HENS-LIV
Research type
Research Study
Full title
Prospective pilot study to investigate the impact of Hepatic Encephalopathy on the Nutritional Intake and Sarcopenia status in patients with chronic LIVer disease
IRAS ID
280736
Contact name
Matthew Armstrong
Contact email
Sponsor organisation
University Hospitals Birmingham
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Liver disease is the third most common cause of premature mortality in the UK. Sarcopenia (loss of muscle mass) and decreased muscle strength/function are major complications of chronic liver disease and their incidence increases as disease progresses. A number of mechanisms may contribute to sarcopenia including age-related loss of motor units and hormonal / immune dysregulation; which in the case of chronic liver disease are exacerbated by insufficient nutritional intake, hypermetabolism, systemic inflammation, an imbalance between protein synthesis and breakdown and reduced physical activity. Evidence suggests that sarcopenia and poor physical function in chronic liver disease is associated with increased mortality, as well as complications such as hepatic encephalopathy, ascites, infections and prolonged hospital admissions. Hepatic encephalopathy is a severe complication of liver disease and affects up to 40% of individuals with chronic liver cirrhosis. It manifests as a wide spectrum of neurological or psychiatric abnormalities and is caused by multiple mechanisms including liver insufficiency and/or portosystemic shunting. Hepatic encephalopathy is commonly categorised by the West Haven criteria based upon impairment of consciousness, intellectual function, and behaviour which is graded from I-IV; with IV being the worst (i.e. coma). Hepatic encephalopathy is known to impact on quality of life (QOL) and is strongly associated with substantial economic burden; often contributing to repeated hospital admissions.
The aim of our study is to investigate the effect of hepatic encephalopathy on nutritional intake (and compliance) and muscle health/function in patients with chronic liver disease. The results will be used to assess the need for, and guide the design of a randomised-control trial to optimise nutritional intake and delivery of nutritional advice to support management of sarcopenia.
REC name
London - Camden & Kings Cross Research Ethics Committee
REC reference
21/LO/0340
Date of REC Opinion
5 May 2021
REC opinion
Unfavourable Opinion