Protein-calorie malnutrition associated with alcoholic hepatitis. Veterans administration cooperative study group on alcoholic hepatitis

Charles L. Mendenhall, Sharon Anderson, Robert E. Weesner, Stephen J. Goldberg, Kathleen A. Crolic

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292 Citations (Scopus)

Abstract

Three hundred sixty-three alcoholic patients with alcoholic hepatitis were studied in six Veterans Administration medical centers. By history, alcohol consumption was 227.9 g per day, with a mean duration of 23.8 years. Cirrhosis accompanied the alcoholic hepatitis in 58.7 percent of the patients who underwent biopsy or autopsy. Complete nutritional assessment was performed in 284 patients, and observed nutritional changes were classified into those associated with marasmus or those characterizing kwashiorkor. A smaller comparison group of 21 alcoholic patients matched for age and alcohol consumption but without clinically evident liver disease was also studied in an identical manner. None of the patients with liver disease was completely free from malnutrition, whereas 62 percent of the alcoholic patients without liver disease showed abnormalities. In patients with alcoholic hepatitis, some findings associated with marasmus were seen in 86 percent, and some features of kwashiorkor were observed in 100 percent. When present together, the complete picture of kwashiorkor and marasmus correlated closely with the clinical severity of the liver disease (p <0.005). The nearly constant association of either complete or partial kwashiorkor or marasmus suggests that the separation of these two entities is artificial in alcoholic patients with liver disease. Although, experimentally, malnutrition may not be essential for the development of alcoholic hepatitis, clinically, it appears to precede the development of the liver injury, which suggests an interaction. Recognition is important so that appropriate nutritional therapy can be provided.

Original languageEnglish (US)
Pages (from-to)211-222
Number of pages12
JournalThe American journal of medicine
Volume76
Issue number2
DOIs
StatePublished - 1984
Externally publishedYes

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Alcoholic Hepatitis
Protein-Energy Malnutrition
United States Department of Veterans Affairs
Kwashiorkor
Liver Diseases
Alcoholics
Malnutrition
Alcohol Drinking
Nutrition Assessment
Autopsy
Fibrosis
History
Biopsy
Liver
Wounds and Injuries

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Protein-calorie malnutrition associated with alcoholic hepatitis. Veterans administration cooperative study group on alcoholic hepatitis. / Mendenhall, Charles L.; Anderson, Sharon; Weesner, Robert E.; Goldberg, Stephen J.; Crolic, Kathleen A.

In: The American journal of medicine, Vol. 76, No. 2, 1984, p. 211-222.

Research output: Contribution to journalArticle

Mendenhall, Charles L. ; Anderson, Sharon ; Weesner, Robert E. ; Goldberg, Stephen J. ; Crolic, Kathleen A. / Protein-calorie malnutrition associated with alcoholic hepatitis. Veterans administration cooperative study group on alcoholic hepatitis. In: The American journal of medicine. 1984 ; Vol. 76, No. 2. pp. 211-222.
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