title: Evaluation of nutritional indicators and body composition in patients with advanced liver disease enrolled for liver transplantation.
abstract: OBJECTIVE
  Malnutrition is prevalent in patients with advanced liver disease (LD) related to multifactorial causes. Fluid retention can underestimate the nutritional status based on anthropometric measures. We evaluated nutritional indicators and body composition (BC) in patients with liver cirrhosis and correlated them with LD severity.
  
  
  METHODS
  Forty three patients with LD enrolled for liver transplantation were evaluated by Anthropometric measures, subjective evaluation (Global Assessment of Nutritional Status - SGA) and biochemical indicators. Single-frequency electrical bioimpedance (SFE-BIA) was used to evaluate body composition (BC). It measured resistance (R), reactance (Xc) and the phase angle (PA). LD severity was estimated by Child-Pugh and Meld criteria (Model for End-Stage Liver Disease).
  
  
  RESULTS
  Child-Pugh index between patients was 7.11 ± 1.70 and Meld was 12.23 ± 4.22. Arm Circumference, Arm Muscle Circumference and Arm Muscle Area, SGA, hemoglobin, hematocrit and albumin showed better correlation with disease severity. Xc and PA showed correlation both with Meld and Child-Pugh score when BC were evaluated. PA was depleted in 55.8% of the patients.
  
  
  CONCLUSIONS
  Diagnosis of malnutrition varied according to the method. Global assessment of nutritional status showed better correlation with disease severity than with objective methods. Single-frequency electrical bioimpedance for body composition analysis in cirrhotic patients must be cautiously used; however, primary vectors seems to be valid and promising in clinical practice.
authors.forename: Daniela Salate Biagioni
authors.initials: DS
authors.lastname: Vulcano
authors.forename: Maria Antonieta de Barros Leite
authors.initials: MA
authors.lastname: Carvalhaes
authors.forename: Alexandre
authors.initials: A
authors.lastname: Bakonyi Neto
mesh_terms: D000328:Adult; D000368:Aged; D001823:Body Composition / Q000502:physiology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D017097:Electric Impedance; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D016031:Liver Transplantation; D008297:Male; D044342:Malnutrition / Q000175:diagnosis*; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status / Q000502:physiology*; D011446:Prospective Studies; D012709:Serum Albumin / Q000032:analysis; D012720:Severity of Illness Index
chemical_list: D006454:Hemoglobins; D012709:Serum Albumin