The metabolism of many nutritional elements (carbohydrate, protein, fat, vitamins, and minerals) is gradually disturbed with progressive chronic liver diseases. In particular, protein‐energy malnutrition (PEM) is known as the most characteristic manifestation of liver cirrhosis (LC) and is closely related to its prognosis. Recently, while sarcopenia (loss of muscle mass and strength or physical performance) has been discussed as an independent factor associated with prognosis in patients with LC, obesity and insulin resistance in patients with LC also contribute to carcinogenesis in LC. Deficiencies of zinc and carnitine are involved in the malnutrition in LC and are associated with hyperammonemia, which is related to the pathogenesis of hepatic encephalopathy. Because the nutritional and metabolic disturbances in LC are fundamentally influenced by many factors, such as the severity of liver damage, the existence of portal‐systemic shunting, and inflammation, proper nutritional assessment is necessary for the nutritional management of patients with LC.
Part of the book: Liver Cirrhosis