Assessment of nutritional status of patients with hepatitis C virus-related liver cirrhosis

April 24, 2008

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1872-034X.2007.00300.x

Hepatology Research 38 (5) , 484–490 doi:10.1111/j.1872-034X.2007.00300.x

Abstract

Original Article

Assessment of nutritional status of patients with hepatitis C virus-related

liver cirrhosis

Naoto Kawabe,11Departments of Internal Medicine and Senju

Hashimoto,11Departments of Internal Medicine and Masao Harata,11Departments of

Internal Medicine and Yoshifumi Nitta,11Departments of Internal Medicine and

Michihito Murao,11Departments of Internal Medicine and Takuji

Nakano,11Departments of Internal Medicine and Hiroaki Shimazaki,11Departments of

Internal Medicine and Kyoko Kobayashi,11Departments of Internal Medicine and

Naruomi Komura,11Departments of Internal Medicine and Hiroko Ito,22Food and

Nutrition, Fujita Health University, Aichi, Japan Asako Niwa,22Food and

Nutrition, Fujita Health University, Aichi, Japan Wakana Narita,22Food and

Nutrition, Fujita Health University, Aichi, Japan Junko Hanashita,22Food and

Nutrition, Fujita Health University, Aichi, Japan Ayako Ikeda22Food and

Nutrition, Fujita Health University, Aichi, Japan and Kentaro

Yoshioka11Departments of Internal Medicine and Dr Kentaro Yoshioka, Division of

Liver, Biliary Tract and Pancreas Diseases, Department of Internal Medicine,

Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi

470-1192, Japan. Email: kyoshiok@... of Internal

Medicine and 2Food and Nutrition, Fujita Health University, Aichi, Japan

Dr Kentaro Yoshioka, Division of Liver, Biliary Tract and Pancreas Diseases,

Department of Internal Medicine, Fujita Health University, 1-98 Dengakugakubo,

Kutsukake, Toyoake, Aichi 470-1192, Japan. Email: kyoshiok@...

Abstract

Aim: Nutrition support for patients with liver cirrhosis, such as late evening

snacks and branched-chain amino acids, has been demonstrated to be effective.

However, the assessment of the malnutrition of liver cirrhosis is still a

problem. The aim of this study was to assess the nutritional status of patients

with liver cirrhosis due to hepatitis C virus by six methods and to test the

sensitivity and specificity of these methods.

Methods: In total, 86 patients with liver cirrhosis due to hepatitis C virus

were assessed for nutritional status by triceps skinfold thickness (TSF), arm

muscle circumference (AMC), subjective global assessment (SGA), nutritional risk

index (NRI), Maastricht index (MI), and instant nutritional assessment (INA).

Results: Malnutrition was found in 11 (12.8%) patients by TSF, 15 (17.4%) by

AMC, 22 (25.6%) by SGA, 52 (60.5%) by the NRI, 66 (76.7%) by the MI, and in 54

(62.8%) by INA. The MI detected malnutrition at a significantly higher rate

compared with the other five methods. Sixty-two patients were diagnosed as

malnourished by the combined index, which defines the patients as malnourished

when any two of the NRI, MI, and INA also define them as malnourished. The

misclassification rate compared with the combined indexes was significantly

lower in the MI (4.7%) than in any of the TSF (59.3%), AMC (59.3%), SGA (46.5%),

NRI (16.3%), and INA (14.0%).

Conclusion: The MI was the best single score to identify the patients who had

malnutrition, including early stage, and may benefit from nutrition support.

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April 24, 2008