Abstract
Background and AimsMalnutrition is a leading cause of morbidity and mortality in cirrhosis. There is no consensus as to the optimal approach for identifying malnutrition in end-stage liver disease. The aim of this study was to measure biochemical, serologic, hormonal, radiographic, and anthropometric features in a cohort of hospitalized cirrhotic patients to characterize biomarkers for identification of malnutrition.DesignIn this prospective observational cohort study, 52 hospitalized cirrhotic patients were classified as malnourished (42.3%) or nourished (57.7%) based on mid-arm muscle circumference < 23 cm and dominant handgrip strength < 30 kg. Anthropometric measurements were obtained. Appetite was assessed using the Simplified Nutrition Appetite Questionnaire (SNAQ) score. Fasting levels of serum adipokines, cytokines, and hormones were determined using Luminex assays. Logistic regression analysis was used to determine features independently associated with malnutrition.ResultsSubjects with and without malnutrition differed in several key features of metabolic phenotype including wet and dry BMI, skeletal muscle index, visceral fat index and HOMA-IR. Serum leptin levels were lower and INR was higher in malnourished subjects. Serum leptin was significantly correlated with HOMA-IR, wet and dry BMI, mid-arm muscle circumference, skeletal muscle index, and visceral fat index. Logistic regression analysis revealed that INR and log-transformed leptin were independently associated with malnutrition.ConclusionsLow serum leptin and elevated INR are associated with malnutrition in hospitalized patients with end-stage liver disease.
Highlights
Malnutrition consists of skeletal muscle loss with or without loss of adipose tissue mass
Subjects with and without malnutrition differed in several key features of metabolic phenotype including wet and dry body mass index (BMI), skeletal muscle index, visceral fat index and HOMA-IR
Serum leptin levels were lower and international normalized ratio (INR) was higher in malnourished subjects
Summary
Malnutrition consists of skeletal muscle loss with or without loss of adipose tissue mass. It is frequently observed in cirrhosis with a reported prevalence as high as 65–90% [1,2,3]. Multiple noninvasive methods for assessing nutritional status have been studied, there is no consensus as to the optimal approach for identifying malnutrition in end-stage liver disease. There is no consensus as to the optimal approach for identifying malnutrition in end-stage liver disease. The aim of this study was to measure biochemical, serologic, hormonal, radiographic, and anthropometric features in a cohort of hospitalized cirrhotic patients to characterize biomarkers for identification of malnutrition
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