Nutritional assessment in primary biliary cirrhosis: the effect of disease severity

80 patients with primary biliary cirrhosis (PBC) were included in a cross-sectional study to assess the effect of disease progression (Mayo Clinic score, histological stage) on nutritional status and energy intake and to validate the use of simple anthropometric indices (mid arm circumference (MAC) and triceps skin fold thickness (TSF)) using dual-energy X-ray absorptiometry (DXA). 33% of patients were found to be malnourished (MAC or TSF below the 5th percentile for age and sex). Both MAC and TSF correlated well with body percentage fat (% fat) measured by DXA (p < 0.01). MAC, TSF and % fat decreased with disease progression (p < 0.001) and in the presence of established cirrhosis. Energy intake fell slightly in these patients but significantly in the presence of ascites. MAC and TSF are useful and practical markers of nutritional status and may identify patients who could benefit from nutritional intervention prior to transplantation.