Hepatology Unit, Digestive Disease Department, Hospital Universitari Parc Tauli, Institut d'Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Spain.
Departament de Medicina, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain.
Nutrients. 2021 Apr 10;13(4):1249. doi: 10.3390/nu13041249.
Patients with cirrhosis often develop malnutrition and micronutrient deficiencies, leading to a worse prognosis and increased mortality. Our main goal was to assess the prevalence of micronutrient deficiencies in patients with decompensated cirrhosis. This was a prospective single-center study including 125 consecutive patients hospitalized for acute decompensation of cirrhosis (mostly of alcoholic etiology). A blood test including trace elements and vitamins was performed on admission. The main micronutrient deficiencies observed were vitamin D (in 94.5%), vitamin A (93.5%), vitamin B6 (60.8%) and zinc (85.6%). Patients in Child-Pugh class C had lower levels of vitamin A ( < 0.0001), vitamin E ( = 0.01) and zinc ( < 0.001), and higher levels of ferritin ( = 0.002) and vitamin B12 ( < 0.001) than those in Child-Pugh class A and B. Patients with a higher model of end-stage liver disease (MELD) score had lower levels of vitamin A ( < 0.0001), vitamin E ( < 0.001), magnesium ( = 0.01) and zinc ( = 0.001), and higher levels of ferritin ( = 0.002) and vitamin B12 ( < 0.0001). Severe hepatic insufficiency correlated with lower levels of zinc, vitamin E and vitamin A, and higher levels of vitamin B12 and ferritin.
肝硬化患者常发生营养不良和微量营养素缺乏，导致预后更差和死亡率增加。我们的主要目标是评估失代偿期肝硬化患者微量营养素缺乏的患病率。这是一项前瞻性单中心研究，包括 125 例连续住院的急性失代偿期肝硬化患者（主要为酒精性病因）。入院时进行了包括微量元素和维生素的血液检查。观察到的主要微量营养素缺乏是维生素 D（94.5%）、维生素 A（93.5%）、维生素 B6（60.8%）和锌（85.6%）。Child-Pugh 分级 C 级患者的维生素 A（<0.0001）、维生素 E（=0.01）和锌（<0.001）水平较低，铁蛋白（=0.002）和维生素 B12（<0.001）水平较高，而 Child-Pugh 分级 A 和 B 级患者的维生素 A（<0.0001）、维生素 E（<0.001）、镁（=0.01）和锌（=0.001）水平较低，铁蛋白（=0.002）和维生素 B12（<0.0001）水平较高。较高的终末期肝病模型（MELD）评分与维生素 A（<0.0001）、维生素 E（<0.001）、镁（=0.01）和锌（=0.001）水平较低，以及维生素 B12（<0.0001）和铁蛋白（=0.002）水平较高相关。严重肝功能不全与锌、维生素 E 和维生素 A 水平较低，以及维生素 B12 和铁蛋白水平较高相关。
