Background: Malnutrition is one of the most common complication in
the increasing number of patients suffering from chronic liver disease (cirrhosis; CLD) and is a leading cause of morbidity and mortality.
Traditional tools used to evaluate nutritional status are not reliable in chronic liver disease due to limitations related to weight, which may
be artificially increased by the presence of ascites, underestimating malnutrition. New strategies to assess nutritional status focussing on
early malnutrition detection are an unmet clinical need. The aim of this ongoing pilot study is to describe the performance of different
measures of nutrition including handgrip strength (HGS), mid-arm circumference (MAC) and subjective global assessment (SGA) in corre-
lation to skeletal muscle index (SMI), an objective measure of skeletal muscle mass, among cirrhotic patients. Methods: In this ongoing pro-
spective study, patients with and without CLD are recruited at the Centre hospitalier de l’Université de Montréal (St-Luc Hospital) in Can-
ada. We assess nutritional status via: HGS as measured in the dominant hand with a calibrated dynamometer, MAC, SGA and SMI, as
measured by computed tomography scan at the level of the third lumbar vertebrae. We also assess recommended and achieved calorie
and protein intake. Spearman correlation coefficient is used to assess correlation between different tools. Results: To date, we recruited
21 patients with and 6 patients without CLD. Preliminary results indicate that SMI tends to correlate with HGS in both groups. Our prelim-
inary results also suggest that SMI varies according to sex and etiology of cirrhosis. Discussion: The impact of age and sex of SMI needs fur-
ther assessment. Objective measures of nutrition assessment in cirrhotics have the potential to reduce the dependence on subjective
measures and allow accurate risk assessment. This may in turn lead to a change in clinical practice toward ensuring nutritional optimization
in this high-risk population and attenuate CLD-related complications.
