Nutritional assessment, handgrip strength and adductor pollicis muscle thickness in patients with chronic viral hepatitis

Arthur Fernandes Cortez,Vivian Pinto De Almeida,Bruno Bordallo Corrêa,Bruno Cezário Costa Reis,Gustavo Scaramuzza Dos Reis,Felipe Sppezapria Barreto,Phillipe Rodrigues Bastos,Carlos Eduardo Brandão Mello

doi:10.1016/j.yclnex.2019.11.002

Arthur Fernandes Cortez, Vivian Pinto De Almeida + Show 6 more

Open Access

https://doi.org/10.1016/j.yclnex.2019.11.002

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Abstract

Summary Backgrounds & aims Nutritional status of patients with chronic liver disease has been gaining prominence since it is directly associated to morbidity and mortality. However, there is still no consensus on the best method for nutritional assessment given the great variability of body composition and the several stages of the disease. The objective was to compare different methods of nutritional evaluation of subjects with chronic viral hepatitis (CVH), including handgrip strength (HGS) and adductor pollicis muscle thickness (APMT), as well as their influence factors. Methods This cross-sectional study enrolled sixty-nine non-cirrhotic patients with CVH by B or C viruses. Subjects were evaluated and classified through subjective global assessment (SGA), anthropometry, HGS and APMT. Each parameter was compared between gender by chi-square test, and by T test within the categories of SGA. Finally, simple correlation and multivariate linear regression were performed to obtain the strength of association of the collected variables and HGS. Results According to the SGA, one-third were considered at nutritional risk (SGA-B). Nutritional risk was found in 59.4%, 65.2% and 88% based on HGS, mid-arm muscle circumference (MAMC) and APMT, respectively. The dominant APMT obtained a mean of 17.2 ± 5.4 mm vs 16.2 ± 4.6 mm of the non-dominant hand. On the other hand, the dominant HGS had a mean of 27.3 ± 11.2 vs 24.2 ± 11.0 of the non-dominant HGS. APMT and HGS values for any limb were significantly higher in males, but below thresholds patterns described for any gender. The HGS of both hands were correlated with sex, age, weight, height, MAMC, tricipital skinfold and APMT (p Conclusion There was a higher nutritional risk in patients with stable CVH when variables dependent of muscle mass were analyzed. APMT was an independent parameter to predict HGS value. We encourage malnutrition screening based on anthropometry, HGS and APMT, since SGA is not such a reliable tool for CVH.

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