Abstract
To determine the validity of skeletal muscle function as a functional marker of nutritional status in patients with liver cirrhosis, 133 subjects were studied. Seventy-four of them suffered from liver cirrhosis; 17 were malnourished patients with gastrointestinal diseases, and 42 constituted normal controls. Adductor pollicis function was assessed. The force developed by this muscle at 10 Hz was expressed as the percentage of the force at 20 Hz ( F10 F20 ). Standard nutritional assessment was also performed and included the measurement of serum transport proteins and of anthropometric parameters. Cirrhotic patients with normal lean body mass, as measured either by arm muscle area or creatinine height index, had F10 F20 values which were not significantly different from those measured in normal controls. Cirrhotic patients with reduced lean body mass had F10 F20 values which were not significantly different from those observed in malnourished patients with gastrointestinal diseases. Finally, cirrhotic patients with normal arm muscle area had F10 F20 values which were significantly different from those in malnourished patients with gastrointestinal diseases. Mean serum levels of total proteins, albumin, and transferrin were not correlated with any of the anthropometric measurements nor with skeletal muscle function. Indeed, we observed a decrease in the mean serum levels of albumin and transferrin which was related to the severity of liver disease. This trend between the severity of liver disease and nutritional markers has not been observed with triceps skinfold thickness, arm muscle area or circumference, and skeletal muscle function. We conclude that, unlike serum transport proteins, skeletal muscle function is not affected by chronic liver disease. Thus, it can be used as a functional measurement of nutritional status in such patients.
Published Version
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