The current study was aimed to assess the prevalence of protein-calorie malnutrition, characteristics, and clinical importance of nutrition disorders in patients with liver cirrhosis on the basis of severity of disease.

The study included 60 patients with cirrhosis (33 male and 27 female) and their nutritional assessment on the parameters of subjective global assessment, anthropometric and biochemical measurements, immunocompentency, thiamin and riboflavin status was conducted. A total of 50 % of these patients had alcoholic origin of disease. Child-Pugh criteria were used to determine the severity of liver disease.

The outcome showed that 13.3% of patients had ideal body weights below 90% and 11.7% had body mass indexes below 18.5 kg/m(2), in regard to energy malnutrition. Protein malnutrition with low albumin and immunoincompetence depicted by an abnormal response to skin tests were commonly found (45% and 22%, respectively) in comparison to energy malnutrition. Ascites and hepatic encephalopathy were more frequently encountered in patients with alcoholic cirrhosis. These patients also had less triceps skinfold thickness in contrast to non-alcoholic cirrhosis. Subjective global assessment and serum proteins were found to be associated with the degree of impaired liver-function. However, immunologic tests were inversely associated with cirrhosis patients. Mean values for creatinine-height index, hemoglobin, cholesterol, and complement C4 displayed remarkable reduction in severe liver failure (Child-Pugh class C) only in patients with alcoholic cirrhosis. Moreover, malnutrition was also observed to be related to the clinical severity of liver disease.

Thus, based on the findings of the study, it is evident that protein-energy malnutrition is a frequent complication of liver cirrhosis and an association exists between nutritional disorders, the degree of liver injury and their etiology. Additionally, nutritional disorders have higher severity with alcoholic cirrhosis in comparison to non-alcoholic cirrhosis.

Source: Nutrition. 2001 Sep;17(9):761-5.