Comparison of Different Nutritional Assessment Tools in Detecting Malnutrition and Sarcopenia among Cirrhotic Patients

Abstract

Malnutrition and sarcopenia are common complications of liver cirrhosis. This study compares the performance of different nutritional assessment techniques in detecting malnourished patients. Data from 156 patients with liver cirrhosis were collected. We assessed the nutritional status of these patients according to: Subjective Global Assessment (SGA); Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT), skinfold thickness (TSF), mid-upper arm circumference (MUAC), mid-upper arm muscle circumference (MUMC), handgrip strength (HGS), body mass index (BMI), and skeletal muscle index (SMI) evaluated by Contrast-Enhanced Computed Tomography (CT). According to EWGSOP2 criteria, combining low HGS with low SMI, the prevalence of malnutrition/sarcopenia was 60.2%. RFH-NPT, MUAC, MAMC, and HGS were excellent tests for detecting malnourished patients. Combining RFH-NPT with MUAC or MUMC increased diagnosis accuracy, AUC = 0.89, p < 0.0001. Age, Child-Pugh class C, albumin level, vitamin D deficiency, male gender, and alcoholic etiology were significantly associated with malnutrition. In conclusion, the prevalence of malnutrition among patients with cirrhosis was relatively high. Our study highlights the potential use of a simpler and inexpensive alternative that can be used as a valuable tool in daily practice, the combination between RFH-NPT and MUAC.

Prognostic nutritional index: A potential biomarker for predicting the prognosis of decompensated liver cirrhosis

“…In patients with liver cirrhosis, although albumin levels are primarily influenced by hepatic synthetic function, it is also influenced by other factors such as decreased protein intake, increase of the catabolic state, increased vascular permeability, systemic inflammatory response, protein-losing enteropathy secondary to portal hypertension, and impaired immunity (38,(40)(41)(42)(43)(44)(45)(46)(47)(48). Additionally, Topan et al reported that low albumin levels were associated with malnutrition in patients with liver cirrhosis (49). Secondly, a previous study has shown that activated and differentiated CD4 + T lymphocytes are recruited to the inflamed liver and cause liver inflammation (50).…”

Evaluación nutricional de pacientes con cirrosis hepática hospitalizados y el impacto en el pronóstico de la enfermedad: estudio de corte transversal

“…Históricamente, la valoración global subjetiva (VGS) representaba el patrón oro de evaluación nutricional, hasta que, en las últimas guías de práctica clínica, se recomendó la aplicación del RFH-GA, por ser una herramienta específica para hepatopatía crónica, mientras que la VGS presentaba una baja correlación con otras mediciones objetivas de evaluación nutricional y subvaloraba la pérdida mus- cular en esta población. 3,[29][30][31] Al respecto, Gottschall halló una prevalencia de malnutrición del 84% con el RFH-GA (n = 56), mientras que Gunsar describió, con el mismo instrumento, 57,2% (n = 222). 12,32 En el presente trabajo, la prevalencia de malnutrición es del 42%, no hallándose antecedentes estadísticos en la población argentina.…”

Osteosarcopenia in NAFLD/MAFLD: An Underappreciated Clinical Problem in Chronic Liver Disease

“…Sarcopenia prevalence in patients with liver cirrhosis (LC) of different aetiologies (prevalence of cirrhotic NASH not specified) varies between 21.7% and 76% [ 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 ]. In studies involving patients with LC of different aetiologies and with a prevalence of NASH/NAFLD ranging from 9.8% to 34.5%, sarcopenia prevalence varies from 19.8% to 48% [ 79 , 80 , 81 ].…”