Chaudhry Asma, Toori Kaleem Ullah, Shaikh Javaria Ilyas
Dr. Asma Chaudhry, MRCP (UK). Department of Medicine, KRL Hospital, Islamabad, Pakistan.
Dr. Kaleem Ullah Toori, FRCP (Glasgow). Department of Medicine, KRL Hospital, Islamabad, Pakistan.
Pak J Med Sci. 2018 Jan-Feb;34(1):154-158. doi: 10.12669/pjms.341.14011.
To identify correlation between biochemical parameters of nutritional status with disease severity in HCV related liver cirrhosis in patients attending tertiary care hospital.
Total 259 HCV related liver cirrhosis patients who attended the outpatient department of KRL Hospital, Islamabad from June 2016 to January 2018 were included in this cross-sectional study. HCV status was confirmed with PCR. Cirrhosis was pre-established by ultrasound, while cirrhosis severity was gauged by CTP score. Biochemical parameters for nutrition status included serum albumin, creatinine, cholesterol, LDL, HDL, triglycerides, hemoglobin, ferritin, sodium, potassium, magnesium and calcium. Other demographic and clinical data were also recorded.
The mean age of patients was 58.73 ± 6.04 years with 57.1% being males. The average BMI was 22.72 ± 1.69 kg/m. Majority patients i.e. 123 (47.5%) belonged to CTP-A, 67 (25.9%) were in CTP-B and 69 (26.6%) in CTP-C groups. Significant negative correlations of cirrhosis severity were established with BMI, albumin, creatinine, cholesterol, LDL, TG, HDL, hemoglobin, sodium and magnesium indicative of malnutrition. Analysis of biochemical parameters amongst individual cirrhosis groups revealed significant negative correlation across the same factors in group CTP-C, while CTP-A correlated positively with these parameters. The only significant correlation found in CTP-B was with albumin, HDL, hemoglobin, sodium and magnesium.
Considering limitations of standard ways alone to assess malnutrition in liver cirrhosis, biochemical parameters are valid to aid in diagnosing malnutrition.
确定在三级护理医院就诊的丙型肝炎病毒（HCV）相关肝硬化患者营养状况的生化参数与疾病严重程度之间的相关性。
本横断面研究纳入了2016年6月至2018年1月在伊斯兰堡KRL医院门诊部就诊的259例HCV相关肝硬化患者。通过聚合酶链反应（PCR）确认HCV状态。通过超声预先确定肝硬化，而通过CTP评分评估肝硬化严重程度。营养状况的生化参数包括血清白蛋白、肌酐、胆固醇、低密度脂蛋白（LDL）、高密度脂蛋白（HDL）、甘油三酯、血红蛋白、铁蛋白、钠、钾、镁和钙。还记录了其他人口统计学和临床数据。
患者的平均年龄为58.73±6.04岁，男性占57.1%。平均体重指数（BMI）为22.72±1.69kg/m²。大多数患者即123例（47.5%）属于CTP-A组，67例（25.9%）属于CTP-B组，69例（26.6%）属于CTP-C组。肝硬化严重程度与BMI、白蛋白、肌酐、胆固醇、LDL、甘油三酯（TG）、HDL、血红蛋白、钠和镁呈显著负相关，提示营养不良。对各个肝硬化组之间的生化参数分析显示，CTP-C组中相同因素之间存在显著负相关，而CTP-A组与这些参数呈正相关。CTP-B组中唯一显著的相关性是与白蛋白、HDL、血红蛋白、钠和镁。
考虑到仅用标准方法评估肝硬化营养不良的局限性，生化参数有助于诊断营养不良。
