Comparison of Malnutrition Risk between Patients with Liver Cirrhosis and Viral Hepatitis Carrier: A Single Center Study

Joo Ah Lee; Tae Hee Lee; Ji Yeong Kim; Min Gyu Seok; Min Gyu Kang; Ji Hyun Jeong; Hoon Sup Koo; Kyung Ho Song; Yong Seok Kim; Sun Moon Kim; Kyu Chan Huh; Young Woo Choi; Young Woo Kang

doi:10.4166/kjg.2014.64.5.284

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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

Original Article

Korean J Gastroenterol 2014;64(5):284-289.

Published online: 4 October 2014

DOI: https://doi.org/10.4166/kjg.2014.64.5.284

Comparison of Malnutrition Risk between Patients with Liver Cirrhosis and Viral Hepatitis Carrier: A Single Center Study

Joo Ah Lee, Tae Hee Lee, Ji Yeong Kim, Min Gyu Seok, Min Gyu Kang, Ji Hyun Jeong, Hoon Sup Koo, Kyung Ho Song, Yong Seok Kim, Sun Moon Kim, Kyu Chan Huh, Young Woo Choi, Young Woo Kang

Department of Internal Medicine, Konyang University College of Medicine, Daejeon, Korea

Correspondence to: Tae Hee Lee, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Konyang University Hospital, 158 Gwanjeodong-ro, Seo-gu, Daejeon 302-718, Korea. Tel: +82-42-600-9370, Fax: +82-42-600-9090, E-mail: green740@naver.com

Received 15 April 201421 July 2014 Accepted 27 July 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Hepatitis, viral, human, Liver cirrhosis, Malnutrition

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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
Characteristic	A (n=150)	B (n=90)	C (n=73)	p-value
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
Malnutrition risk level	A (n=150)	B (n=90)	C (n=73)	Total
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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