Journal List > Korean J Gastroenterol > v.64(5) > 1007298

Lee, Lee, Kim, Seok, Kang, Jeong, Koo, Song, Kim, Kim, Huh, Choi, and Kang: Comparison of Malnutrition Risk between Patients with Liver Cirrhosis and Viral Hepatitis Carrier: A Single Center Study

Abstract

Background/Aims

It is well-known that patients with chronic liver disease commonly have nutritional deficiency. In the present study, we investigated the differences in malnutrition risk between patients with liver cirrhosis and viral hepatitis carrier.

Methods

Patients with chronic liver disease who have been hospitalized at Konyang University Hospital from May 2012 to April 2013 were analyzed retrospectively. The malnutrition risk was divided into three categories (low, intermediate, and high) according to Konyang University Hospital Malnutrition Screening, which include BMI, serum albumin, total lymphocyte count (TLC), hemoglobin, weight change, appetite, and dysphagia, within 24 hours of hospitalization.

Results

Among a total of 460 patients, 313 had liver cirrhosis (LC), and 147 were viral hepatitis carriers. Age (p<0.001), serum albumin level (p<0.001), TLC (p=0.011), hemoglobin (p<0.001) and serum cholesterol level (p=0.005) were significant different between the two groups. However, there were no difference in height, weight, and BMI. The malnutrition risk of the patients with viral hepatitis carrier was significantly lower than that of the patients with LC (p<0.001). In addition, among 313 patients with LC, malnutrition risk of the patients with Child-Pugh class A (n=150) was significantly lower than that of the patients with class B (n=90) or C (n=73) (p<0.001).

Conclusions

Viral hepatitis carrier group had significantly lower malnutrition risk than LC group. The risk of malnutrition in Child-Pugh class A group was significantly lower than that in class B or C group.

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Table 1.
Konyang University Hospital Malnutrition Screening (KUHMS)
Point BMI (kg/m2) Albumin (g/dL) TLC (cells/mm3) Weight loss (kg/mo) Weight gain (kg/mo) Appetite Dysphagia
1 18.5-29.9 >3.3 1,200-1,500 1-3 1-3 Usual Yes
2 30-34.9, 15-18.4 ≥2.6 800-1,199 4-6 4-6 Bad No (0 point)
3 ≥35, <14.9 <2.6 <800 >7 >7 Good (0 point) No (0 point)

Malnutrition risk level: adequate A (low), 1–5 points; level 1 (intermediate), 6–10 points; level 2 (high), 11–15 points.

TLC, total lymphocyte count.

Table 2.
Comparison between Liver Cirrhosis Patients and Viral Hepatitis Carriers
Characteristic Liver cirrhosis (n=313) Viral hepatitis carrier (n=147) p-value
Age (yr) 57±12.4 52±14.8 <0.001
Height (cm) 162.7±11.4 164.5±10.4 0.104
Weight (kg) 62.3±11.5 63.6±14.7 0.308
BMI (kg/m2) 23.9±9.2 23.4±4.0 0.502
Albumin (g/dL) 3.3±0.8 3.8±0.7 <0.001
TLC (cells/mm3) 1,526.7±980 1,775±958.3 0.011
Hb (g/dL) 11.6±2.6 12.8±2.3 <0.001
Cholesterol (mg/dL) 139.9±62 174.3±63.7 0.005

Values are presented as mean±SD (T-test for independent samples).

TLC, total lymphocyte count; Hb, hemoglobin.

Table 3.
Comparison on Malnutrition Risk Level
Malnutrition risk level Liver cirrhosis (n=313) Viral hepatitis carrier (n=147) Total
Low 202 (64.5) 124 (84.4) 326 (70.9)
Intermediate 109 (34.8) 22 (15.0) 131 (28.5)
High 2 (0.6) 1 (0.7) 3 (0.7)

Values are presented as n (%).

Cross tabulation analysis (Pearson's chi-square test) was used.

Table 4.
Nutritional Status of the Patients with Liver Cirrhosis according to Child-Pugh Class
Characteristic Child-Pugh class
p-value
A (n=150) B (n=90) C (n=73)
Age (yr) 56.83±11.98 57.22±12.75 57.47±12.88 NS
Height (cm) 162.11±10.18 161.83±14.88 164.80±8.16 NS
Weight (kg) 62.45±11.04 59.87±12.05 65.16±11.33 A vs. B, 0.209
        B vs. C, 0.010
        A vs. C, 0.223
BMI (kg/m2) 23.70±4.01 24.24±15.96 23.93±3.53 NS
Albumin (g/dL) 3.74±0.67 3.06±0.76 2.76±0.59 A vs. B, <0.001
        B vs. C, 0.013
        A vs. C, <0.001
TLC (cells/mm3) 1,799.20±1,091.37 1,199.94±765.57 1,369.61±811.82 A vs. B, <0.001
        B vs. C, 0.491
        A vs. C, 0.005
Hb (g/dL) 12.39±2.54 11.05±2.65 10.60±2.33 A vs. B, <0.001
        B vs. C, 0.488
        A vs. C, <0.001
Cholesterol (mg/dL) 165.45±60.17 123.54±53.68 111.55±56.95 A vs. B, <0.001
        B vs. C, 0.603
        A vs. C, <0.001

Values are presented as mean±SD.

TLC, total lymphocyte count; Hb, hemoglobin; NS, not significant.

Oneway ANOVA, Tukey's honestly significant difference was used.

Table 5.
Comparison on Malnutrition Risk Level according to Child-Pugh Class
Malnutrition risk level Child-Pugh class
Total
A (n=150) B (n=90) C (n=73)
Low 127 (84.7) 43 (47.8) 32 (43.8) 202 (64.5)
Intermediate 23 (15.3) 47 (52.2) 39 (53.4) 109 (34.8)
High 0 (0) 0 (0) 2 (2.7) 2 (0.6)

Values are presented as n (%).

Cross tabulation analysis (Pearson's chi-square test, linear-by-linear association) was used.

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