Portal Hypertension in Malnutrition and Sarcopenia in Decompensated Cirrhosis—Pathogenesis, Implications and Therapeutic Opportunities
Malnutrition and sarcopenia are highly prevalent in patients with decompensated cirrhosis and are associated with poorer clinical outcomes. Their pathophysiology is complex and multifactorial, with protein-calorie malnutrition, systemic inflammation, reduced glycogen stores and hormonal imbalances a...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/16/1/35 |
| _version_ | 1797358308028317696 |
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| author | Ryma Terbah Adam Testro Paul Gow Avik Majumdar Marie Sinclair |
| author_facet | Ryma Terbah Adam Testro Paul Gow Avik Majumdar Marie Sinclair |
| author_sort | Ryma Terbah |
| collection | DOAJ |
| description | Malnutrition and sarcopenia are highly prevalent in patients with decompensated cirrhosis and are associated with poorer clinical outcomes. Their pathophysiology is complex and multifactorial, with protein-calorie malnutrition, systemic inflammation, reduced glycogen stores and hormonal imbalances all well reported. The direct contribution of portal hypertension to these driving factors is however not widely documented in the literature. This review details the specific mechanisms by which portal hypertension directly contributes to the development of malnutrition and sarcopenia in cirrhosis. We summarise the existing literature describing treatment strategies that specifically aim to reduce portal pressures and their impact on nutritional and muscle outcomes, which is particularly relevant to those with end-stage disease awaiting liver transplantation. |
| first_indexed | 2024-03-08T15:00:03Z |
| format | Article |
| id | doaj.art-1afdac7f764a48038ae707e090bd6b38 |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-08T15:00:03Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-1afdac7f764a48038ae707e090bd6b382024-01-10T15:05:18ZengMDPI AGNutrients2072-66432023-12-011613510.3390/nu16010035Portal Hypertension in Malnutrition and Sarcopenia in Decompensated Cirrhosis—Pathogenesis, Implications and Therapeutic OpportunitiesRyma Terbah0Adam Testro1Paul Gow2Avik Majumdar3Marie Sinclair4Liver Transplant Unit, Austin Health, 145 Studley Road, Heidelberg, VIC 3084, AustraliaLiver Transplant Unit, Austin Health, 145 Studley Road, Heidelberg, VIC 3084, AustraliaLiver Transplant Unit, Austin Health, 145 Studley Road, Heidelberg, VIC 3084, AustraliaLiver Transplant Unit, Austin Health, 145 Studley Road, Heidelberg, VIC 3084, AustraliaLiver Transplant Unit, Austin Health, 145 Studley Road, Heidelberg, VIC 3084, AustraliaMalnutrition and sarcopenia are highly prevalent in patients with decompensated cirrhosis and are associated with poorer clinical outcomes. Their pathophysiology is complex and multifactorial, with protein-calorie malnutrition, systemic inflammation, reduced glycogen stores and hormonal imbalances all well reported. The direct contribution of portal hypertension to these driving factors is however not widely documented in the literature. This review details the specific mechanisms by which portal hypertension directly contributes to the development of malnutrition and sarcopenia in cirrhosis. We summarise the existing literature describing treatment strategies that specifically aim to reduce portal pressures and their impact on nutritional and muscle outcomes, which is particularly relevant to those with end-stage disease awaiting liver transplantation.https://www.mdpi.com/2072-6643/16/1/35cirrhosisportal hypertensionsarcopeniamalnutrition |
| spellingShingle | Ryma Terbah Adam Testro Paul Gow Avik Majumdar Marie Sinclair Portal Hypertension in Malnutrition and Sarcopenia in Decompensated Cirrhosis—Pathogenesis, Implications and Therapeutic Opportunities Nutrients cirrhosis portal hypertension sarcopenia malnutrition |
| title | Portal Hypertension in Malnutrition and Sarcopenia in Decompensated Cirrhosis—Pathogenesis, Implications and Therapeutic Opportunities |
| title_full | Portal Hypertension in Malnutrition and Sarcopenia in Decompensated Cirrhosis—Pathogenesis, Implications and Therapeutic Opportunities |
| title_fullStr | Portal Hypertension in Malnutrition and Sarcopenia in Decompensated Cirrhosis—Pathogenesis, Implications and Therapeutic Opportunities |
| title_full_unstemmed | Portal Hypertension in Malnutrition and Sarcopenia in Decompensated Cirrhosis—Pathogenesis, Implications and Therapeutic Opportunities |
| title_short | Portal Hypertension in Malnutrition and Sarcopenia in Decompensated Cirrhosis—Pathogenesis, Implications and Therapeutic Opportunities |
| title_sort | portal hypertension in malnutrition and sarcopenia in decompensated cirrhosis pathogenesis implications and therapeutic opportunities |
| topic | cirrhosis portal hypertension sarcopenia malnutrition |
| url | https://www.mdpi.com/2072-6643/16/1/35 |
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