Panchani Nishah N, Colvin Tyler, Aryan Mahmoud, Shoreibah Mohamed G
Internal Medicine, University of Alabama at Birmingham, Birmingham, USA.
Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, USA.
Cureus. 2022 May 26;14(5):e25352. doi: 10.7759/cureus.25352. eCollection 2022 May.
Background Hepatic encephalopathy (HE), a major complication of end-stage cirrhosis, is often associated with nutritional deficiencies. We aimed to assess the frequency in which vitamins and zinc were tested for and deficient in our cirrhotic population with HE. Methods We performed a retrospective chart review of 143 patients with decompensated cirrhosis that were seen in a hepatology clinic from January 2020 to May 2021. Patient demographics and decompensations were recorded. Vitamins and minerals that were evaluated included zinc, vitamin B12, folate, vitamin D, and thiamine. Continuous variables were reported as mean ± standard deviation and categorical variables were calculated as frequency percentages. Results Out of 143 patients, 73 were found to have HE. Out of 73, 33 were male, and the average MELD was 15.5 ± 6.3. 44% of patients had NASH cirrhosis, and 30% had alcoholic cirrhosis. Of the minority of patients that had their nutrient levels checked, 17/23 (74%) were deficient in zinc (<60 mcg/dL). 75% of patients were deficient in thiamine. 2/34 (6%) were deficient in folate (<5.9 ng/mL), 2/10 (20%) in vitamin D (<20 ng/mL), and 2/47 (4%) in B12 (<300 pg/mL). Conclusion Nutritional deficiencies are common in cirrhotics with HE. Further studies are needed to determine if routine testing and treatment for vitamin and Zinc deficiencies would have a positive impact on the clinical trajectory of HE.
背景 肝性脑病（HE）是终末期肝硬化的主要并发症，常伴有营养缺乏。我们旨在评估在我们患有HE的肝硬化患者群体中检测维生素和锌以及缺乏这些营养素的频率。方法 我们对2020年1月至2021年5月在肝病门诊就诊的143例失代偿期肝硬化患者进行了回顾性病历审查。记录患者的人口统计学信息和失代偿情况。评估的维生素和矿物质包括锌、维生素B12、叶酸、维生素D和硫胺素。连续变量以平均值±标准差报告，分类变量以频率百分比计算。结果 在143例患者中，73例被发现患有HE。在这73例患者中，33例为男性，平均终末期肝病模型（MELD）评分为15.5±6.3。44%的患者患有非酒精性脂肪性肝炎（NASH）肝硬化，30%的患者患有酒精性肝硬化。在少数接受营养水平检查的患者中，17/23（74%）的患者锌缺乏（<60 mcg/dL）。75%的患者硫胺素缺乏。2/34（6%）的患者叶酸缺乏（<5.9 ng/mL），2/10（20%）的患者维生素D缺乏（<20 ng/mL），2/47（4%）的患者维生素B12缺乏（<300 pg/mL）。结论 营养缺乏在患有HE的肝硬化患者中很常见。需要进一步研究以确定对维生素和锌缺乏进行常规检测和治疗是否会对HE的临床病程产生积极影响。
