Nutritional issues in patients with obesity and cirrhosis

查看全文 作　　者：Luigi [1,2]Schiavo;Luca [3,4]Busetto;Manuela [5,6]Cesaretti;Shira Zelber-[7,8]Sagi;Liat [8,9]Deutsch;Antonio [10,11,12]Iannelli

机构地区：[1]Department of Translational Medical Science,University of Campania“Luigi Vanvitelli”,Naples 80131,Italy;[2]Ⅸ Division of General Surgery,Vascular Surgery and Applied Biotechnology,Naples University Policlinic,Naples 80131,Italy;[3]Department of Medicine,University of Padua,Padua 35128,Italy;[4]Center for the Study and the Integrated Management of Obesity,University Hospital of Padua,Padua 35128,Italy;[5]Department of HPB Surgery and Liver Transplantation,Hopital Beaujon,AP-HP,Clichy 92110,France;[6]Department of Nanophysics,Italian Institute of Technology,Genova 16163,Italy;[7]School of Public Health,University of Haifa,Haifa 3498838,Israel;[8]Department of Gastroenterology and Liver disease,Tel Aviv Medical Center,62431,Tel-Aviv 62431,Israel;[9]The Sackler Faculty of Medicine,Tel-Aviv University,Tel-Aviv 62431,Israel;[10]Digestive Unit,Archet 2 Hospital,University Hospital of Nice,F-06202,Nice,France;[11]Inserm,U1065,Team 8“Hepatic complications of obesity”,Nice F-06204,France;[12]University of Nice Sophia-Antipolis,Nice F-06107,France

出　　处：《World Journal of Gastroenterology》索引2018年第24卷第30期,共17页

摘　　要：Obesity and metabolic syndrome are considered as responsible for a condition known as the non-alcoholic fatty liver disease that goes from simple accumulation of triglycerides to hepatic inflammation and may progress to cirrhosis.Patients with obesity also have an increased risk of primary liver malignancies and increased body mass index is a predictor of decompensation of liver cirrhosis.Sarcopenic obesity confers a risk of physical impairment and disability that is significantly higher than the risk induced by each of the two conditions alone as it has been shown to be an independent risk factor for chronicliver disease in patients with obesity and a prognostic negative marker for the evolution of liver cirrhosis and the results of liver transplantation.Cirrhotic patients with obesity are at high risk for depletion of various fat-soluble,water-soluble vitamins and trace elements and should be supplemented appropriately.Diet,physical activity and protein intake should be carefully monitored in these fragile patients according to recent recommendations.Bariatric surgery is sporadically used in patients with morbid obesity and cirrhosis also in the setting of liver transplantation.The risk of sarcopenia,micronutrient status,and the recommended supplementation in patients with obesity and cirrhosis are discussed in this review.Furthermore,the indications and contraindications of bariatric surgery-induced weight loss in the cirrhotic patient with obesity are discussed. 关键词：OBESITY CIRRHOSIS SARCOPENIA MALNUTRITION BARIATRIC surgery

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Nutritional issues in patients with obesity and cirrhosis

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