Nutritional status in non-alcoholic sub-clinical porto-systemic encephalopathy

AIM:To understand the role of nutritional status in cirrhotic patients without clinical porto-systemic encephalopathy (PSE).METHODS:Fifty-one non-alcoholic patients with cirrhosis without PSE were studied prospectively and compared with 20 healthy volunteers. The nutritional evaluation included serum prealbumin, albumin, transferrin, body mass index (BMI), mid-arm muscle circumference (MAMC), and grip power. The occurrence of subclinical PSE (SPSE) was defined when N20-N65 inter-peak latencies of median nerve-stimulated somatosensory evoked potentials were > 2.5 standard deviations of control means. Blood chemistries were tested within 12h of somatosensory evoked potentials test and nutritional evaluation.RESULTS:Twenty-five, 17 and 9 cirrhotic patients were graded as Child-Pugh class A, B, and C, respectively. Twenty-four (47.1%) patients developed SPSE. Cirrhotic patients with SPSE had lower serum albumin (2.8g/dL ± 0.5g/dL vs 3.1g/dL ± 0.7g/dL, P < 0.001) levels than those without SPSE. Prealbumin (10.6mg/dL ± 5.7mg/dL vs 12.5mg/dL ± 5.8mg/dL), transferrin (164mg/dL ± 46mg/dL vs 178mg/dL ± 58mg/dL), BMI (23.7kg/m(2) ± 2.7kg/m(2) vs 25.3kg/m(2) ± 3.6kg/m(2)), MAMC (22.2cm ± 2.6cm vs 22.7cm ± 3.5cm), and grip power (26.3kg ± 6.4kg vs 26.9kg ± 6.8kg) were not different between cirrhotic patients with and without SPSE. N20-N65 inter-peak latencies were correlated with serum albumin levels (P =0.01) but not with prealbumin, transferrin, BMI, MAMC,or grip power. Serum albumin, prealbumin and transferrin levels were different among cirrhotic patients with Child-Pugh classes A, B, and C (P < 0.05). BMI, MAMC, and grip power were not different among Child-Pugh classes A, B and C.CONCLUSION:Our data suggest that serum albumin level is a simple test in the evaluation of nutritional status in patients with cirrhosis.