Koulentaki Mairi, Drygiannakis Ioannis, Mantaka Aikaterini, Moschapidakis Evangelos, Chalkiadaki Anna, Augoustaki Aikaterini, Spyridaki Aspasia, Kouroumalis Elias, Markaki Anastasia
Department of Gastroenterology, University Hospital of Heraklion, 71500 Heraklion, Greece.
Department of Nutrition and Dietetics Sciences, Hellenic Mediterranean University, 72300 Sitia, Greece.
Healthcare (Basel). 2022 May 6;10(5):859. doi: 10.3390/healthcare10050859.
Malnutrition is highly prevalent in liver cirrhosis (LC). It increases as the severity of the disease progresses and it is related to poor survival. The objectives of the study were the nutritional assessment of Greek LC patients, using various nutritional assessment and screening tools, and the comparison of their predictive value for mortality. In total, 137 (77 male) consecutive LC patients (median age: 67 years) were assessed with subjective global assessment (SGA) and mini nutritional assessment (MNA) questionnaires, anthropometrics, handgrip strength (HGS) tests, and bioelectric impedance analysis (BIA), in comparison to a control group of 148 healthy people. Disease severity was assessed using the model for end-stage liver disease (MELD) scores. Patients were followed up for a median of 19 months. Survival curves were calculated using the Kaplan-Meier method. In total, 60% and 43% of patients were of adequate nutritional status by SGA and MNA, respectively, which was confirmed by most anthropometric measurements. MNA and SGA scores correlated significantly with anthropometrics and BIA-derived parameters. Besides the MELD score, mid-arm circumference (MAC), triceps skinfold (TSF), BIA's phase angle (Pha), and MNA predicted mortality in cirrhotic patients. The nutritional assessment demonstrated an unexpectedly high prevalence of well-nourished LC patients. MNA was a strong predictor of mortality.
营养不良在肝硬化（LC）患者中极为普遍。随着疾病严重程度的增加，营养不良的情况也会加剧，且与生存率低相关。本研究的目的是使用各种营养评估和筛查工具对希腊肝硬化患者进行营养评估，并比较它们对死亡率的预测价值。总共对137例（77例男性）连续的肝硬化患者（中位年龄：67岁）进行了主观全面评定（SGA）和微型营养评定（MNA）问卷评估、人体测量、握力（HGS）测试以及生物电阻抗分析（BIA），并与148名健康人的对照组进行比较。使用终末期肝病模型（MELD）评分评估疾病严重程度。对患者进行了中位时间为19个月的随访。使用Kaplan-Meier方法计算生存曲线。总体而言，分别有60%和43%的患者通过SGA和MNA评估为营养状况良好，这在大多数人体测量中得到了证实。MNA和SGA评分与人体测量和BIA衍生参数显著相关。除了MELD评分外，上臂中部周长（MAC）、三头肌皮褶厚度（TSF）、BIA的相位角（Pha）和MNA可预测肝硬化患者的死亡率。营养评估显示营养状况良好的肝硬化患者患病率出乎意料地高。MNA是死亡率的有力预测指标。
