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Bruch JP, Álvares-DA-Silva MR, Alves BC, Dall'alba V. REDUCED HAND GRIP STRENGTH IN OVERWEIGHT AND OBESE CHRONIC HEPATITIS C PATIENTS. ARQUIVOS DE GASTROENTEROLOGIA 2017; 53:31-5. [PMID: 27281502 DOI: 10.1590/s0004-28032016000100007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 12/02/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hepatitis C is a liver disease that causes significant changes in metabolism, and also has an impact on nutritional status. OBJECTIVE To evaluate the nutritional status and cardiovascular risk in patients with chronic hepatitis C. METHODS This cross-sectional study investigated 58 patients with chronic hepatitis C, non-cirrhotic and were not under active pharmacological treatment. Patients with significant alcohol consumption (greater than 10 g ethanol/day) were excluded. Patients underwent nutritional assessment through anthropometric measurements and functional assessment using hand grip strength by dynamometry. The physical activity was assessed using the International Physical Activity Questionnaire. Patients also underwent clinical and laboratory evaluation. Cardiovascular risk was calculated by the Framingham score. RESULTS The mean age of patients was 51.6±9.7 years, 55.2% were female, and 79.3% had genotype 1. The most prevalent degree of fibrosis was F1 (37.9%) followed by F2 (27.6%) and F3 (1.7%). The prevalence of overweight/obesity considering the body mass index was 70.7%. However, 57.7% of men and 68.8% of women were considered malnourished according to hand grip strength. These patients also had waist circumference (93.5±10.7 cm) and neck circumference (37.0±3.6 cm) high. Almost 60% of patients were considered sedentary or irregularly active. In relation to cardiovascular risk, 50% of patients had high risk of suffering a cardiovascular event within 10 years. CONCLUSION Although most patients with hepatitis C presented overweight, associated with high cardiovascular risk, they also have reduced functional capacity, indicative of protein-caloric commitment. Therefore, body mass index can not be considered the only method of assessment for nutritional diagnosis of patients with liver disease. Adopting methods such as hand grip strength can be important for a better understanding of nutritional status of these patients.
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Affiliation(s)
- Juliana Paula Bruch
- Programa de pós-graduação: Ciências em Gastroenterologia e Hepatologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil;, Universidade Federal do Rio Grande do Sul, Programa de pós-graduação: Ciências em Gastroenterologia e Hepatologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre RS , Brazil.,Centro de Estudos em Alimentação e Nutrição (CESAN), Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre, RS, Brasil, Universidade Federal do Rio Grande do Sul, Centro de Estudos em Alimentação e Nutrição, Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre RS , Brazil
| | - Mário Reis Álvares-DA-Silva
- Programa de pós-graduação: Ciências em Gastroenterologia e Hepatologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil;, Universidade Federal do Rio Grande do Sul, Programa de pós-graduação: Ciências em Gastroenterologia e Hepatologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre RS , Brazil.,Departamento de Medicina Interna, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brasil, Universidade Federal do Rio Grande do Sul, Departamento de Medicina Interna, Faculdade de Medicina, UFRGS, Porto Alegre RS , Brazil.,Divisão de Gastroenterologia, Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre, RS, Brasil;, Universidade Federal do Rio Grande do Sul, Divisão de Gastroenterologia, Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre RS , Brazil
| | - Bruna Cherubini Alves
- Programa de pós-graduação: Ciências em Gastroenterologia e Hepatologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil;, Universidade Federal do Rio Grande do Sul, Programa de pós-graduação: Ciências em Gastroenterologia e Hepatologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre RS , Brazil.,Centro de Estudos em Alimentação e Nutrição (CESAN), Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre, RS, Brasil, Universidade Federal do Rio Grande do Sul, Centro de Estudos em Alimentação e Nutrição, Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre RS , Brazil
| | - Valesca Dall'alba
- Programa de pós-graduação: Ciências em Gastroenterologia e Hepatologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil;, Universidade Federal do Rio Grande do Sul, Programa de pós-graduação: Ciências em Gastroenterologia e Hepatologia, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre RS , Brazil.,Centro de Estudos em Alimentação e Nutrição (CESAN), Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre, RS, Brasil, Universidade Federal do Rio Grande do Sul, Centro de Estudos em Alimentação e Nutrição, Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre RS , Brazil.,Departamento de Nutrição, Faculdade de Medicina, UFRGS, Porto Alegre, RS, Brasil, Universidade Federal do Rio Grande do Sul, Departamento de Nutrição, Faculdade de Medicina, UFRGS, Porto Alegre RS , Brazil.,Divisão de Nutrição, Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre, RS, Brasil, Universidade Federal do Rio Grande do Sul, Divisão de Nutrição, Hospital de Clínicas de Porto Alegre, UFRGS, Porto Alegre RS , Brazil
