Nutritional disorders in chronic liver diseases. Part 2. Assessment of sarcopenia and correction of eating disorders

Abstract

Introduction. The pathophysiology of abnormalities associated with insufficient intake of nutrients in chronic liver diseases emphasizes the importance of therapeutic interventions for malnutrition and sarcopenia, which are dynamic conditions and have the potential for regress if properly corrected. Objectives. To review in brief publications highlighting the problem of assessing sarcopenia, the latest guidelines for the correction of malnutrition in chronic diffuse liver diseases. Material and methods. The study and analysis of the English and Russian languages articles with a search depth of up to 30 years, contained in the PubMed, Cochrane Collaboration, UpToDate, eLIBRARY databases, were carried out. Key words and their combinations were: “body mass index”, “malnutrition”, “muscle wasting”, “nutrition risk”, “sarcopenia”, “nutrition status”, “complications of liver cirrhosis”. Results. Recommendations are given concerning diet, calorie consumption and protein intake in patients with chronic liver diseases, primarily with liver cirrhosis. Recommendations for changing physical activity in case of malnutrition are discussed. Some mistakes in the correction of malnutrition in this group of patients are also analyzed. Conclusions. The current recommendations for the management of malnutrition and its key manifestation, sarcopenia, are undoubtedly beneficial, which is confirmed by a number of studies in groups of patients with chronic liver diseases. Correction of nutritional status disorders in liver diseases should be one of the tasks of the practicing doctor, the implementation of which has the potential to change the poor prognosis.

Keywords

• liver cirrhosis
• malnutrition
• sarcopenia
• nutritional status