title: Nutritional status and quality of life in current patients with liver cirrhosis as assessed in 2007-2011.
abstract: OBJECTIVE
  Current guidelines recommended adequate nutritional support for patients with liver cirrhosis to improve clinical outcome and quality of life (QOL). However, these evidences were obtained more than 10 years ago when malnutrition prevailed. In recent years, the impact of obesity on liver damage and carcinogenesis has grown. We attempted to elucidate the nutritional state and QOL in present cirrhotics.
  
  
  METHODS
  A research group supported by the Ministry of Health, Labor and Welfare of Japan recruited 294 cirrhotics between 2007 and 2011. Subjects comprised 171 males and 123 females, 158 of whom had hepatocellular carcinoma (HCC) and Child-Pugh grades A : B : C were 154:91:49. Anthropometry, blood biochemistry and indirect calorimetry were conducted, and QOL was measured using Short Form-8.
  
  
  RESULTS
  The mean body mass index (BMI) of all patients was 23.1 ± 3.4 kg/m(2) , and 31% showed obesity (BMI ≥ 25.0). In subjects without ascites, edema or HCC, mean BMI was 23.6 ± 3.6, and 34% had obesity. Protein malnutrition defined as serum albumin of less than 3.5 g/dL and energy malnutrition as respiratory quotient of less than 0.85 appeared in 61% and 43%, respectively, and protein-energy malnutrition (PEM) in 27% of all subjects. Among subjects without HCC, each proportion was 67%, 48% and 30%, respectively. QOL was significantly lower on all subscales than Japanese national standard values, but was similar regardless the presence or absence of HCC.
  
  
  CONCLUSIONS
  While PEM is still present in liver cirrhosis, an equal proportion has obesity in recent patients. Thus, in addition to guidelines for PEM, establishment of nutrition and exercise guidelines seems essential for obese patients with liver cirrhosis.
authors: The First Department of Internal Medicine, Gifu University School of Medicine, Gifu.
authors: Makoto
authors: M
authors: Shiraki
authors: Shuhei
authors: S
authors: Nishiguchi
authors: Masaki
authors: M
authors: Saito
authors: Yoshitaka
authors: Y
authors: Fukuzawa
authors: Toshihiko
authors: T
authors: Mizuta
authors: Masaki
authors: M
authors: Kaibori
authors: Tatsunori
authors: T
authors: Hanai
authors: Kayoko
authors: K
authors: Nishimura
authors: Masahito
authors: M
authors: Shimizu
authors: Hisashi
authors: H
authors: Tsurumi
authors: Hisataka
authors: H
authors: Moriwaki