Abstract
Assessment of Micronutrient Status and Its Association with Clinical Outcomes in Adult Patients with Liver Cirrhosis: A Single-arm Retrospective Cohort Study
Kathleen Marie M. Monfort, MD; Ira I. Yu, MD
National Kidney and Transplant Institute
Significance: Micronutrient deficiencies are common in patients with liver cirrhosis. These deficiencies are exacerbated by malnutrition, poor digestion, and diuretic use. This study aimed to determine the micronutrient status of adult Filipino patients with liver cirrhosis, focusing on the prevalence of deficiencies and their association with clinical outcomes.
Methodology: This was a single-center single-arm retrospective cohort study conducted among adult cirrhosis at the NKTI. Micronutrient levels were reported, and prevalence of micronutrient deficiencies was determined. Univariate logistic regression was done to determine the association between specific micronutrient deficiencies and clinical outcomes, with odds ratios and corresponding 95% confidence intervals reported. Missing data were neither replaced nor estimated.
Results: Out of 461 patients assessed, 234 (50.76%) had at least one deficiency, with vitamin D and zinc being the most common deficiencies. Other deficiencies included iron deficiency, hypocalcemia, hypophosphatemia, and hypomagnesemia. Vitamin B12 deficiency was rare. Vitamin D deficiency was significantly associated with poorer outcomes, with 351% increased odds compared to those without deficiency. Calcium and phosphorus deficiencies were associated with 48% and 82% decreased odds of poorer outcomes, respectively. Zinc, iron, and magnesium deficiencies did not exhibit any statistically significant associations with clinical outcomes.
Conclusion: Vitamin deficiencies are common among patients with liver cirrhosis, and routine screening and monitoring of vitamin D levels are warranted. However, further research is needed to clarify these associations. The study’s limitations include a small sample size, and not all patients have a complete set micronutrient panel.
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
Week 1: July 15-21, 2023 Week 2: July 22-28, 2023 Week 3: July 29-August 4, 2023 Week 4: August 5-11, 2023 |
| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |