NUTRITIONAL STATUS AND SARCOPENIA IN CHRONIC LIVER DISEASE: PREVALENCE, ASSESSMENT, AND CLINICAL CORRELATIONS IN A NORTH INDIAN COHORT

Abstract

: Chronic liver disease (CLD) is a progressive condition marked by sustained hepatic inflammation, fibrosis, and parenchymal remodeling, leading to cirrhosis, portal hypertension, liver failure, and hepatocellular carcinoma. Malnutrition, particularly protein-energy malnutrition (PEM) and sarcopenia, is a frequent but under-recognized complication in CLD that adversely affects outcomes. Accurate assessment of nutritional status is often complicated by fluid retention and systemic alterations in these patients.

Materials and Methods: This cross-sectional observational study was conducted over two years in the Department of Gastroenterology, MM Institute of Medical Sciences, Mullana and included 100 patients. Their clinical and biochemical parameters were determined which included CBC, LFT, RFT, PT/INR and Viral markers, nutritional status was assessed using Subjective Global Assessment (SGA), anthropometry (BMI, MAC, MAMC, TSFT, Hand Grip Strength), and CT-derived L3 Skeletal Muscle Index (L3SMI). Disease severity was graded by Child–Turcotte–Pugh (CTP) score, and associations with complications (hepatic encephalopathy, acute kidney injury, variceal bleeding, spontaneous bacterial peritonitis) were analysed.

Results: The mean age was 51.6 ± 12.4 years; 77% were male. Alcohol-related CLD was the most common etiology (54%). Malnutrition (SGA B or C) was present in 74% of patients. A significant association was observed between worsening CTP class and prevalence of malnutrition (p < 0.000001). Sarcopenia prevalence was 66%, highest in CTP C. Anthropometric measures and hand grip strength declined progressively with worsening nutritional status (p < 0.0001). Sarcopenia was most frequent in alcohol-related CLD (81.5%). Variceal bleeding was the most common complication (41%), followed by AKI (28%) and hepatic encephalopathy (21%).