Study On Nutritional Status Of Patients With Chronic Liver Disease And The Correlation With Liver Elasticity

Background and Objective:It has been confirmed that the nutritional status may have an impact on the prognosis of patients with chronic liver diseases (CLD).Therefore, it is very important that CLD patients should be evaluated with the nutritional risk and malnutrition screening early. However, at present Chinese doctors still pay insufficient attention to the nutritional status of hospitalized patients, and nutritional support research is still in its infancy. Few of the crucial problems include whether there is need to carry out the nutrition support and the timing of treatment is uncertain, whether nutritional status affects health care spending is unclear, and the relationship between the liver fibrosis progression and nutritional status of the CLD patients is lack of research data. Therefore, this study has two purposes. The first is through the research to understand the nutritional status of hospitalized CLD patients, the cost for treatment and the relationship between residential area distribution and nutrition, providing reference for evaluating hospitalized CLD patients’overall conditions, saving medical expenses and adjusting long-term nutritional intervention. The second is by analyzing the liver fibrosis development of hospitalized CLD patients and comparing differences in nutritional status among CLD patients with various liver fibrosis stages, to assess the association between the elasticity of liver and nutritional status.Method:The study was a prospective descriptive one, by using continuous sampling method. Totally,205 and 224 hospitalized CLD patients were enrolled into two parts of our research, all the enrolled patients were treated at liver fibrosis diagnosis and treatment center in 302 military hospital of China from February and September of 2014. Nutritional risk screening 2002 (NRS 2002) was applied to evaluate the nutritional risk of different groups of patients, subjective global assessment (SGA) was used to determine the nutritional status of these patients. Meanwhile, patients’ triceps skin (TSF), mid-upper arm muscle circumference (MAMC), handgrip strength (HG), albumin (ALB), prealbumin (PA), total lymphocyte count (TLC), hospitalization days (HOD), hospitalization expenses (HOE) and liver stiffness measurements (LSM) were also recorded and analyzed.Results:Firstly, the nutritional risk of hospitalized patients was 37.1%, and the overall malnutrition rate was 23.2%. The risk was increased with the increase in the severity of chronic viral liver diseases. The average HOD and HOE of patients with nutritional risk were twice as much as those without, and the ratio of complication onset was higher. There were no difference in these parameters between patients from cities and from countryside. Secondly, when the liver fibrosis stage was getting severe, the nutritional risk was increased and nutritional status decreased. The liver stiffness measurements of CLD patients with higher nutritional risk were higher than those with lower nutritional risk.Conclusions:Firstly, hospitalized patients with higher nutritional risk and malnutrition rate will suffer more and spend more on treatment, therefore need more active nutrition intervention. Secondly, there are differences in the nutritional status among CLD patients with various liver stiffness measurement (LSM), the higher liver stiffness measurement, the worse nutritional status. The elasticity of liver might be related to nutritional status.