Utility of standard nutritional parameters in detecting body cell mass depletion in patients with end-stage liver disease

Fatima A. Figueiredo, E. Rolland Dickson, Tousif M. Pasha, Michael K. Porayko, Terry M. Therneau, Michael Malinchoc, Sara R. DiCecco, Nickie M. Francisco-Ziller, Pavla Kasparova, Michael R. Charlton

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)575-581
Number of pages7
JournalLiver Transplantation
Volume6
Issue number5
DOIs
StatePublished - Jan 1 2000

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ASJC Scopus subject areas

  • Surgery
  • Hepatology
  • Transplantation

Cite this

Figueiredo, F. A., Dickson, E. R., Pasha, T. M., Porayko, M. K., Therneau, T. M., Malinchoc, M., DiCecco, S. R., Francisco-Ziller, N. M., Kasparova, P., & Charlton, M. R. (2000). Utility of standard nutritional parameters in detecting body cell mass depletion in patients with end-stage liver disease. Liver Transplantation, 6(5), 575-581. https://doi.org/10.1053/jlts.2000.9736