Pathophysiological-Based Nutritional Interventions in Cirrhotic Patients with Sarcopenic Obesity: A State-of-the-Art Narrative Review
In recent decades, following the spread of obesity, metabolic dysfunction has come to represent the leading cause of liver disease. The classical clinical presentation of the cirrhotic patient has, therefore, greatly changed, with a dramatic increase in subjects who appear overweight or obese. Due t...
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MDPI AG
2024-01-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/16/3/427 |
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| author | Ernestina Santangeli Chiara Abbati Rusi Chen Alma Di Carlo Simona Leoni Fabio Piscaglia Silvia Ferri |
| author_facet | Ernestina Santangeli Chiara Abbati Rusi Chen Alma Di Carlo Simona Leoni Fabio Piscaglia Silvia Ferri |
| author_sort | Ernestina Santangeli |
| collection | DOAJ |
| description | In recent decades, following the spread of obesity, metabolic dysfunction has come to represent the leading cause of liver disease. The classical clinical presentation of the cirrhotic patient has, therefore, greatly changed, with a dramatic increase in subjects who appear overweight or obese. Due to an obesogenic lifestyle (lack of physical activity and overall malnutrition, with an excess of caloric intake together with a deficit of proteins and micronutrients), these patients frequently develop a complex clinical condition defined as sarcopenic obesity (SO). The interplay between cirrhosis and SO lies in the sharing of multiple pathogenetic mechanisms, including malnutrition/malabsorption, chronic inflammation, hyperammonemia and insulin resistance. The presence of SO worsens the outcome of cirrhotic patients, affecting overall morbidity and mortality. International nutrition and liver diseases societies strongly agree on recommending the use of food as an integral part of the healing process in the comprehensive management of these patients, including a reduction in caloric intake, protein and micronutrient supplementation and sodium restriction. Based on the pathophysiological paths shared by cirrhosis and SO, this narrative review aims to highlight the nutritional interventions currently advocated by international guidelines, as well as to provide hints on the possible role of micronutrients and nutraceuticals in the treatment of this multifaceted clinical condition. |
| first_indexed | 2024-03-08T03:51:12Z |
| format | Article |
| id | doaj.art-e36ac68dce8b4fec855314195de0faca |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-08T03:51:12Z |
| publishDate | 2024-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-e36ac68dce8b4fec855314195de0faca2024-02-09T15:19:57ZengMDPI AGNutrients2072-66432024-01-0116342710.3390/nu16030427Pathophysiological-Based Nutritional Interventions in Cirrhotic Patients with Sarcopenic Obesity: A State-of-the-Art Narrative ReviewErnestina Santangeli0Chiara Abbati1Rusi Chen2Alma Di Carlo3Simona Leoni4Fabio Piscaglia5Silvia Ferri6Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, ItalyDepartment of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, ItalyDepartment of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, ItalyDivision of Internal Medicine, Hepatobiliary and Immunoallergologic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyDivision of Internal Medicine, Hepatobiliary and Immunoallergologic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyDepartment of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, ItalyDivision of Internal Medicine, Hepatobiliary and Immunoallergologic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, ItalyIn recent decades, following the spread of obesity, metabolic dysfunction has come to represent the leading cause of liver disease. The classical clinical presentation of the cirrhotic patient has, therefore, greatly changed, with a dramatic increase in subjects who appear overweight or obese. Due to an obesogenic lifestyle (lack of physical activity and overall malnutrition, with an excess of caloric intake together with a deficit of proteins and micronutrients), these patients frequently develop a complex clinical condition defined as sarcopenic obesity (SO). The interplay between cirrhosis and SO lies in the sharing of multiple pathogenetic mechanisms, including malnutrition/malabsorption, chronic inflammation, hyperammonemia and insulin resistance. The presence of SO worsens the outcome of cirrhotic patients, affecting overall morbidity and mortality. International nutrition and liver diseases societies strongly agree on recommending the use of food as an integral part of the healing process in the comprehensive management of these patients, including a reduction in caloric intake, protein and micronutrient supplementation and sodium restriction. Based on the pathophysiological paths shared by cirrhosis and SO, this narrative review aims to highlight the nutritional interventions currently advocated by international guidelines, as well as to provide hints on the possible role of micronutrients and nutraceuticals in the treatment of this multifaceted clinical condition.https://www.mdpi.com/2072-6643/16/3/427cirrhosissarcopenic obesityinflammationhyperammonemiainsulin-resistancenutrition |
| spellingShingle | Ernestina Santangeli Chiara Abbati Rusi Chen Alma Di Carlo Simona Leoni Fabio Piscaglia Silvia Ferri Pathophysiological-Based Nutritional Interventions in Cirrhotic Patients with Sarcopenic Obesity: A State-of-the-Art Narrative Review Nutrients cirrhosis sarcopenic obesity inflammation hyperammonemia insulin-resistance nutrition |
| title | Pathophysiological-Based Nutritional Interventions in Cirrhotic Patients with Sarcopenic Obesity: A State-of-the-Art Narrative Review |
| title_full | Pathophysiological-Based Nutritional Interventions in Cirrhotic Patients with Sarcopenic Obesity: A State-of-the-Art Narrative Review |
| title_fullStr | Pathophysiological-Based Nutritional Interventions in Cirrhotic Patients with Sarcopenic Obesity: A State-of-the-Art Narrative Review |
| title_full_unstemmed | Pathophysiological-Based Nutritional Interventions in Cirrhotic Patients with Sarcopenic Obesity: A State-of-the-Art Narrative Review |
| title_short | Pathophysiological-Based Nutritional Interventions in Cirrhotic Patients with Sarcopenic Obesity: A State-of-the-Art Narrative Review |
| title_sort | pathophysiological based nutritional interventions in cirrhotic patients with sarcopenic obesity a state of the art narrative review |
| topic | cirrhosis sarcopenic obesity inflammation hyperammonemia insulin-resistance nutrition |
| url | https://www.mdpi.com/2072-6643/16/3/427 |
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