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Original Article
 
Handgrip dynamometer: A useful tool for nutritional assessment of alcoholic liver disease
Vikas Pandey1, Pathik Parikh1, Jignesh Patel1, Prabha Sawant1
1Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital.

Article ID: 100004G01VP2015
doi:10.5348/g01-2015-4-CR-4

Address correspondence to:
Dr. Vikas Pandey
Mumbai, Maharashtra
India, 400084
Phone: 09619265036

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How to cite this article:
Pandey V, Parikh P, Patel J, Sawant P. Handgrip dynamometer: A useful tool for nutritional assessment of alcoholic liver disease. Edorium J Gastroenterol 2015;2:13–18.


Abstract
Aims: Proper nutritional assessment of patients who have liver diseases carries its own challenges. Primary objectives of the study were to assess the prevalence of nutritional deficiency in alcoholic liver disease (ALD) with special reference to handgrip (HG) strength.
Methods: The prospective case control study evaluated nutritional status by anthropometry parameters including BMI, triceps skinfold thickness (TSFT) and midarm muscle circumference (MAC) and laboratory measurements for hemoglobin, and albumin. Skeletal muscle function was assessed by measuring HG using novel handgrip dynamometer.
Results: The study included 75 male patients of ALD and age matched 75 male controls. Among 75 patients, 24 were in CTP class A, 35 in CTP B and 16 in CTP class C. Mean alcohol consumption was 70.3 grams per day for 14.8 years. Mean BMI in cases group (22.2±4.84) and controls (23.1±4.03) were statistically not significant. TSSF and MAC were higher in control group (17.5±4.4 and 25.85±3.07 respectively) as compared to cases (12.1±5.6 and 22.58±4.37 respectively) (p <0.05) Hemoglobin level did not correlated well with malnutrition between two groups. Serum albumin level was significantly low (2.49±0.66) as compared to controls (4.1±0.31) (low synthesis) Patients had significantly less right (25.9 versus 41; p < 0.01) and left (23.02 versus 40.18; p < 0.01) HGS than controls. Among the cases, Handgrip measurement also correlated well with disease severity with CTP class.
Conclusion: HG seems to be a simple, inexpensive, and effective method to detect protein-calorie malnutrition in patients with ALD.

Keywords: Alcoholic liver disease, Child-Turcotte-Pugh class, Hand grip dynamometry, Protein-calorie malnutrition


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Author Contributions
Vikas Pandey – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Pathik Parikh – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Jignesh Patel – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Prabha Sawant – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Vikas Pandey et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.