Murat KEKİLLİ, Zuhal DAĞ, Hüseyin KÖSEOĞLU

The use of prealbumin as a predictor of malnutrition in cirrhotic patients and the effect of nutritional support in patients with low prealbumin levels

Background/aim: Malnutrition is an important and commonly seen prognostic factor in patients with cirrhosis. The diagnosis ofmalnutrition in cirrhosis patients may be challenging, and an easily measured and widely usable marker is lacking. Prealbumin,however, is an easily measured marker. In the current study we measured prealbumin levels in cirrhotic patients with no clinicallyapparent malnutrition and used it as a malnutrition marker. Another aim of this study was to evaluate the effect of nutritional supporton patient with low prealbumin levels.Materials and methods: Fifty-two patients with Child A and Child B cirrhosis were selected for the study. Prealbumin levels werestudied, and Child and MELD scores were calculated. Patients with prealbumin levels ˂180 mg/L were considered to have malnutrition,and two different types of nutritional products were given to these patients. The patients given nutritional support were investigated amonth later, and parameters were compared.Results: According to the prealbumin threshold of 180 mg/L, malnutrition frequencies were 59.3% for Child A and 95% for Child Bcirrhosis. After the provision of nutritional support statistically significant improvements in albumin and INR levels were detected. Inaddition, the MELD score decreased; however, it was not statistically significant (P: 0.088). A statistically significant decrease in theMELD score was only obtained in patients with Child B cirrhosis (P: 0.033). When the oral replacement therapies were investigatedseparately, a statistically significant decrease in MELD scores was detected with product 1 (P: 0.043).Conclusion: Prealbumin can be used as an easily measured parameter for earlier detection of malnutrition in patients with cirrhosisand without clinically apparent malnutrition. Oral nutritional support, especially with products containing relatively high carbohydratelevels and low protein, may have a favorable effect on MELD scores.

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