Anthropometric, biochemical and clinical assessment of malnutrition in Malaysian patients with advanced cirrhosis

BACKGROUND There is limited data on the nutritional status of Asian patients with various aetiologies of cirrhosis. This study aimed to determine the prevalence of malnutrition and to compare nutritional differences between various aetiologies. METHODOLOGY A cross-sectional study of adult patients with decompensated cirrhosis was conducted. Nutritional status was assessed using standard anthropometry, serum visceral proteins and subjective global assessment (SGA). RESULTS Thirty six patients (mean age 59.8 +/- 12.8 years; 66.7% males; 41.6% viral hepatitis; Child-Pugh C 55.6%) with decompensated cirrhosis were recruited. Malnutrition was prevalent in 18 (50%) patients and the mean caloric intake was low at 15.2 kcal/kg/day. SGA grade C, as compared to SGA grade B, demonstrated significantly lower anthropometric values in males (BMI 18.1 +/- 1.6 vs 26.3 +/- 3.5 kg/m2, p < 0.0001; MAMC 19.4 +/- 1.5 vs 24.5 +/- 3.6 cm, p = 0.002) and females (BMI 19.4 +/- 2.7 vs 28.9 +/- 4.3, p = 0.001; MAMC 18.0 +/- 0.9 vs 28.1 +/- 3.6, p < 0.0001), but not with visceral proteins. The SGA demonstrated a trend towards more malnutrition in Child-Pugh C compared to Child-Pugh B liver cirrhosis (40% grade C vs 25% grade C, p = 0.48). Alcoholic cirrhosis had a higher proportion of SGA grade C (41.7%) compared to viral (26.7%) and cryptogenic (28.6%) cirrhosis, but this was not statistically significant. CONCLUSION Significant malnutrition in Malaysian patients with advanced cirrhosis is common. Alcoholic cirrhosis may have more malnutrition compared to other aetiologies of cirrhosis.