Malnutrition in cirrhotic patients: anthropometric measurements as a method of assessing nutritional status

This study was undertaken to evaluate by anthropmetric measurements the nutritional status of cirrhotic patients at different stages of the disease and to establish intra- and inter-observer variability in the determination of these parameters. In 60 healthy controls and 108 cirrhotics (63 'well compensated' and 45 'decompensated' groups A and B + C on the Child-Pugh classification respectively) two independent experienced observers measured biceps, triceps, subscapular and overiliac skinfold thicknesses and arm circumference three times. Each observer was unaware of the results obtained by the other. No significant intra- or inter-observer variability was found. The study indicates that skinfold thickness measurements are a reliable and reproducible method of assessing the nutritional status of cirrhotics. It was found that more than 50 per cent of the decompensated patients were malnourished, with skinfold values significantly lower than those of the controls. In comparison with skinfold thickness and arm circumference, parameters such as body weight and lean body mass are unreliable, and other indices such as muscle and/or fat arm area do not add any significant information to the evaluation of the nutritional status of cirrhotics.