Department of Gastroenterology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
Best Pract Res Clin Gastroenterol. 2013 Aug;27(4):619-29. doi: 10.1016/j.bpg.2013.06.018.
Patients with hepatic disorders are exceptionally vulnerable to developing malnutrition because of the key role played by the liver in regulating the nutritional state and the energy balance. Moreover, the presence of chronic liver disorders could reduce the appetite and thus influence the nutrient intake. Poor nutritional status has been shown in various patient groups with hepatic disorders, and particularly in patients with alcoholic cirrhosis who are at high nutritional risk. It is well established that malnourished patients with liver diseases generally have a higher risk of developing adverse clinical outcomes and increased healthcare costs. Nutrition screening with the Subjective Global Assessment and anthropometric measurements are an important first step in the early identification of malnutrition and initiates the whole nutrition care process. It is therefore important for appropriate nutrition policies and protocols to be implemented so that all patients with chronic liver diseases are monitored closely from a nutritional standpoint. Early and evidence-based nutritional interventions are eagerly needed to minimize the nutritional decline associated with chronic liver disorders and ultimately improve the prognosis of such patients. This review includes a comprehensive analysis of methods to identify malnutrition in patients with chronic liver diseases as well as the extent and impact of the malnutrition problem in selected patient populations.
由于肝脏在调节营养状态和能量平衡方面起着关键作用，因此肝脏疾病患者极易发生营养不良。此外，慢性肝脏疾病的存在可能会降低食欲，从而影响营养摄入。各种肝脏疾病患者群体中都存在营养状况不佳的情况，特别是在营养风险较高的酒精性肝硬化患者中。营养不良的肝病患者一般具有更高的发生不良临床结局和增加医疗保健费用的风险，这一点已得到充分证实。使用主观整体评估和人体测量进行营养筛查是早期识别营养不良并启动整个营养护理过程的重要第一步。因此，实施适当的营养政策和方案非常重要，以便从营养角度密切监测所有慢性肝脏疾病患者。非常需要早期和基于证据的营养干预措施，以尽量减少与慢性肝脏疾病相关的营养下降，并最终改善此类患者的预后。本综述包括对识别慢性肝脏疾病患者营养不良的方法以及选定患者群体中营养不良问题的程度和影响的全面分析。
