| [ Summary ] |
The liver plays a central role in nutrient and fuel metabolism. Thus, protein‒energy malnutrition (PEM) is frequently observed in patients with liver cirrhosis and associated with their poor prognosis. Protein malnutrition is conventionally evaluated through the measurement of serum albumin levels, and branched‒chain amino acids (BCAA) administration increases these levels and improves the quality of life (QOL) and survival of patients with liver cirrhosis. Energy malnutrition is evaluated through the measurement of respiratory quotient (RQ), arm muscle circumference, arm circumference, and serum free fatty acid level. Late‒evening snacks (LES) improve the RQ, liver dysfunction, and QOL of liver cirrhosis patients. Therefore, many guidelines for the treatment of liver cirrhosis now recommend nutritional therapy. In addition, the importance of the nutrition and exercise intervention for obese and sarcopenic patients with liver cirrhosis was recently established. Furthermore, in 2016, The Japan Society of Hepatology proposed assessment criteria for sarcopenia in liver disease. |