Panagaria Namita, Varma Kanika, Nijhawan Sandeep, Mathur Amit, Rai R R
Department of Home Science, University of Rajasthan, Jaipur, India.
Trop Gastroenterol. 2006 Apr-Jun;27(2):75-9.
The aim of the study was to assess and compare the nutritional status of alcoholic and non alcoholic cirrhotic patients.
81 patients with liver cirrhosis--41 alcoholic (AC) & 40 non alcoholic (NAC), were selected. Nutritional status was assessed using anthropometric measurements viz. skin fold thickness, arm and muscle circumferences and areas. Food intake was evaluated using 48 hour dietary recall. Creatinine Height Index and Lean Body Mass were calculated from 24 hour urinary creatinine excretion.
Mean values of Mid Arm Muscle Area, for both AC and NAC (2947+/-8.12 mm(2) v/s 3534+/-6.96 mm(2) respectively), were below the 5th percentile of Frisancho's cut off, with significant reduction in alcoholics (P = 0.00). Creatinine Height Index (CHI) and Lean Body Mass (LBM) were higher in patients without fluid retention as compared to those with fluid retention. Patients without Ascites showed a positive correlation between body weight and Lean Body Mass (r=0.471; rho=0.438; P=0.00).
Malnutrition is widely prevalent in cirrhotics, with greater impairment in alcoholics. A positive correlation could be elicited between Lean Body Mass & Actual Body Weight in patients without ascites. Creatinine Height Index and Lean Body Mass may be more reliable parameters for the assessment of nutritional status in patients with liver cirrhosis.
本研究旨在评估和比较酒精性和非酒精性肝硬化患者的营养状况。
选取81例肝硬化患者,其中41例为酒精性肝硬化(AC)患者,40例为非酒精性肝硬化(NAC)患者。通过人体测量学指标评估营养状况,即皮褶厚度、上臂围和肌肉围及面积。采用48小时饮食回顾法评估食物摄入量。根据24小时尿肌酐排泄量计算肌酐身高指数和去脂体重。
AC组和NAC组的上臂中部肌肉面积平均值(分别为2947±8.12mm²和3534±6.96mm²)均低于弗里桑乔标准的第5百分位数,酒精性肝硬化患者的该指标显著降低(P = 0.00)。与有液体潴留的患者相比,无液体潴留患者的肌酐身高指数(CHI)和去脂体重(LBM)更高。无腹水患者的体重与去脂体重呈正相关(r = 0.471;rho = 0.438;P = 0.00)。
营养不良在肝硬化患者中广泛存在,酒精性肝硬化患者的营养损害更严重。无腹水患者的去脂体重与实际体重之间存在正相关。肌酐身高指数和去脂体重可能是评估肝硬化患者营养状况更可靠的参数。