{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T07:34:18Z","timestamp":1788593658652,"version":"build-2803163510"},"reference-count":27,"publisher":"FapUNIFESP (SciELO)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Gastroenterol."],"abstract":"<jats:p>ABSTRACT  BACKGROUND: Protein-calorie malnutrition is common in chronic liver disease (CLD) but adequate clinical tools for nutritional assessment are not defined.  OBJECTIVE: In CLD patients, it was aimed: 1. Characterize protein-calorie malnutrition; 2. Compare several clinical, anthropometric and functional tools; 3. Study the association malnutrition\/CLD severity and malnutrition\/outcome.  METHODS: Observational, prospective study. Consecutive CLD ambulatory\/hospitalised patients were recruited from 01-03-2012 to 31-08-2012, studied according with age, gender, etiology, alcohol consumption and CLD severity defined by Child-Turcotte-Pugh. Nutritional assessment used subjective global assessment, anthropometry, namely body-mass index (BMI), triceps skinfold, mid upper arm circumference, mid arm muscular circumference and handgrip strength. Patients were followed during two years and survival data was recorded.  RESULTS: A total of 130 CLD patients (80 men), aged 22-89 years (mean 60 years) were included. Most suffered from alcoholic cirrhosis (45%). Hospitalised patients presented more severe disease ( P &lt;0.001) and worst nutritional status defined by BMI ( P =0.002), mid upper arm circumference ( P &lt;0.001), mid arm muscular circumference ( P &lt;0.001), triceps skinfold ( P =0.07) and subjective global assessment ( P &lt;0.001). A third presented deficient\/low handgrip strength. Alcohol consumption ( P =0.03) and malnutrition detected by BMI ( P =0.03), mid upper arm circumference ( P =0.001), triceps skinfold ( P =0.06), mid arm muscular circumference ( P =0.02) and subjective global assessment ( P &lt;0.001) were associated with CLD severity. From 25 patients deceased during follow-up, 17 patients were severely malnourished according with triceps skinfold. Malnutrition defined by triceps skinfold predicted mortality ( P &lt;0.001).  CONCLUSION: Protein-calorie malnutrition is common in CLD patients and alcohol plays an important role. Triceps skinfold is the most efficient anthropometric parameter and is associated with mortality. Nutritional assessment should be considered mandatory in the routine care of CLD patients.<\/jats:p>","DOI":"10.1590\/s0004-2803.201700000-28","type":"journal-article","created":{"date-parts":[[2017,7,6]],"date-time":"2017-07-06T21:37:45Z","timestamp":1499377065000},"page":"225-231","source":"Crossref","is-referenced-by-count":27,"title":["OUTCOME AND NUTRITIONAL ASSESSMENT OF CHRONIC LIVER DISEASE PATIENTS USING ANTHROPOMETRY AND SUBJECTIVE GLOBAL ASSESSMENT"],"prefix":"10.1590","volume":"54","author":[{"given":"Gon\u00e7alo","family":"NUNES","sequence":"first","affiliation":[{"name":"GENE - Artificial Feeding Team,  Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla Adriana","family":"SANTOS","sequence":"additional","affiliation":[{"name":"GENE - Artificial Feeding Team,  Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"BAROSA","sequence":"additional","affiliation":[{"name":"GENE - Artificial Feeding Team,  Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"FONSECA","sequence":"additional","affiliation":[{"name":"GENE - Artificial Feeding Team,  Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Teresa","family":"BARATA","sequence":"additional","affiliation":[{"name":"GENE - Artificial Feeding Team,  Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"FONSECA","sequence":"additional","affiliation":[{"name":"GENE - Artificial Feeding Team,  Portugal; Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz,  Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2017,7,6]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.nut.2004.02.002","article-title":"Comparison between handgrip strength, subjective global assessment, and prognostic nutritional index in assessing malnutrition and predicting clinical outcome in cirrhotic outpatients","volume":"21","author":"Alvares-da-Silva MR","year":"2005","journal-title":"Nutrition"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1007\/s11011-016-9828-8","article-title":"Lower values of handgrip strength and adductor pollicis muscle thickness are associated with hepatic encephalopathy manifestations in cirrhotic patients","volume":"31","author":"Augusti L","year":"2016","journal-title":"Metab Brain Dis"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/0016-5085(90)90293-A","article-title":"Effect of total enteral nutrition on the short-term outcome of severely malnourished cirrhotics. A randomized controlled trial","volume":"98","author":"Cabre E","year":"1990","journal-title":"Gastroenterology"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1177\/0884533610368712","article-title":"Nutrition in hepatic encephalopathy","volume":"25","author":"Chadalavada R","year":"2010","journal-title":"Nutr Clin Pract"},{"key":"ref5","series-title":"The Liver and Portal Hypertension","author":"Child