Malnutrition in cirrhosis: contribution and consequences of sarcopenia on metabolic and clinical responses.
Malnutrition is the most common, reversible complication of cirrhosis that adversely affects survival, response to other complications, and quality of life. Sarcopenia, or loss of skeletal muscle mass, and loss of adipose tissue and altered substrate use as a source of energy are the 2 major components of malnutrition in cirrhosis. Current therapies include high protein supplementation especially as a late evening snack. Exercise protocols have the potential of aggravating hyperammonemia and portal hypertension. Recent advances in understanding the molecular regulation of muscle mass has helped identify potential novel therapeutic targets including myostatin antagonists, and mTOR resistance.
Department of Gastroenterology, Metrohealth Medical Center, 2500 Metrohealth Drive, Cleveland, OH 44109, USA.
Pranav
P
Periyalwar
Srinivasan
S
Dasarathy
D004044:Dietary Proteins / Q000008:administration & dosage; D006801:Humans; D008103:Liver Cirrhosis / Q000178:diet therapy / Q000378:metabolism*; D044342:Malnutrition / Q000178:diet therapy / Q000378:metabolism*; D018482:Muscle, Skeletal / Q000378:metabolism*; D055948:Sarcopenia / Q000378:metabolism*
D004044:Dietary Proteins