Retrospective Cohort Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Sep 28, 2015; 7(21): 2358-2362
Published online Sep 28, 2015. doi: 10.4254/wjh.v7.i21.2358
Development of risky varices in alcoholic cirrhosis with a well-maintained nutritional status
Hirayuki Enomoto, Yoshiyuki Sakai, Yoshinori Iwata, Ryo Takata, Nobuhiro Aizawa, Naoto Ikeda, Kunihiro Hasegawa, Chikage Nakano, Takashi Nishimura, Kazunori Yoh, Akio Ishii, Tomoyuki Takashima, Hiroki Nishikawa, Hiroko Iijima, Shuhei Nishiguchi
Hirayuki Enomoto, Yoshiyuki Sakai, Yoshinori Iwata, Ryo Takata, Nobuhiro Aizawa, Naoto Ikeda, Kunihiro Hasegawa, Chikage Nakano, Takashi Nishimura, Kazunori Yoh, Akio Ishii, Tomoyuki Takashima, Hiroki Nishikawa, Hiroko Iijima, Shuhei Nishiguchi, Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Hyogo 663-8501, Japan
Author contributions: All authors participated in the studies; Enomoto H and Sakai Y wrote and edited the manuscript; all authors were involved in the manuscript revision and approved the final version of the manuscript.
Institutional review board statement: The study was reviewed and approved by Hyogo College of Medicine ethics committee.
Informed consent statement: Written informed consent about personal and medical data collection was obtained from all patients.
Conflict-of-interest statement: None of the authors have conflicts of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hirayuki Enomoto, MD, PhD, Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya, Hyogo 663-8501, Japan. enomoto@hyo-med.ac.jp
Telephone: +81-798-456472 Fax: +81-798-456474
Received: June 19, 2015
Peer-review started: June 20, 2015
First decision: July 27, 2015
Revised: August 5, 2015
Accepted: September 7, 2015
Article in press: September 8, 2015
Published online: September 28, 2015
Abstract

AIM: To compare the nutritional status between alcoholic compensated cirrhotic patients and hepatitis C virus (HCV)-related cirrhotic patients with portal hypertension.

METHODS: A total of 21 patients with compensated cirrhosis (14 with HCV-related cirrhosis and seven with alcoholic cirrhosis) who had risky esophageal varices were investigated. In addition to physical variables, including the body mass index, triceps skinfold thickness, and arm-muscle circumference, the nutritional status was also assessed using the levels of pre-albumin (pre-ALB), retinol-binding protein (RBP) and non-protein respiratory quotient (NPRQ) measured with an indirect calorimeter.

RESULTS: A general assessment for the nutritional status with physical examinations did not show a significant difference between HCV-related cirrhosis and alcoholic cirrhosis. However, the levels of pre-ALB and RBP in alcoholic compensated cirrhotic patients were significantly higher than those in HCV-related compensated cirrhotic patients. In addition, the frequency of having a normal nutritional status (NPRQ ≥ 0.85 and ALB value > 3.5 g/dL) in alcoholic compensated cirrhotic patients was significantly higher than that in HCV-related compensated cirrhotic patients.

CONCLUSION: According to our small scale study, alcoholic compensated cirrhotic patients can develop severe portal hypertension even with a relatively well-maintained liver function and nutritional status compared with HCV-related cirrhosis.

Keywords: Alcoholic liver cirrhosis, Hepatitis C virus, Rapid-turnover proteins, Albumin, Nutritional status, Esophageal varices, Portal hypertension, Non-protein respiratory quotient

Core tip: We compared the nutritional status between alcoholic compensated cirrhotic patients and hepatitis C virus (HCV)-related cirrhotic compensated patients. The levels of rapid-turnover proteins in alcoholic compensated cirrhotic patients were significantly higher than those in HCV-related compensated cirrhotic patients. When the nutritional status was determined using the albumin level and non-protein respiratory quotient, the frequency of having a normal nutritional status in alcoholic compensated cirrhotic patients was significantly higher than that in HCV-related compensated cirrhotic patients. These findings suggest that alcoholic compensated cirrhotic patients can develop severe portal hypertension even with a relatively well-maintained liver function and nutritional status.