Sarcopenic Obesity in Liver Cirrhosis: Possible Mechanism and Clinical Impact

The picture of chronic liver diseases (CLDs) has changed considerably in recent years. One of them is the increase of non-alcoholic fatty liver disease. More and more CLD patients, even those with liver cirrhosis (LC), tend to be presenting with obesity these days. The annual rate of muscle loss increases with worsening liver reserve, and thus LC patients are more likely to complicate with sarcopenia. LC is also characterized by protein-energy malnutrition (PEM). Since the PEM in LC can be invariable, the patients probably present with sarcopenic obesity (Sa-O), which involves both sarcopenia and obesity. Currently, there is no mention of Sa-O in the guidelines; however, the rapidly increasing prevalence and poorer clinical consequences of Sa-O are recognized as an important public health problem, and the diagnostic value of Sa-O is expected to increase in the future. Sa-O involves a complex interplay of physiological mechanisms, including increased inflammatory cytokines, oxidative stress, insulin resistance, hormonal disorders, and decline of physical activity. The pathogenesis of Sa-O in LC is diverse, with a lot of perturbations in the muscle–liver–adipose tissue axis. Here, we overview the current knowledge of Sa-O, especially focusing on LC.

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Liver Cirrhosis: Evaluation, Nutritional Status, and Prognosis

Mediators of Inflammation ◽

10.1155/2015/872152 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 43

Author(s):

Hiroki Nishikawa ◽

Yukio Osaki

Keyword(s):

Liver Cirrhosis ◽

Liver Disease ◽

Nutritional Status ◽

Chronic Liver Disease ◽

Current Knowledge ◽

Protein Energy Malnutrition ◽

Chronic Liver ◽

Noninvasive Methods ◽

Protein Energy ◽

Single Disease Entity

The liver is the major organ for the metabolism of three major nutrients: protein, fat, and carbohydrate. Chronic hepatitis C virus infection is the major cause of chronic liver disease. Liver cirrhosis (LC) results from different mechanisms of liver injury that lead to necroinflammation and fibrosis. LC has been seen to be not a single disease entity but one that can be graded into distinct clinical stages related to clinical outcome. Several noninvasive methods have been developed for assessing liver fibrosis and these methods have been used for predicting prognosis in patients with LC. On the other hand, subjects with LC often have protein-energy malnutrition (PEM) and poor physical activity. These conditions often result in sarcopenia, which is the loss of skeletal muscle volume and increased muscle weakness. Recent studies have demonstrated that PEM and sarcopenia are predictive factors for poorer survival in patients with LC. Based on these backgrounds, several methods for evaluating nutritional status in patients with chronic liver disease have been developed and they have been preferably used in the clinical field practice. In this review, we will summarize the current knowledge in the field of LC from the viewpoints of diagnostic method, nutritional status, and clinical outcomes.

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Dynamic Oral Texture Properties of Selected Indigenous Complementary Porridges Used in African Communities

Foods ◽

10.3390/foods8060221 ◽

2019 ◽

Vol 8 (6) ◽

pp. 221 ◽

Cited By ~ 3

Author(s):

James Makame ◽

Tanita Cronje ◽

Naushad M. Emmambux ◽

Henriette De Kock

Keyword(s):

Young Children ◽

Low Income ◽

Nutrient Intake ◽

Control Method ◽

Protein Energy Malnutrition ◽

Public Health Problem ◽

Major Public Health Problem ◽

Texture Properties ◽

Protein Energy ◽

Infants And Young Children

Child malnutrition remains a major public health problem in low-income African communities, caused by factors including the low nutritional value of indigenous/local complementary porridges (CP) fed to infants and young children. Most African children subsist on locally available starchy foods, whose oral texture is not well-characterized in relation to their sensorimotor readiness. The sensory quality of CP affects oral processing (OP) abilities in infants and young children. Unsuitable oral texture limits nutrient intake, leading to protein-energy malnutrition. The perception of the oral texture of selected African CPs (n = 13, Maize, Sorghum, Cassava, Orange-fleshed sweet potato (OFSP), Cowpea, and Bambara) was investigated by a trained temporal-check-all-that-apply (TCATA) panel (n = 10), alongside selected commercial porridges (n = 19). A simulated OP method (Up-Down mouth movements- munching) and a control method (lateral mouth movements- normal adult-like chewing) were used. TCATA results showed that Maize, Cassava, and Sorghum porridges were initially too thick, sticky, slimy, and pasty, and also at the end not easy to swallow even at low solids content—especially by the Up-Down method. These attributes make CPs difficult to ingest for infants given their limited OP abilities, thus, leading to limited nutrient intake, and this can contribute to malnutrition. Methods to improve the texture properties of indigenous CPs are needed to optimize infant nutrient intake.

