Denutrition in Cirrhosis: Prevalence and Risk Factors among a Moroccan Center

Abstract

Background: Denutrition is common in patients with liver cirrhosis and is recognized as an independent prognostic factor. Its prevalence is correlated with the severity of cirrhosis. Its evaluation is difficult to quantify, due to the presence of many confounding factors, interfering with the usual nutritional parameters. The aim of this work is to evaluate the prevalence of undernutrition among cirrhotic patients using different methods and to identify the risk factors. Methods: we conducted a prospective descriptive and analytical study of cirrhotic patients, nutritional status was assessed by body mass index (BMI), brachial circumference (BC), nutritional index, mini nutritional assessment (MNA) score, and by the results of the biological assessment. Results: 135 patients were included, the average age was 50 years the sex ratio was M/F=1/2. The etiology of cirrhosis was essentially viral. The severity of cirrhosis was estimated according to the Child score which B in 59.25% and C in 18.55% of cases. All patients were on a low-salt diet, 55.55% of them had anorexia. The mean body mass index was 20.7 kg/m2. The brachial circumference was in favor of undernutrition in 50 patients. After analytical study, the risk factors significantly associated with anthropometric values in favor of undernutrition were: poor socioeconomic conditions, digestive disorders, low-salt diet, existence of hepatic encephalopathy. Conclusion: Denutrition in cirrhotic patients constitutes a prognostic factor of mortality independent of cirrhosis, and its evaluation is therefore of increasing interest in the management of cirrhotic patients. In our population, nutritional indexes and BC were the most sensitive methods for the detection of undernutrition. In our population, nutritional indexes and BC were the most sensitive methods to detect undernutrition. The risk factors were related to circumstances inducing a decrease in food intake and hypermetabolism.