Determining Whether Low Protein Intake (< 1.0 g/kg) Is a Risk Factor for Malnutrition in Patients with Cirrhosis

Abstract

Background: The prevalence of malnutrition in patients with cirrhosis is considerably high. Body mass index (BMI) is a well-known risk factor for malnutrition, but the other risk factors are unknown. We investigated the prevalence of malnutrition and its risk factors in patients with cirrhosis. Methods: In total, 361 patients with cirrhosis were enrolled. Muscle quality and quantity were retrospectively assessed using the grip strength test and bioelectrical impedance analysis. Subjective global assessment (SGA) of malnutrition and dietary intake assessments were performed by a clinical dietician. Results: The prevalence rates of sarcopenia, malnutrition assessed by SGA, and inadequate energy intake were 22.7%, 13.6%, and 27.5%, respectively. The prevalence of malnutrition evaluated using any of the assessment methods was 46.3%, and no significant difference was observed according to liver disease etiology. The prevalence of malnutrition increased with the increasing disease severity (p = 0.034) and decreasing BMI (p = 0.007). The prevalence of malnutrition was 64.4% in patients with protein intake <1.0 g/kg. Low protein intake, Child-Pugh C grade, older age, and low BMI were independent risk factors for malnutrition in multivariate analysis. Conclusions: Low protein intake (<1.0 g/kg) is an independent risk factor for malnutrition in patients with cirrhosis.