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Relationship of Insulin Resistance to Protein-Energy Malnutrition in Patients with Alcoholic Liver Cirrhosis: Effect of Short-Term Nutritional Support

Alcoholism Clinical and Experimental Research ◽

10.1111/j.1530-0277.1992.tb01903.x ◽

1992 ◽

Vol 16 (5) ◽

pp. 971-978 ◽

Cited By ~ 5

Author(s):

Denis G. Wahl ◽

Jean-Marc Dollet ◽

Manuel Kreher ◽

Bruno Champigneulle ◽

Marc-Andre Bigard ◽

...

Keyword(s):

Insulin Resistance ◽

Liver Cirrhosis ◽

Nutritional Support ◽

Protein Energy Malnutrition ◽

Alcoholic Liver Cirrhosis ◽

Short Term ◽

Protein Energy ◽

Relationship Of

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Malnutrition Essentials for Neurologists and Neurosurgeons: A Review of the Literature

Journal of Pediatric Neurology ◽

10.1055/s-0040-1721852 ◽

2021 ◽

Author(s):

Alican Tahta ◽

Yaşar B. Turgut ◽

Cem Şahin

Keyword(s):

Oxidative Stress ◽

Immune Deficiency ◽

Surgical Outcome ◽

Protein Energy Malnutrition ◽

Public Health Problem ◽

Review Of The Literature ◽

Factors Affecting ◽

Protein Energy ◽

Oxidative Stress Status ◽

Essential Knowledge

AbstractMalnutrition still causes deaths in the world today and protein energy malnutrition (PEM) is characterized by increased oxidative stress, immune deficiency, and development of various infections. Even today, however, it is an underrecognized and undertreated entity in neurology and neurosurgery. In this report, we therefore seek to review the available literature regarding various factors affecting surgical outcome of children with malnutrition undergoing some neurosurgical interventions including shunt surgery and traumatic brain injury in intensive care unit, in addition its effects upon oxidative stress status and immunity. Furthermore, we attempt to provide essential knowledge of malnutrition affecting surgical outcome of patients with PEM. Based on available evidence in the published literature, it is concluded that it is a serious public health problem characterized by increased oxidative stress, immune deficiency, and development of various infections.

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The public health significance of Trichuris trichiura

Parasitology ◽

10.1017/s0031182000006867 ◽

2000 ◽

Vol 121 (S1) ◽

pp. S73-S95 ◽

Cited By ~ 146

Author(s):

L.S. STEPHENSON ◽

C.V. HOLLAND ◽

E.S. COOPER

Keyword(s):

Public Health ◽

Blood Loss ◽

Protein Energy Malnutrition ◽

Public Health Problem ◽

Preschool Age ◽

Educational Opportunities ◽

Community Control ◽

Repeated Treatment ◽

Important Public Health Problem ◽

Poor Growth

An estimated 1049 million persons harbour T. trichiura, including 114 million preschool-age children and 233 million school-age children. The prevalence of T. trichiura is high and may reach 95% in children in many parts of the world where protein energy malnutrition and anaemias are also prevalent and access to medical care and educational opportunities is often limited. The Trichuris dysentery syndrome (TDS) associated with heavy T. trichiura, which includes chronic dysentery, rectal prolapse, anaemia, poor growth, and clubbing of the fingers constitutes an important public health problem, as do lighter but still heavy infections, even if not strictly TDS, especially in children. The profound growth stunting in TDS can be reversed by repeated treatment for the infection and, initially, oral iron. However findings from Jamaica strongly suggest that the significant developmental and cognitive deficits seen are unlikely to disappear without increasing the positive psychological stimulation in the child's environment. The severe stunting in TDS now appears likely to be a reaction at least in part to a chronic inflammatory response and concomitant decreases in plasma insulin-like growth factor-1 (IGF-1), increases in tumor necrosis factor-α (TNF-α) in the lamina propria of the colonic mucosa and peripheral blood (which likely decrease appetite and intake of all nutrients) and a decrease in collagen synthesis. Improvements in cognitive performance have been found after treatment for relatively heavy infections (without chronic dysentery) in school-going children; it is unclear precisely how much T. trichiura interferes with children's ability to access educational opportunities, but treatment of infections whenever possible is obviously sensible. The blood loss that can occur in T. trichiura infection is likely to contribute to anaemia, particularly if the child also harbours hookworm, malaria and/or has a low intake of dietary iron. Community control is important, particularly for the individuals within a population who harbour heavy worm burdens; this means children, with special attention to girls who will experience increased iron requirements and blood loss due to menstruation, pregnancies, and lactation. Mebendazole and albendazole, both of which are on the WHO Essential Drugs List, are very effective against T. trichiura; multiple doses are needed to attain complete parasitological cure in all cases. However the goal of control programmes in endemic areas is morbidity reduction, which follows when intensity of infection is significantly reduced.