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Coffee Consumption Decreases Risks for Hepatic Fibrosis and Cirrhosis: A Meta-Analysis. PLoS One 2015; 10:e0142457. [PMID: 26556483 PMCID: PMC4640566 DOI: 10.1371/journal.pone.0142457] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 10/20/2015] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND AIM Previous studies have demonstrated that coffee consumption may be inversely correlated with hepatic fibrosis and cirrhosis. However, the reported results have been inconsistent. To summarize previous evidences quantitatively, a meta-analysis was performed. METHODS The Medline, Web of Science, and Embase databases (from inception to June 2015) were searched to identify relevant trials that evaluated the effects of coffee consumption on hepatic fibrosis or cirrhosis. Odds ratios (ORs) of advanced hepatic fibrosis or cirrhosis for low or moderate, high, and any coffee consumption versus no consumption were pooled. Two cups per day was used as the cut-off level between low or moderate and high consumption. RESULTS Sixteen studies were included, involving 3034 coffee consumers and 132076 people who do not consume coffee. The pooled results of the meta-analysis indicated that coffee consumers were less likely to develop cirrhosis compared with those who do not consume coffee, with a summary OR of 0.61 (95%CI: 0.45-0.84). For low or moderate coffee consumption versus no consumption, the pooled OR of hepatic cirrhosis was 0.66 (95%CI: 0.47-0.92). High coffee consumption could also significantly reduce the risk for hepatic cirrhosis when compared with no coffee consumption (OR = 0.53, 95%CI: 0.42-0.68). The effect of coffee consumption on hepatic fibrosis was summarized as well. The pooled OR of advanced hepatic fibrosis for coffee consumption versus no consumption was 0.73 (95%CI: 0.58-0.92). The protective effect of coffee on hepatic fibrosis and cirrhosis was also identified in subgroup meta-analyses of patients with alcoholic liver disease and chronic hepatitis C virus (HCV) infection. CONCLUSION Coffee consumption can significantly reduce the risk for hepatic fibrosis and cirrhosis.
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Khalaf N, White D, Kanwal F, Ramsey D, Mittal S, Tavakoli-Tabasi S, Kuzniarek J, El-Serag HB. Coffee and Caffeine Are Associated With Decreased Risk of Advanced Hepatic Fibrosis Among Patients With Hepatitis C. Clin Gastroenterol Hepatol 2015; 13:1521-31.e3. [PMID: 25777972 DOI: 10.1016/j.cgh.2015.01.030] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 01/12/2015] [Accepted: 01/28/2015] [Indexed: 12/23/2022]
Abstract
BACKGROUND & AIMS Coffee or caffeine has been proposed to protect against hepatic fibrosis, but few data are available on their effects in patients with chronic hepatitis C virus (HCV) infection. METHODS We conducted a cross-sectional study of veterans with chronic HCV infection to evaluate the association between daily intake of caffeinated and decaffeinated coffee, tea, and soda, and level of hepatic fibrosis, based on the FibroSURE test (BioPredictive, Paris, France) (F0-F3, mild [controls] vs. F3/F4-F4, advanced). Models were adjusted for multiple potential confounders including age, alcohol abuse, and obesity. RESULTS Among 910 patients with chronic HCV infection, 98% were male and 38% had advanced hepatic fibrosis. Daily intake of caffeinated coffee was higher among controls than patients with advanced fibrosis (1.37 vs. 1.05 cups/d; P = .038). In contrast, daily intake of caffeinated tea (0.61 vs. 0.56 cups/d; P = .651) or soda (1.14 vs. 0.95 cans/d; P = .106) did not differ between the groups. A higher percentage of controls (66.0%) than patients with advanced fibrosis (57.9%) consumed 100 mg or more of caffeine daily from all sources (P = .014); controls also received a larger proportion of their caffeine from coffee (50.2% vs. 43.0%; P = .035). Hepatoprotective effects of an average daily intake of 100 mg or more of caffeine (adjusted odds ratio, 0.71; 95% confidence interval, 0.53-0.95; P = .020) and 1 cup or more of caffeinated tea by non-coffee drinkers (adjusted odds ratio, 0.56; 95% confidence interval, 0.34-0.94; P = .028) persisted after adjustment for confounders, including insulin resistance. CONCLUSIONS A modest daily caffeine intake (as little as 100 mg) may protect against advanced hepatic fibrosis in men with chronic HCV infection. Additional research is needed to confirm these findings in women and in people with other chronic liver diseases.
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Affiliation(s)
- Natalia Khalaf
- Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas; Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
| | - Donna White
- Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas; Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
| | - Fasiha Kanwal
- Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas; Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
| | - David Ramsey
- Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas; Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
| | - Sahil Mittal
- Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas; Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
| | - Shahriar Tavakoli-Tabasi
- Section of Infectious Diseases, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
| | - Jill Kuzniarek
- Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas
| | - Hashem B El-Serag
- Section of Gastroenterology and Hepatology, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas; Section of Health Services Research, Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas.
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