension, Liver Int, 29, 9, pp. 1396-1402, (2009)
  • [6] Mendenhall C.L., Moritz T.E., Roselle G.A., Morgan T.R., Nemchausky B.A., Tamburro C.H., Et al., Protein energy malnutrition in severe alcoholic hepatitis: diagnosis and response to treatment. The VA Cooperative Study Group #275, JPEN J Parenter Enteral Nutr, 19, 4, pp. 258-265, (1995)
  • [7] Gunsar F., Raimondo M.L., Jones S., Terreni N., Wong C., Patch D., Et al., Nutritional status and prognosis in cirrhotic patients, Aliment Pharmacol Ther, 24, 4, pp. 563-572, (2006)
  • [8] Mendenhall C.L., Anderson S., Weesner R.E., Goldberg S.J., Crolic K.A., Protein-calorie malnutrition associated with alcoholic hepatitis. Veterans Administration Cooperative Study Group on Alcoholic Hepatitis, Am J Med, 76, 2, pp. 211-222, (1984)
  • [9] Mendenhall C., Roselle G.A., Gartside P., Moritz T., Relationship of protein calorie malnutrition to alcoholic liver disease: a reexamination of data from two Veterans Administration Cooperative Studies, Alcohol Clin Exp Res, 19, 3, pp. 635-641, (1995)
  • [10] Lin S.Y., Wang Y.Y., Sheu W.H., Increased serum leptin concentrations correlate with soluble tumour necrosis factor receptor levels in patients with cirrhosis, Clin Endocrinol, 57, 6, pp. 805-811, (2002)