Background/aims: Impaired retinol status may be associated with development of cirrhosis to hepatocellular carcinoma (HCC). Besides cirrhotic severity, retinol may be influenced by compromised nutrition status. This study investigated the interrelations among retinol, malnutrition, and severity of cirrhosis and further aimed to examine whether malnutrition proxies commonly measured in hospital would be useful to predict retinol concentrations in different cirrhosis stages.
Methodology: Fifty patients with liver cirrhosis, but without HCC were classified into the three Child-Pugh stages. Nutrition assessment was performed and fasting plasma retinol was analyzed using high-pressure liquid chromatography.
Results: Plasma retinol concentrations were significantly reduced as cirrhotic stage progressed accordingly (p for trend < 0.05). Stratified by each Child-Pugh class, subjects having albumin < 3.5 g/dL, prealbumin < 15 mg/dL and transferrin < 200 mg/dL showed significantly lower retinol concentrations compared to their respective counterparts (p<0.05), except that all Child-Pugh C patients had prealbumin < 15 mg/dL or transferrin < 200 mg/dL. After adjusting for confounders, albumin < 3.5 g/dL (beta = -14.2, SE = 6.5, p=0.028) or prealbumin < 15 mg/dL, (beta = -34.0, SE = 7.6, p<0.001) was negatively associated with retinol levels; transferrin < 200 mg/dL however. was not related.
Conclusions: Retinol status was independently associated with malnutrition defined by albumin and prealbumin in cirrhosis patients. These malnutrition indicators are routinely measured by laboratory devices available in hospitals and may be used for prediction of retinol status in patients in different stages.