Proceedings from the 2018 Canadian Association for the Study of the Liver Single Topic Conference—Decompensated cirrhosis: from clinic to transplant

The prevalence of malnutrition increases along with liver disease severity, and survival worsens with progressive malnourishment (1). Malnutrition, used as a synonym of under nutrition may however go unrecognized. It should also encompass the entity of sarcopenic obesity, given that the general prevalence of obesity and hence also the prevalence of cirrhosis and end-stage liver disease related to non-alcoholic fatty liver disease is increasing. Women have a physiologically lower muscle mass than men, which may make it more difficult to appreciate a decrease in muscle mass, and hence sarcopenia may be less sensitive in identifying malnutrition in women in the way it does with men. Women do, however, have more subcutaneous fat (2). There is a close relationship between episodes of decompensation, malnutrition, and sarcopenia, as well as hepatic encephalopathy, bacterial infections, and recurrent infections that lead to reduced survival in patients with cirrhosis.