Clinical and nutritional factors predictive of plasma lipid unsaturation deficiency in advanced liver cirrhosis: a logistic regression analysis.
OBJECTIVE
To identify those clinical and nutritional factors associated with plasma lipid unsaturation deficiency in cirrhosis.


METHODS
Fatty acid profiles of plasma phospholipids (PL) and cholesteryl esters (CE) were measured in 101 inpatients with advanced cirrhosis and in 44 age- and sex-matched healthy controls. Double-bond index (DBI) was calculated for each fraction and binarily categorized in each patient using the 5th percentile of the control group as the cut-off limit. The association of 12 routine clinical, biological, and nutritional variables with derangement of each DBI was multivariately assessed by means of stepwise logistic regression analysis.


RESULTS
The DBI of PL and CE were below the 5th percentile of the control group in 60 and 68 of 101 cirrhotic patients, respectively. After multivariate analyses, the variables found to be independent predictors of impaired unsaturation were: 1) The presence of moderate/severe malnutrition (odds ratio: 1.3-8.0 (95% CI); p < 0.05) and serum tau-GT > 1 mukat/L (odds ratio: 0.2-1.0; NS) for plasma PL, and 2) the presence of moderate/severe malnutrition (odds ratio: 1.8-17.4; p < 0.05), serum bilirubin > 50 mumol/L (odds ratio 1.7-14.5; p < 0.05) and serum tau-GT > 1 mukat/L (odds ratio 0.1-1.1; NS) for CE.


CONCLUSIONS
Malnutrition appears to be a major factor for impaired lipid unsaturation in advanced cirrhosis. Thus, the possibility of improving plasma lipid unsaturation in these patients by means of nutritional support should be further investigated.
Cabré
E
E
Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
Núñez
M
M
González-Huix
F
F
Fernández-Bañares
F
F
Abad
A
A
Gil
A
A
Esteve
M
M
Planas
R
R
Moreno
J
J
Morillas
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002788:Cholesterol Esters / Q000097:blood; D005231:Fatty Acids, Unsaturated / Q000097:blood*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009752:Nutritional Status; D016017:Odds Ratio; D010743:Phospholipids / Q000097:blood; D011237:Predictive Value of Tests
D002788:Cholesterol Esters; D005231:Fatty Acids, Unsaturated; D010743:Phospholipids