Nutrition status of patients with chronic hepatitis B or C.

Objective: Nutrition disorders in patients with chronic liver disease have become a recent concern because these disorders influence outcomes. We investigated patients' nutrition status, included consecutively in the last 2 years to the study, and related the results with the severity of liver disease.

Methods: A total of 230 patients with hepatitis B (n = 80) or C (n = 150) were evaluated by the subjective global assessment (SGA) and body mass index (BMI). The risk of metabolic complications was assessed by waist circumference (WC) and the percentage of body fat (%BF). Alcohol abuse was defined as daily consumption >20 g and >30 g for women and men, respectively.

Results: The mean age was 54 years, with 52.6% women, 75% patients without cirrhosis, and 15% patients with cirrhosis. According to the SGA, 86.5% of patients were nourished, and 13.5% were malnourished. Malnutrition was associated with cirrhosis (prevalence ratio [PR], 1.25; 95% confidence interval [CI], 1.1-1.4; P < .001), alcohol abuse, direct bilirubin >3.0 mg/dL, international normalized ratio >1.1, platelet <150 × 10(3)/mm(3), hemoglobin <12 g/dL, and serum albumin <3.5 g/dL (P < .05). According to the BMI, 43.9% of patients were eutrophic, 33.5% were overweight, 21.3% were obese, and 1.3% were underweight. Obese patients had a higher prevalence of steatosis than eutrophic (PR, 1.53; 95% CI, 1.15-2.04; P = .003) and overweight (PR, 1.71; 95% CI, 1.33-2.20; P < .001) patients. Overweight/obesity was associated with WC >94 cm (men) and >80 cm (women), %BF >25% (men) and >32% (women) (P < .01), triglyceride >150 mg/dL, high-density lipoprotein cholesterol <40 mg/dL, glucose >99 mg/dL, insulin >20 µU/mL, homeostatic model assessment-insulin resistance >3.2, and thyroid-stimulating hormone >2.5 µU/mL (P < .05).

Conclusions: Overweight/obesity is prevalent among patients with hepatitis B and C and can contribute to the development of steatosis. Malnutrition is also observed and is related to the severity of liver disease.