Protein-calorie malnutrition (PCM) is a frequent finding in patients with liver cirrhosis. The degree of PCM is a predictor of morbidity and mortality in these patients. The traditional methods of assessment of nutritional status, based on objective measurements such as anthropometrics, serum levels of hepatically synthesized proteins, and cellular immunity, are of limited use because they are affected by the presence of fluid retention and impaired hepatic synthetic function composition analysis, based on measurements of total and extracellular body water (TBW, ECW), body cell mass (BCM), total body fat (TBF), and total body mineral (TBM), is a measurement of the most important compartments offering several advantages over the traditional methods. In patients with liver cirrhosis, TBW, ECW, and BCM are most accurately measured by deuterium and bromide dilution technique. The gold standard for TBF and TBM is absorptiometry (DEXA). The purpose of this study is: firstly, to examine body composition in a multicompartmental model in liver cirrhosis compared to controls; secondly, to compare nutritional status in a model of 4 compartments (fat + mineral + body cell mass + others) obtained by DEXA + isotope dilution techniques with a model of 2 compartments (fat + free fat mass) obtained by traditional methods; and, thirdly, to prospectively determine the predictive role of the new body composition analysis in outcome. Statistical comparisons of body compartments and other techniques will be made using one way analysis of variance and paired t-test. The relationship between body compartments and outcome will be examined using univariate regression analysis. Those variables that have been found to be significant in the univariate analysis will be examined using multivariage regression.
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