TY - JOUR
T1 - Utility of standard nutritional parameters in detecting body cell mass depletion in patients with end-stage liver disease
AU - Figueiredo, Fatima A.
AU - Dickson, E. Rolland
AU - Pasha, Tousif M.
AU - Porayko, Michael K.
AU - Therneau, Terry M.
AU - Malinchoc, Michael
AU - DiCecco, Sara R.
AU - Francisco-Ziller, Nickie M.
AU - Kasparova, Pavla
AU - Charlton, Michael R.
N1 - Funding Information:
From the Division of Gastroenterology and Hepatology, Mayo Clinic and Foundation, Rochester, MN. Supported in part by Public Health Service grants no. GCRC RR00585 and RO1 DK 434238; and the Fulbright/Capes Doctoral Research Program (Escola Paulista de Medicina/UERJ). Address reprint requests to Michael R. Charlton, MD, Division of Gastroenterology and Hepatology, Mayo Clinic and Foundation, 200 First St, SW, Rochester, MN 55905. Telephone: 507-266-7054; FAX: 507-266-2810; E-mail: charlton.michael@mayo.edu Copyright © 2000 by the American Association for the Study of Liver Diseases 1527-6465/00/0605-0011$3.00/0 doi:10.1053/jlts.2000.9736
PY - 2000
Y1 - 2000
N2 - Protein-calorie malnutrition, best measured by body cell mass (BCM) depletion, has been associated with adverse outcomes in patients with end-stage liver disease. We prospectively measured BCM and multiple standard nutritional parameters in patients with end-stage liver disease to determine which, if any, of the traditionally measured nutritional parameters correlate with BCM. A detailed nutritional assessment, including BCM analysis, subjective global assessment, anthropometry, handgrip dynamometry, laboratory tests, and body composition measured by dual-energy X-ray absorptiometry was performed in 69 sequential patients awaiting liver transplantation. The frequency of abnormalities of specific parameters of nutritional status varied between 19% and 99%. Most of the commonly measured parameters of nutritional status correlated poorly with BCM. Patients with depleted BCM (lowest quartile for sex) had midarm circumference (P < .01), arm-muscle circumference (P < .001), handgrip strength (P < .001), blood urea nitrogen (P < .01), and creatinine (P < .01) values less than those for patients with greater BCM (highest 3 quartiles for sex). In multivariate analysis, arm-muscle circumference and handgrip strength were the best predictors of BCM. The combined criteria of handgrip strength less than 30 kg and arm-muscle circumference less than 23 cm have a sensitivity of 94% and a negative predictive value of 97% in identifying patients with depleted BCM. Although abnormalities of nutritional parameters are highly prevalent among patients with end-stage liver disease, most parameters of nutritional status do not correlate with BCM. In patients with end-stage liver disease, armmuscle circumference and handgrip strength are the most sensitive markers of BCM depletion.
AB - Protein-calorie malnutrition, best measured by body cell mass (BCM) depletion, has been associated with adverse outcomes in patients with end-stage liver disease. We prospectively measured BCM and multiple standard nutritional parameters in patients with end-stage liver disease to determine which, if any, of the traditionally measured nutritional parameters correlate with BCM. A detailed nutritional assessment, including BCM analysis, subjective global assessment, anthropometry, handgrip dynamometry, laboratory tests, and body composition measured by dual-energy X-ray absorptiometry was performed in 69 sequential patients awaiting liver transplantation. The frequency of abnormalities of specific parameters of nutritional status varied between 19% and 99%. Most of the commonly measured parameters of nutritional status correlated poorly with BCM. Patients with depleted BCM (lowest quartile for sex) had midarm circumference (P < .01), arm-muscle circumference (P < .001), handgrip strength (P < .001), blood urea nitrogen (P < .01), and creatinine (P < .01) values less than those for patients with greater BCM (highest 3 quartiles for sex). In multivariate analysis, arm-muscle circumference and handgrip strength were the best predictors of BCM. The combined criteria of handgrip strength less than 30 kg and arm-muscle circumference less than 23 cm have a sensitivity of 94% and a negative predictive value of 97% in identifying patients with depleted BCM. Although abnormalities of nutritional parameters are highly prevalent among patients with end-stage liver disease, most parameters of nutritional status do not correlate with BCM. In patients with end-stage liver disease, armmuscle circumference and handgrip strength are the most sensitive markers of BCM depletion.
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U2 - 10.1053/jlts.2000.9736
DO - 10.1053/jlts.2000.9736
M3 - Article
C2 - 10980056
AN - SCOPUS:0033812317
SN - 1527-6465
VL - 6
SP - 575
EP - 581
JO - Liver Transplantation
JF - Liver Transplantation
IS - 5
ER -