The Relationship of Obesity, Nutritional Status and Muscle Wasting in Patients Assessed for Liver Transplantation
| Autor: | Simone I. Strasser, Geoffrey W. McCaughan, Robert Cheng, Liam Finegan, Katharine Kline, Margaret Allman-Farinelli, David G. Bowen, Elise Kempler, Sharon Carey, Helen Vidot, Amelia Lin, Nicholas A. Shackel |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Liver Cirrhosis
Male 0301 basic medicine obesity medicine.medical_specialty Cirrhosis medicine.medical_treatment lcsh:TX341-641 Liver transplantation Gastroenterology Article 03 medical and health sciences 0302 clinical medicine Atrophy Internal medicine medicine Humans Wasting 030109 nutrition & dietetics Nutrition and Dietetics liver transplantation business.industry cirrhosis muscle wasting Middle Aged medicine.disease Muscle atrophy nutritional status Transplantation Muscular Atrophy Cross-Sectional Studies Nutrition Assessment Sarcopenia Female 030211 gastroenterology & hepatology medicine.symptom business lcsh:Nutrition. Foods and food supply Body mass index Food Science |
| Zdroj: | Nutrients Volume 11 Issue 9 Nutrients, Vol 11, Iss 9, p 2097 (2019) |
| ISSN: | 2072-6643 |
| DOI: | 10.3390/nu11092097 |
| Popis: | Introduction: Obesity co-exists with malnutrition and muscle atrophy in patients with cirrhosis. Muscle wasting is a feature of sarcopenia, a known determinant of patient outcomes. This is the first description of a relationship between obesity, subjective global assessment (SGA) of nutritional status and muscle wasting in patients with cirrhosis. Methods: The relationship between body mass index (BMI with obesity defined as &ge 30 kg/m2), nutritional status (assessed by liver-specific subjective global assessment&mdash SGA) and muscle wasting (assessed by corrected total cross-sectional psoas muscle area&mdash cTPA) was analysed in patients with cirrhosis considered for liver transplantation between 1 January 2012 and 31 December 2014. Results: There were 205 patients, of whom 70% were males. The mean age was 52 ± 0.7 years and the Model for End-Stage Liver Disease (MELD) score was 16.8 ± 0.5. Overall, 31% of patients were obese and 56% of well-nourished (SGA A) individuals were obese. Muscle wasting was identified in 86% of all patients, irrespective of their nutritional status (A, B, C). All obese males classified as well-nourished (SGA A) were sarcopenic and 62% of obese females classified as SGA A were sarcopenic. Muscle wasting was worse in obese individuals (cTPA 230.9 mm2/m2 ± 12.9, p < 0.0001) and more likely to be associated with hepatic encephalopathy (p = 0.03). Univariate and multivariate analysis demonstrated testosterone deficiency was significantly associated with muscle wasting (p = 0.007) but not obesity (p = 0.8). Conclusion: Obesity combined with muscle wasting is common in patients with cirrhosis. Muscle wasting is common in well-nourished (SGA A) obese patients. Consequently, all patients assessed for liver transplantation should undergo additional screening for malnutrition and muscle wasting irrespective of BMI. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|