Shin Soan, Jun Dae Won, Saeed Waqar Khalid, Koh Dong Hee
School of Medicine, Hanyang University, Seoul, South Korea.
Department of Internal Medicine, School of Medicine, Hanyang University, Seoul, South Korea.
Ann Transl Med. 2021 Jan;9(2):172. doi: 10.21037/atm-20-4868.
Interest in research on malnutrition is decreasing due to thoughts that the problem of malnutrition has been solved in an age of over-nourishment or obesity and defining malnutrition is not uniform. This study aimed to critically appraise the prevalence of malnutrition according to various diagnostic tools and proportion of severity used in previous studies. A literature review was performed using a total of 16 studies published between 1980 and 2020 regarding malnutrition in patients with chronic liver disease. Most of the analyzed studies were conducted before 2010, and only a few studies were conducted after 2010. Nutrition assessment tool (NAT) and nutrition screening tool (NST) to explain malnutrition were distinguished; however, there was no clear distinction between them. NST often used questionnaires while NST used various malnutrition measuring tools. Our results show that, in the age of over-nourishment, reduction in malnutrition in chronic liver disease still hasn't been significant. Malnutrition prevalence in studies published prior to 2,000 ranged between 13.3% and 85% (mean, 37.6%), whereas that in studies published after 2,000 ranged between 13.3% and 78.5% (mean, 35.2%). Malnutrition prevalence largely depends on the diagnostic tool and proportion of disease severity in the target population. The prevalence of malnutrition in patients with chronic liver diseases varies widely. This big difference is related to various diagnostic tools, mixed etiologies, and different disease severity in different studies. The prevalence of malnutrition was 36.4% (10-80.3%) in all patients with liver disease, 39.9% (13.3-80.3%) in compensated liver disease, and 44.1% (26.7-93.6%) in decompensated cirrhosis. Malnutrition prevalence was 38.2% and 23.7% in alcoholism-related and hepatitis C virus (HCV)-related diseases, respectively. Malnutrition also largely depended on the judgement tool. Malnutrition prevalence according to the diagnostic tool was approximately 28-85% for subjective global assessment (SGA), 30.8-78.5% for anthropometric approach, and 21-80.3% for clinical judgment. It became similar over time.
由于认为在营养过剩或肥胖时代营养不良问题已得到解决且营养不良的定义不统一，对营养不良研究的关注度正在下降。本研究旨在严格评估根据各种诊断工具得出的营养不良患病率以及先前研究中使用的严重程度比例。使用1980年至2020年间发表的共16项关于慢性肝病患者营养不良的研究进行了文献综述。大多数分析研究是在2010年之前进行的，2010年之后进行的研究较少。区分了解释营养不良的营养评估工具（NAT）和营养筛查工具（NST）；然而，它们之间没有明确的区分。NST通常使用问卷，而NAT使用各种营养不良测量工具。我们的结果表明，在营养过剩时代，慢性肝病中营养不良的减少仍然不显著。2000年之前发表的研究中营养不良患病率在13.3%至85%之间（平均37.6%），而2000年之后发表的研究中营养不良患病率在13.3%至78.5%之间（平均35.2%）。营养不良患病率在很大程度上取决于诊断工具和目标人群中疾病严重程度的比例。慢性肝病患者中营养不良的患病率差异很大。这种巨大差异与各种诊断工具、混合病因以及不同研究中不同的疾病严重程度有关。所有肝病患者中营养不良的患病率为36.4%（10 - 80.3%），代偿性肝病患者中为39.9%（13.3 - 80.3%），失代偿性肝硬化患者中为44.1%（26.7 - 93.6%）。酒精性肝病和丙型肝炎病毒（HCV）相关疾病中营养不良的患病率分别为38.2%和23.7%。营养不良在很大程度上也取决于判断工具。根据诊断工具，主观全面评定法（SGA）的营养不良患病率约为28 - 85%，人体测量法为30.8 - 78.5%，临床判断为21 - 80.3%。随着时间推移，情况变得相似。
