[Clinical and biochemical parameters of nutrition to predict hepatic encephalopathy in cirrhotic patients].
OBJECTIVE
Protein-calorie malnutrition is a common complication in cirrhosis. Protein restriction for the treatment of hepatic encephalopathy (HE) may cause disease progression and poor prognosis. Therefore, we evaluated important clinical parameters for nutritional state in cirrhotic patients with or without HE to predict the development of HE.


METHODS
Twenty-two cirrhotic patients were divided into two groups; group A-13 patients without HE and group B-9 patients with HE. Clinical and biochemical parameters, serum proteins {serum albumin, insulin-like growth factor-1 (IGF-1), transferrin, leptin, etc}, immunologic parameters and anthropometry were measured.


RESULTS
Child-Pugh score and Model for End-stage Liver Disease (MELD) scale were higher in group B (p<0.01). After correction of various factors affecting nutritional assessment, especially of Child-Pugh score and MELD scale, leptin was higher in group B (p<0.05). There was no difference in anthropometric measurements. Transferrin correlated inversely with MELD scale in group A (p<0.01). IGF-1 correlated inversely with total lymphocyte count in group B (p<0.05). Leptin correlated with Child-Pugh scores, total lymphocyte count and mid-arm muscle circumference in group A (p<0.05, p<0.05 and p<0.05, respectively), and correlated inversely with CD8 in group B (p<0.05).


CONCLUSIONS
Leptin level is higher in patients with HE, and further studies for parameters of nutrition to predict HE in many cirrhotic patients will be needed.
Kim
Hyung Keun
HK
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Oh
Hyun Jong
HJ
Nam
Sun Woo
SW
Choi
Jong Young
JY
Cho
Se Hyun
SH
Yoon
Seung Kyu
SK
Han
Jun Yeol
JY
Yang
Jin Mo
JM
Han
Nam Ik
NI
Ahn
Byung Min
BM
Choi
Sang Wook
SW
Kim
Jae Kwang
JK
Lee
Young Suk
YS
Chung
Kyu Won
KW
Sun
Hee Sik
HS
D000368:Aged; D000886:Anthropometry; D015415:Biomarkers / Q000097:blood*; D005260:Female; D006501:Hepatic Encephalopathy / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D020738:Leptin / Q000097:blood; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D014168:Transferrin / Q000032:analysis
D015415:Biomarkers; D020738:Leptin; D014168:Transferrin; D007334:Insulin-Like Growth Factor I