title: The relation of fibrosis stage with nutritional deficiencies and bioelectrical impedance analysis of body composition in patients with chronic hepatitis C.
abstract: Background. Nutritional deficiencies may aggravate the course of chronic hepatitis C (CHC). Our aim has been to perform a comprehensive analysis of body composition and nutritional deficiencies in CHC patients in non-cirrhotic and compensated cirrhotic stages to correlate the detected deficiencies with the fibrosis stage.
  
  
  METHODS
  Body multifrequency bioimpedance analysis (BIA) and a wide and simultaneous analytical profile were prospectively performed in 74 CHC patients (36 male) with known METAVIR fibrosis stage established with liver biopsy or transient elastography. Results were analyzed to identify deviations from the normal range and variations according to the fibrosis stage.
  
  
  RESULTS
  Body fat compartment was greater in women. Body composition did not change among the 4 stages of liver fibrosis. Low levels (< 30 μg/L) of vitamin D were detected in 74.3% of patients irrespective of the fibrosis stage. Most analytical results remained into the normal range with the exceptions of thrombocytopenia and vitamin A deficiency, that were limited to the stage 4 of fibrosis, and low Zn and LDL-cholesterol values, that were frequently found in patients with advanced (F3 and F4) fibrosis stage.
  
  
  CONCLUSIONS
  Body composition and most biochemical parameters, including cyanocobalamin, folic acid and vitamin E, are well preserved in compensated patients with CHC, with the exception of generalized vitamin D insufficiency and of deficiencies of vitamin A and zinc that are restricted to the more advanced, although still compensated, stages of the disease.
authors.affiliation: Services of Gastroenterology Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Mateos-Muñoz
authors.affiliation: Services of Gastroenterology Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Department of Medicine, Medical School, Universidad Complutense, Madrid, Spain.
authors.forename: María J
authors.initials: MJ
authors.lastname: Devesa-Medina
authors.affiliation: Services of Endocrinology Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
authors.forename: María P
authors.initials: MP
authors.lastname: Matía-Martín
authors.affiliation: Services of Endocrinology Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
authors.forename: María J
authors.initials: MJ
authors.lastname: Torrejón
authors.affiliation: Clinical Microbiology, and Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Department of Medicine, Medical School, Universidad Complutense, Madrid, Spain.
authors.forename: Avelina
authors.initials: A
authors.lastname: Suárez
authors.affiliation: Services of Endocrinology Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
authors.forename: Angélica
authors.initials: A
authors.lastname: Larrad-Sáinz
authors.affiliation: Services of Gastroenterology Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Department of Medicine, Medical School, Universidad Complutense, Madrid, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Rey-Díaz-Rubio
authors.affiliation: Services of Clinical Biochemistry Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
authors.forename: María C
authors.initials: MC
authors.lastname: Cárdenas
authors.affiliation: Services of Pathology Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain;
authors.forename: Luis
authors.initials: L
authors.lastname: Ortega-Medina
authors.affiliation: Services of Gastroenterology Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Department of Medicine, Medical School, Universidad Complutense, Madrid, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Ladero
mesh_terms: D000368:Aged; D001706:Biopsy; D001823:Body Composition; D008078:Cholesterol, LDL / Q000097:blood; D054459:Elasticity Imaging Techniques; D017097:Electric Impedance; D005260:Female; D005492:Folic Acid / Q000097:blood; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000453:epidemiology; D006801:Humans; D006995:Hypobetalipoproteinemias / Q000097:blood* / Q000453:epidemiology; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000453:epidemiology; D008875:Middle Aged; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000453:epidemiology; D014802:Vitamin A Deficiency / Q000097:blood* / Q000453:epidemiology; D014805:Vitamin B 12 / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood* / Q000453:epidemiology; D014810:Vitamin E / Q000097:blood; D015032:Zinc / Q000097:blood* / Q000172:deficiency
chemical_list: D008078:Cholesterol, LDL; D014810:Vitamin E; D005492:Folic Acid; D015032:Zinc; D014805:Vitamin B 12