Topan Mirabela-Madalina, Sporea Ioan, Dănilă Mirela, Popescu Alina, Ghiuchici Ana-Maria, Lupușoru Raluca, Șirli Roxana
Department of Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy, 30041 Timisoara, Romania.
Advanced Regional Research Center in Gastroenterology and Hepatology, "Victor Babeș" University of Medicine and Pharmacy, 30041 Timisoara, Romania.
Diagnostics (Basel). 2022 Apr 3;12(4):893. doi: 10.3390/diagnostics12040893.
Malnutrition and sarcopenia are common complications of liver cirrhosis. This study compares the performance of different nutritional assessment techniques in detecting malnourished patients. Data from 156 patients with liver cirrhosis were collected. We assessed the nutritional status of these patients according to: Subjective Global Assessment (SGA); Royal Free Hospital-Nutritional Prioritizing Tool (RFH-NPT), skinfold thickness (TSF), mid-upper arm circumference (MUAC), mid-upper arm muscle circumference (MUMC), handgrip strength (HGS), body mass index (BMI), and skeletal muscle index (SMI) evaluated by Contrast-Enhanced Computed Tomography (CT). According to EWGSOP2 criteria, combining low HGS with low SMI, the prevalence of malnutrition/sarcopenia was 60.2%. RFH-NPT, MUAC, MAMC, and HGS were excellent tests for detecting malnourished patients. Combining RFH-NPT with MUAC or MUMC increased diagnosis accuracy, AUC = 0.89, p < 0.0001. Age, Child-Pugh class C, albumin level, vitamin D deficiency, male gender, and alcoholic etiology were significantly associated with malnutrition. In conclusion, the prevalence of malnutrition among patients with cirrhosis was relatively high. Our study highlights the potential use of a simpler and inexpensive alternative that can be used as a valuable tool in daily practice, the combination between RFH-NPT and MUAC.
营养不良和肌肉减少症是肝硬化的常见并发症。本研究比较了不同营养评估技术在检测营养不良患者方面的表现。收集了156例肝硬化患者的数据。我们根据以下指标评估这些患者的营养状况:主观全面评定法(SGA);皇家自由医院营养优先排序工具(RFH-NPT)、皮褶厚度(TSF)、上臂中部周长(MUAC)、上臂中部肌肉周长(MUMC)、握力(HGS)、体重指数(BMI)以及通过对比增强计算机断层扫描(CT)评估的骨骼肌指数(SMI)。根据欧洲老年人肌肉减少症工作组(EWGSOP2)标准,将低HGS与低SMI相结合,营养不良/肌肉减少症的患病率为60.2%。RFH-NPT、MUAC、MAMC和HGS是检测营养不良患者的优秀指标。将RFH-NPT与MUAC或MUMC相结合可提高诊断准确性,曲线下面积(AUC)=0.89,p<0.0001。年龄、Child-Pugh C级、白蛋白水平、维生素D缺乏、男性性别和酒精性病因与营养不良显著相关。总之,肝硬化患者中营养不良的患病率相对较高。我们的研究强调了一种更简单、廉价的替代方法的潜在用途,该方法可作为日常实践中的一种有价值工具,即RFH-NPT与MUAC的联合使用。