Korean J Med.  2006 Jun;70(6):650-655.

Biochemical assessment of protein-calorie malnutrition in hepatic encephalopathy

• Chung JS
• Kim JI
• Cho SH
• Park SH
• Han JY
• Kim JK
• Lee YS
• Chung KW
• Sun HS

Abstract

BACKGROUND: Most patients with hepatic encephalopathy have their protein intake restricted. Therefore, protein-calorie malnutrition becomes more severe and may cause more serious problems, such as infection and poor prognosis. The aim of this study is to determine better biochemical parameters for the assessment of nutritional status in patients with hepatic encephalopathy.
METHODS
A total 109 patients (30 normal controls and 79 chronic hepatitis B) were enrolled. 79 patients were divided into three groups: chronic HBV infection (hepatitis group, n=28), liver cirrhosis without past history of hepatic encephalopathy (cirrhosis group, n=27), liver cirrhosis with present or past history of hepatic encephalopathy (encephalopathy group, n=24). Serum albumin, total lymphocyte count, IGF-1, growth hormone, retinol binding protein, leptin and fibronectin were measured.
RESULTS
Serum albumin level, total lymphocyte count, IGF-1, and growth hormone were significantly lower in encephalopathy group than other groups (p<0.001, p=0.003, p<0.001, and p<0.001, respectively). However, RBP, leptin, and fibronectin were not different among the groups. The level of serum albumin and IGF-1 were significantly lower in encephalopathy group than cirrhosis group (p=0.002, p<0.001, respectively), but growth hormone was not significantly different between cirrhosis group and encephalopathy group.
CONCLUSIONS
The level of serum albumin and IGF-1 may be important parameter for nutritional support in chronic liver disease, especially in patients with hepatic encephalopathy, because the level of serum albumin and IGF-1 relate with hepatic encephalopathy as well as reflect the progression of chronic liver disease.

Keyword

Malnutrition; Hepatic encephalopathy; Insulin-like growth factor-1

MeSH Terms

Carrier Proteins
Fibronectins
Fibrosis
Growth Hormone
Hepatic Encephalopathy*
Hepatitis, Chronic
Humans
Insulin-Like Growth Factor I
Leptin
Liver Cirrhosis
Liver Diseases
Lymphocyte Count
Malnutrition
Nutritional Status
Nutritional Support
Prognosis
Protein-Energy Malnutrition*
Serum Albumin
Vitamin A
Carrier Proteins
Fibronectins
Growth Hormone
Insulin-Like Growth Factor I
Leptin
Serum Albumin
Vitamin A