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The Impact of Transjugular Intrahepatic Portosystemic Shunt on Nutrition in Liver Cirrhosis Patients: A Systematic Review.
Gazda, Jakub; Di Cola, Simone; Lapenna, Lucia; Khan, Saniya; Merli, Manuela.
Afiliación
  • Gazda J; 2nd Department of Internal Medicine, Pavol Jozef Safarik University and Louis Pasteur University Hospital, 040 12 Kosice, Slovakia.
  • Di Cola S; Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy.
  • Lapenna L; Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy.
  • Khan S; Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy.
  • Merli M; Department of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy.
Nutrients ; 15(7)2023 Mar 27.
Article en En | MEDLINE | ID: mdl-37049459
BACKGROUND AND AIMS: Liver cirrhosis leads to clinically significant portal hypertension. Transjugular intrahepatic portosystemic shunt (TIPS) has been shown to effectively reduce the degree of portal hypertension and treat its complications. However, poor nutritional status has been shown to be associated with hepatic encephalopathy, acute on chronic liver failure, and mortality following TIPS placement. The purpose of this systematic review is to create another perspective and evaluate the effect of TIPS placement on the nutritional status of patients with liver cirrhosis. METHODS: A comprehensive search of four major electronic databases was conducted to identify studies that assessed the nutritional status of cirrhotic patients before and after TIPS placement. The risk of bias was evaluated using ROBINS-I guidelines. RESULTS: Fifteen studies were analyzed in this review. The results indicate that among the 11 studies that evaluated changes in ascites-free weight and body mass index or body cell mass, 10 reported an improvement in one or more measures. Furthermore, all seven studies that evaluated changes in muscle mass demonstrated an increase in muscle mass. Among the four studies that evaluated subcutaneous fat tissue, three showed a significant expansion, while two out of three studies evaluating visceral fat tissue reported a significant reduction. CONCLUSIONS: The results of this systematic review suggest that TIPS placement is associated with improvement in the nutritional status of cirrhotic patients, indicated by an increase in ascites-free weight, body mass index, and muscle mass. Additionally, TIPS placement leads to a shift in the distribution of fat mass, with a preference for subcutaneous over visceral adipose tissue. Notably, sarcopenic patients seem to benefit the most from TIPS placement in terms of nutritional status.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Encefalopatía Hepática / Derivación Portosistémica Intrahepática Transyugular / Hipertensión Portal Tipo de estudio: Etiology_studies / Guideline / Systematic_reviews Límite: Humans Idioma: En Revista: Nutrients Año: 2023 Tipo del documento: Article País de afiliación: Eslovaquia Pais de publicación: Suiza
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Encefalopatía Hepática / Derivación Portosistémica Intrahepática Transyugular / Hipertensión Portal Tipo de estudio: Etiology_studies / Guideline / Systematic_reviews Límite: Humans Idioma: En Revista: Nutrients Año: 2023 Tipo del documento: Article País de afiliación: Eslovaquia Pais de publicación: Suiza