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Assessment of Malnutrition, Sarcopenia and Frailty in Patients with Cirrhosis: Which Tools Should We Use in Clinical Practice?

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Service de Médecine Digestive et Hépatobiliaire, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
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Service de Nutrition Clinique, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
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Unité de Nutrition Humaine, UMR 1019 INRA-Université Clermont Auvergne, 63000 Clermont-Ferrand, France
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Service de radiologie adultes, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
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Institut Pascal, Thérapies guidées par l’image, UMR 6602 CNRS-SIGMA-Université Clermont Auvergne, 63000 Clermont-Ferrand, France
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Centre Hépatobiliaire, AP-HP Hôpital Paul-Brousse, UMR 1193 INSERM-Université Paris Sud, 94800 Villejuif, France
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(1), 186; https://doi.org/10.3390/nu12010186
Received: 6 December 2019 / Revised: 2 January 2020 / Accepted: 7 January 2020 / Published: 9 January 2020
(This article belongs to the Special Issue Nutrition in Liver Cirrhosis and Liver Transplantation)
Malnutrition is a common comorbidity in patients with cirrhosis. Its prognostic value is indisputable as it greatly affects the evolution of liver diseases. It has a major impact on both morbi-mortality before and after liver transplantation. Being now integrated in the definition of malnutrition and recognized as a new entity in the international classification of diseases, physicians have taken great interest in sarcopenia. Its negative consequences on the fate of patients with cirrhosis are well-demonstrated. The concept of frailty has recently been enlarged to chronic liver diseases as symptoms of impaired global physical functioning. In this article, we will discuss the definitions of malnutrition and emphasize its links with sarcopenia and frailty. We will show the relevance of frailty and sarcopenia in the course of liver diseases. The emerging role of muscle depletion on the cardiorespiratory system will also be highlighted. The importance of body composition will be demonstrated and the main tools reviewed. Finally, we adapted the definition of malnutrition to patients with cirrhosis based on the assessment of sarcopenia together with reduced food intakes. View Full-Text
Keywords: malnutrition; sarcopenia; frailty; liver; cirrhosis; liver transplantation; prognosis; body composition; skeletal muscle index; handgrip strength; lean mass; fat mass malnutrition; sarcopenia; frailty; liver; cirrhosis; liver transplantation; prognosis; body composition; skeletal muscle index; handgrip strength; lean mass; fat mass
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Buchard, B.; Boirie, Y.; Cassagnes, L.; Lamblin, G.; Coilly, A.; Abergel, A. Assessment of Malnutrition, Sarcopenia and Frailty in Patients with Cirrhosis: Which Tools Should We Use in Clinical Practice? Nutrients 2020, 12, 186.

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