Early detection of protein depletion in alcoholic cirrhosis: Role of body composition analysis

Prijatmoko, Dwi; Strauss, Boyd J G; Lambert, John; Sievert, William; Stroud, Dan; Wahlqvist, Mark L.; Katz, Benjamin; Colman, John; Jones, Penelope; Korman, M. G.

doi:10.1016/0016-5085(93)91083-t

Cited by 134 publications

(102 citation statements)

References 20 publications

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“…In contrast, nutritional status was very comparable in female cirrhotic patients and healthy controls while control patients had a reduced FFM. Previous studies have shown that anthropometry is a reliable index to evaluate FM in cirrhotic patients, giving comparable results with other methods such as biolectrical impedance analysis and dual-energy X-ray absorptiometry, even in patients with an advanced disease and an increased total body water (Prijatmoko et al, 1993;Plauth et al, 1997). In contrast, anthropometry underestimates FFM in comparison with multicompartment model analysis because of the increased hydratation of FFM in these patients (Prijatmoko et al, 1993).…”

Section: Discussionmentioning

confidence: 91%

Serum leptin levels in alcoholic liver cirrhosis: relationship with gender, nutritional status, liver function and energy metabolism

et al. 2001

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Objective: To determine serum leptin levels in alcoholic liver cirrhosis and the relationship with gender, nutritional status, liver function, energy metabolism, inflammatory state and refeeding. Subjects: Thirty-seven hospitalized alcoholic cirrhotic patients (M=F: 24=13), 27 hospitalized patients at risk of malnutrition but with normal liver function (M=F: 15=12) as control patients, and 31 healthy control subjects (M=F: 17=14) participated. Design: Liver function was assessed from Child -Pugh classification; anthropometric parameters and resting energy expenditure (REE) were measured; caloric intake was evaluated over 5 days; and serum leptin and insulin were assayed. The same protocol was performed after 1 month refeeding in 22 patients. Healthy subjects were studied as controls for anthropometric parameters and serum leptin levels. Results: Serum leptin levels were higher in male cirrhotic patients than in the other two male groups (P ¼ 0.0079) and in the same range in the female groups. They were higher in female than in male subjects in the three groups. In female cirrhotic patients, logarithmically transformed serum leptin levels correlated significantly with fat mass (P ¼ 0.0043), insulin levels (P ¼ 0.0072), REE (P ¼ 0.0133), bilirubin levels (P < 0.0001), prothrombin time (P ¼ 0.0003) and Pugh score (P ¼ 0.0266) in simple regression analysis and with insulin levels (P ¼ 0.0137), but not with fat mass (P ¼ 0.0761), Pugh score (P ¼ 0.4472) and REE (P ¼ 0.4576) in multiple regression analysis. In the male cirrhotic and control patients, log (leptin) levels correlated with CRP (C reactive protein) (r ¼ 0.365, P ¼ 0.0223). Log (leptin) levels did not correlate with caloric intake in any of the groups. Leptin levels (P < 0.05) and fat mass (P < 0.02) increased with refeeding while liver function improved (P < 0.01). Conclusion: There is a gender difference in regulation of serum leptin level in alcoholic liver cirrhosis. Insulin level is the best determinant of leptin level in female patients while inflammatory state related to alcoholic hepatitis seems to have a greater influence in male patients. Although leptin levels positively correlated with REE in female patients, there is no evidence that leptin reduces caloric intake and fat stores in these patients. Descriptors: leptin; liver cirrhosis; nutritional status; liver failure; energy metabolism European Journal of Clinical Nutrition (2001) 55, 980-988

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Section: Discussionmentioning

confidence: 91%

Serum leptin levels in alcoholic liver cirrhosis: relationship with gender, nutritional status, liver function and energy metabolism

et al. 2001

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“…[1][2][3][4] However, there remains some debate as to the impact of disease severity, primary cause, and metabolic indices on nutritional status. [5][6][7][8] It is clear that the presence of undernutrition will impact negatively on clinical outcome.…”

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confidence: 99%

Macronutrient preference, dietary intake, and substrate oxidation among stable cirrhotic patients

et al. 1999

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Anorexia in liver disease is common; however, its association with aberrant metabolism and the type of cirrhosis has not been considered. Dietary intake, nutritional status, fasting substrate oxidation, and macronutrient preference were examined in controls (n ‫؍‬ 18) and 65 patients with hepatocellular (n ‫؍‬ 31) or biliary cirrhosis (n ‫؍‬ 34). Energy intakes were lowest in hepatocellular patients (

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“…The individuals with hepatic disease develop a malnutrition scenario due to decrease in food intake, deficit in absorption and transport of nutrients and increase of the energetic cost at rest (20,21) . In our study, the patients of both groups presented mean body mass index (BMI) which does not correspond to a malnutrition and cachexia episode.…”

Section: Discussionmentioning

confidence: 99%

Capacidade funcional e força muscular respiratória de candidatos ao transplante hepático

Pereira

Figueredo

Galant

et al. 2011

Rev Bras Med Esporte

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Introduction: Chronic liver disease results in large functional impact, causing loss of muscle mass and function with consequent reduction of functional capacity. Objective: To evaluate and compare the respiratory muscle strength and functional capacity of candidates for liver transplantation who are under Class B or C according to Child Pugh Score and to correlate these variables within each group. Methods -Cross-sectional study with a convenience sample of 35 patients divided into two groups based on the score obtained in the Child Pugh Score B (19 patients) and Child Pugh Score C (16 patients). All subjects were evaluated in a single moment, and the maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) as well as the distance walked during the 6-minute walk test (6MWT) were measured. Results: Individuals classified with Child Pugh Score B showed higher values in the MIP (-86.05 vs. 23.89 -57.94 14.14), p = 0.001, in MEP (84.16 vs. 28.26 72.00 16 1994), p = 0.142, and the distance walked in 6MWT (473.63 vs 376.13 39.00 55.276), p = 0.001. We also found a positive correlation between the values of MIP and distance walked during 6MWT in group B of the Child Pugh Score, r = 0.64 and p = 0.003. Conclusion: The progress of liver disease contributes to the onset of several complications, which together appear to contribute to the reduction of functional capacity of individuals. In our study this was evidenced by the worse performance of Child Pugh score C group. This may suggest that the wait for liver transplantation (LTx) can worsen the functional capacity of these individuals.

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Early detection of protein depletion in alcoholic cirrhosis: Role of body composition analysis

Cited by 134 publications

References 20 publications

Serum leptin levels in alcoholic liver cirrhosis: relationship with gender, nutritional status, liver function and energy metabolism

Serum leptin levels in alcoholic liver cirrhosis: relationship with gender, nutritional status, liver function and energy metabolism

Macronutrient preference, dietary intake, and substrate oxidation among stable cirrhotic patients

Capacidade funcional e força muscular respiratória de candidatos ao transplante hepático

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