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Asessment of protein energy malnutrition among the 6 to 59 months age children in sinkat locality red sea state

Omdurman Islamic University Journal ◽

10.52981/oiuj.v9i1.1773 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Ilyas Tahani Babikir

Keyword(s):

Red Sea ◽

Prevalence Rate ◽

Economic Status ◽

Protein Energy Malnutrition ◽

Public Health Problem ◽

Anthropometric Measurement ◽

Major Public Health Problem ◽

Sea State ◽

Cross Sectional ◽

Protein Energy

Asessment of protein energy malnutrition among the 6 to 59 months age children in sinkat locality red sea state Poor children feeding practices can lead to malnutrition which is a major public health problem in developing countries including sudan. This cross sectional study was conducted during May 2011 to May 2012 to measure the prevalence rate of PEM among children of 6-59 months age and to assess the knowledge ,attitudes of mothers towards their children nutrition. A stratified sampling techniques were used for selected 384 children . The data collected by questionnaire and anthropometric measurement for weight & height of children and then categorized according to WHO guidelines. The result revealed that the prevalence rate was 72% ,most infected age range between 1 to 3years,only (27% ) of mothers continue breast feeding when children were infected with diarrhoea, also the result indicated that there is a significant relationship between the protein energy malnutrition and age of the children and family size , also the study indicated that the persistent diarrhea or repeated attacks of acute respirotary infection, malaria and measles were underlying causes of PEM particularly for children in border line. Therefore , increasing awareness to mothers about the nutrition ,and improvement of economic status of families is recommended.

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Prognostic significance of low skeletal muscle mass compared with protein-energy malnutrition in liver cirrhosis

Hepatology Research ◽

10.1111/hepr.12843 ◽

2017 ◽

Vol 47 (10) ◽

pp. 1042-1052 ◽

Cited By ~ 4

Author(s):

Hiroki Nishikawa ◽

Hirayuki Enomoto ◽

Akio Ishii ◽

Yoshinori Iwata ◽

Yuho Miyamoto ◽

...

Keyword(s):

Skeletal Muscle ◽

Liver Cirrhosis ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Protein Energy Malnutrition ◽

Prognostic Significance ◽

Protein Energy

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NUTRITIONAL STATUS AND RELATED FACTORS AMONG SECONDARY SCHOOL STUDENT IN HUE CITY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.5.6 ◽

2018 ◽

Vol 8 (5) ◽

pp. 42-51

Author(s):

Tu Nguyen Minh ◽

Nhung Pham Thi Kim ◽

Hoa Tran Thi ◽

Nga Nguyen Thanh ◽

Thang Tran Binh

Keyword(s):

Secondary School ◽

Nutritional Status ◽

Dietary Habits ◽

Protein Energy Malnutrition ◽

Public Health Problem ◽

Secondary School Student ◽

The Body ◽

Related Factors ◽

Factors Associated ◽

Protein Energy

Introduction: The change in perception of of appearance in the adolescent, which led to shift in the nutritional status of the body. Therefore, a comprehensive assessment of nutritional status at this age needs attention and poses as a public health problem. Objectives: The aims of present study was to describle the prevalance of nutrituon status and obtain associated factors among secondary school student in Hue city. Material and method: A cross-sectional study was conducted on 613 students aged 11-14 years (6 th-9th grade) at two secondary high schools in Hue city. Students were enrolled in anthropometric measures and interviewed with the questionnaire. Results: The prevalence of protein-energy malnutrition accounted for 11.9%, of which severity was 3.9% and mild condition was 8.0%. The prevalence of overweight, obesity was 15.8% (overweight 12.9% and obesity 2.9%, respectively). Regarding factors associated with protein-energy malnutrition was found including educational of mother, dietary habits. Factors associated with overweightobesity including: mother education, snacking habits, eating too much rice. Female tend to be lower risk than male 80%. Conclusion: The prevalence of protein-energy malnutrition accounted for a high proportion of this study, and dietary habits were closely related to an increase in the prevalence of overweight-obesity. Key words: Protein-energy malnutrition, overweight-obesity, nutrition, secondary school, student

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