Protein-energy malnutrition muscle proteins

It is estimated that 30% of aU cirrhotic patients have protein-energy malnutrition, 40% have protein malnutrition, and 10% have energy mabiutrition. Additionally, among alcoholic cirrhotic patients, 73% of patients have midarm muscle circumferences below the fifth percentile, and 51% have tricep skinfold thickness below the 25th... 

Prealbumin and retinol-binding protein, traditionally sensitive markers of protein-energy malnutrition, may not be as reliable in patients with hepatic failure. Liver failure can cause decreased concentrations of both, independent of nutritional status. Indeed, many of the commonly used markers of nutritional status correlate poorly with body cell mass in those with end-stage liver disease. Midarm muscle circumference and handgrip strength have been found to be the best... 

Kwashiorkor A disease of protein—energy malnutrition in which there is oedema masking the severe muscle wastage, fatty infiltration of the liver and abnormalities of hair structure and hair and skin pigmentation. 

Protein-energy malnutrition in adults—Many of the signs observed in children suffering from PEM will be found in adult patients who have protein and/or energy deficiencies. However, in the case of adults, the ratio of weight to height has been found to be less sensitive than other indicators of PEM. Better indicators of the severity of protein deficiency are serum albumin, triceps skinfold, and muscle circumference. These three measurements are distinctly subnormal in moderate to severe protein deficiencies. 

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