Nutritional status in alcoholics with and without chronic skeletal muscle myopathy

There was a significant reduction in body mass index (15%) and creatinine-height index (22%) in the chronic alcoholics with atrophic quadriceps biopsies indicating significant loss of skeletal muscle protein. Various parameters of nutrition were assessed in chronic alcoholics with and without the commonly associated selective atrophy of type II skeletal muscle fibres, to determine if malnutrition is related to the muscle injury. Serum alkaline ribonuclease activity, a marker of protein nutritional status, was significantly higher in chronic alcoholics compared to controls, suggesting some degree of overall protein malnutrition. However there was no significant difference in this enzyme activity between alcoholics with and without atrophic muscle biopsies. Deficiencies of one or more of thiamine, riboflavin, pyridoxine, Vitamin B12 and folate were found in half of the chronic alcoholics. There was no preponderance of such vitamin deficiencies among those patients with atrophic muscle biopsies. It is concluded that the quadriceps type II fibre atrophy is accompanied by a generalised decrease in skeletal muscle mass and that it is not primarily related to the patient's nutritional status.