Mateos-Muñoz Beatriz, Devesa-Medina María J, Matía-Martín María P, Torrejón María J, Suárez Avelina, Larrad-Sáinz Angélica, Rey-Díaz-Rubio Enrique, Cárdenas María C, Ortega-Medina Luis, Ladero José M
Services of Gastroenterology Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
Services of Gastroenterology Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Department of Medicine, Medical School, Universidad Complutense, Madrid, Spain.
Ann Hepatol. 2016 Jul-Aug;15(4):492-500.
Background. Nutritional deficiencies may aggravate the course of chronic hepatitis C (CHC). Our aim has been to perform a comprehensive analysis of body composition and nutritional deficiencies in CHC patients in non-cirrhotic and compensated cirrhotic stages to correlate the detected deficiencies with the fibrosis stage.
Body multifrequency bioimpedance analysis (BIA) and a wide and simultaneous analytical profile were prospectively performed in 74 CHC patients (36 male) with known METAVIR fibrosis stage established with liver biopsy or transient elastography. Results were analyzed to identify deviations from the normal range and variations according to the fibrosis stage.
Body fat compartment was greater in women. Body composition did not change among the 4 stages of liver fibrosis. Low levels (< 30 μg/L) of vitamin D were detected in 74.3% of patients irrespective of the fibrosis stage. Most analytical results remained into the normal range with the exceptions of thrombocytopenia and vitamin A deficiency, that were limited to the stage 4 of fibrosis, and low Zn and LDL-cholesterol values, that were frequently found in patients with advanced (F3 and F4) fibrosis stage.
Body composition and most biochemical parameters, including cyanocobalamin, folic acid and vitamin E, are well preserved in compensated patients with CHC, with the exception of generalized vitamin D insufficiency and of deficiencies of vitamin A and zinc that are restricted to the more advanced, although still compensated, stages of the disease.
背景。营养缺乏可能会加重慢性丙型肝炎（CHC）的病程。我们的目的是对非肝硬化和代偿期肝硬化阶段的CHC患者的身体成分和营养缺乏情况进行全面分析，以将检测到的缺乏情况与纤维化阶段相关联。
对74例已知通过肝活检或瞬时弹性成像确定METAVIR纤维化阶段的CHC患者（36例男性）进行前瞻性身体多频生物电阻抗分析（BIA）和广泛同步分析。分析结果以确定与正常范围的偏差以及根据纤维化阶段的变化。
女性的体脂部分更大。肝纤维化的4个阶段中身体成分没有变化。无论纤维化阶段如何，74.3%的患者检测到维生素D水平低（<30μg/L）。除血小板减少症和维生素A缺乏仅限于纤维化4期，以及低锌和低密度脂蛋白胆固醇值在晚期（F3和F4）纤维化阶段患者中经常发现外，大多数分析结果仍在正常范围内。
除了普遍存在的维生素D不足以及维生素A和锌缺乏仅限于疾病更晚期（尽管仍为代偿期）阶段外，CHC代偿期患者的身体成分和大多数生化参数，包括钴胺素、叶酸和维生素E，都保存良好。