CG","year":"1964"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/j.nut.2015.01.014","article-title":"Functional status and heart rate variability in end-stage liver disease patients: association with nutritional status","volume":"31","author":"de Lima DC","year":"2015","journal-title":"Nutrition"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1177\/014860718701100108","article-title":"What is subjective global assessment of nutritional status?","volume":"11","author":"Detsky A","year":"1987","journal-title":"J Parenter Enter Nutr"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1590\/S0004-28032012000100005","article-title":"Nutritional assessment in patients with cirrhosis","volume":"49","author":"Fernandes SA","year":"2012","journal-title":"Arq Gastroenterol"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1097\/00007890-200011150-00014","article-title":"Impact of nutritional status on outcomes after liver transplantation","volume":"70","author":"Figueiredo F","year":"2000","journal-title":"Transplantation"},{"issue":"808-19","key":"ref10","article-title":"New standards of weight and body composition by frame size and height for assessment of nutritional status of adults and the elderly","volume":"40","author":"Frisancho AR","year":"1984","journal-title":"Am J Clin Nutr"},{"key":"ref11","first-page":"220","article-title":"Nutritional assessment in patients with cirrhosis: the use of indirect calorimetry","volume":"41","author":"Gottschall CB","year":"2004","journal-title":"Arq Gastroenterol"},{"key":"ref12","first-page":"339","article-title":"Subjective global assessment: alternative nutrition-assessment technique for liver-transplant candidates","volume":"9","author":"Hasse J","year":"1993","journal-title":"Nutrition"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1038\/ncpgasthep0443","article-title":"Nutritional support in patients with chronic liver disease","volume":"3","author":"Henkel A","year":"2006","journal-title":"Nat Clin Pract Gastroenterol Hepatol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"12835","DOI":"10.3748\/wjg.v21.i45.12835","article-title":"Nutritional care in hospitalized patients with chronic liver disease","volume":"21","author":"Huynh DK","year":"2015","journal-title":"World J Gastroenterol"},{"key":"ref15","first-page":"1","article-title":"Anthropometric reference data for children and adults: United States, 2003-2006","volume":"10","author":"McDowell M","year":"2008","journal-title":"Natl Health Stat Report"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.clnu.2006.01.018","article-title":"ESPEN Guidelines on Enteral Nutrition: Liver disease","volume":"25","author":"Plauth M","year":"2006","journal-title":"Clin Nutr"},{"key":"ref17","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0135933","article-title":"The Association between Parameters of Malnutrition and Diagnostic Measures of Sarcopenia in Geriatric Outpatients","volume":"10","author":"Reijnierse EM","year":"2015","journal-title":"PLoS One"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/ggi.12508","article-title":"Prognostic value of handgrip strength in people aged 60 years and older: A systematic review and meta-analysis","volume":"16","author":"Rijk JM","year":"2016","journal-title":"Geriatr Gerontol Int"},{"key":"ref19","first-page":"594","article-title":"Nutritional support in patients with liver cirrhosis","volume":"35","author":"Rivera Irigoin R","year":"2012","journal-title":"Gastroenterol Hepatol"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"2940","DOI":"10.4254\/wjh.v7.i30.2940","article-title":"Nutritional assessment in cirrhotic patients with hepatic encephalopathy","volume":"7","author":"Romeiro FG","year":"2015","journal-title":"World J Hepatol"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1111\/jgh.13062","article-title":"Handgrip strength as a predictor of bone mineral density in outpatients with cirrhosis","author":"Santos LA","year":"2016","journal-title":"J Gastroenterol Hepatol"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1007\/s00421-001-0570-4","article-title":"Norms and correlates of bioimpedance phase angle in healthy human subjects, hospitalized patients, and patients with liver cirrhosis","volume":"86","author":"Selberg O","year":"2002","journal-title":"Eur J Appl Physiol"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.jpge.2015.06.004","article-title":"Nutrition in Chronic Liver Disease","volume":"22","author":"Silva M","year":"2015","journal-title":"GE Port J Gastroenterol."},{"key":"ref24","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jamda.2013.06.013","article-title":"New normative values for handgrip strength: Results from the UK Biobank","volume":"14","author":"Spruit MA","year":"2013","journal-title":"J Am Med Dir Assoc"},{"key":"ref25","series-title":"International standards for anthropometric assessment","author":"Stewart A","year":"2011"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1093\/ajcn\/60.2.269","article-title":"Evaluation of nutritional status by using anthropometry in adults with alcoholic and nonalcoholic liver disease","volume":"602","author":"Thuluvath 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