Annals of Clinical Nutrition and Metabolism

Letter from the Editor: Chi-Min Park; Ann Clin Nutr Metab 2022;14(1):1-1. Published online June 1, 2022; DOI: https://doi.org/10.15747/ACNM.2022.14.1.1

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Liver Cirrhosis and Sarcopenia: Hye Yeon Chon, Tae Hee Lee; Ann Clin Nutr Metab 2022;14(1):2-9. Published online June 1, 2022; DOI: https://doi.org/10.15747/ACNM.2022.14.1.2

Abstract PDF: Malnutrition is one of the most common complications in patients with liver cirrhosis. In previous studies, cirrhotic patients with severe malnutrition have been associated with higher morbidity and mortality rates before and after liver transplantation. Frailty and sarcopenia are phenotypes of severe malnutrition that have been associated with complications requiring hospitalization or mortality during the wait for transplantation in patients with cirrhosis. Tools for evaluating frailty include the Activities of Daily Living scale, the Karnofsky Performance Status scale, and the Liver Frailty Index. Diagnosed by using computed tomography, sarcopenia is measured with the skeletal muscle index at L3 and is normalized by height. Nutritional status should be evaluated within the first 24~48 hours of hospitalization in every patient with cirrhosis. Among the various available screening tools, the Royal Free Hospital-Nutritional Prioritizing Tool proposed in the UK is recommended. Nutritional counseling with a multidisciplinary team is recommended to improve long-term survival in patients with cirrhosis. Multidisciplinary nutrition management should include evaluating nutritional status and providing guidance for achieving nutritional goals. Most guidelines suggest a calorie intake of 25~35 kcal/kg/day, and the recommended protein intake is 1.2~1.5 g/kg/day. One beneficial technique for patients is to divide the total recommended intake across four to five daily meals, including a nighttime snack. The principles of nutritional intervention in cirrhotic patients are not different from those in noncirrhotic patients. For improvement of sarcopenia, a strategic approach including physical activity and exercise, hormone replacement therapy, ammonia-lowering agents, and treatment of underlying liver disease is required.

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Effect of Probiotics/Synbiotics on Postoperative Outcomes in Patients Undergoing Abdominal Surgery: In Ja Park; Ann Clin Nutr Metab 2022;14(1):10-19. Published online June 1, 2022; DOI: https://doi.org/10.15747/ACNM.2022.14.1.10

Abstract PDF: Environmental factors, drugs, diet, and surgery alter the composition of the gut microbiota leading to the production of different metabolites or toxins that can cause disease or delay postoperative recovery. Surgical damage leads to gut barrier disruption, increased intestinal permeability, gut microbial imbalance, and immunologic compromise of the host with subsequent bacterial translocation from the gastrointestinal tract to systemic circulation. Therefore, perioperative stabilization of the intestinal microbiota is a potential method of reducing postoperative complication rates. Probiotics have been proposed as a viable option for prophylaxis of postoperative infections through increased intestinal motility to prevent bacterial overgrowth, improve gut barrier function, and modulate immune response. This review investigates microbial changes after surgery and the influence of probiotics on postoperative microbial composition. Infectious postoperative complications and immunologic changes related to probiotics/synbiotics were also reviewed in patients who underwent abdominal surgery.

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Drug-Induced Vitamin Deficiency: Jung Won Jung, So Young Park, Hyunah Kim; Ann Clin Nutr Metab 2022;14(1):20-31. Published online June 1, 2022; DOI: https://doi.org/10.15747/ACNM.2022.14.1.20

Abstract PDF: Drug-induced vitamin depletion can occur in hospitalized patients due to the administration of specific medications, which could potentially adversely affect patient outcomes. Signs and symptoms related to vitamin deficiency while taking certain medications should be monitored carefully and managed appropriately if those deficiencies are clinically significant. This article reviews potential drug-induced vitamin depletion and discusses the evidence supporting vitamin deficiency related to the use of specific medications.

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Development of the Korean Version of the Gastrointestinal Quality of Life Index Questionnaire: In Jun Yang, Heung-Kwon Oh, Jeehye Lee, Jung Wook Suh, Hong-min Ahn, Hyeonjeong Park, Hyun Hee Sim, Yong Beom Cho, In Kyu Lee, Seungbum Ryoo, Dong-Won Lee, Duck-Woo Kim, Sung-Bum Kang; Ann Clin Nutr Metab 2022;14(1):32-37. Published online June 1, 2022; DOI: https://doi.org/10.15747/ACNM.2022.14.1.32

Abstract PDF: Purpose: To establish a standardized quality of life measurement that allows global cross-study comparisons, we translated the Gastrointestinal Quality of Life Index (GIQLI) into Korean and linguistically validated the Korean version of the GIQLI (K-GIQLI) in patients who underwent colorectal surgery.
Materials and Methods: A cross-cultural adaptation of the original GIQLI was created based on the established guidelines. Based on participation in a cognitive interview, 20 patients with colorectal cancer were enrolled in the study. To ensure that the Korean version of the questionnaire was understood as intended, the time needed to complete the questionnaire was measured, and three additional items related to comprehension were added.
Results: From May to July 2021, two translators, whose native language was Korean translated the GIQLI items into Korean, and a native English editor who had no knowledge of the original questionnaire translated the items back into English. In the cognitive interview, the median age of the patients was 61.8 (range: 44~82) years, and the median time required to complete the questionnaire was 6.5 (range: 5~10) min. For the language and cultural adaptation process, the participants’ comprehension of the questionnaire was measured on a scale of 1~5, with a mean score of 4 (range: 3~4).
Conclusion: The K-GIQLI was developed and did not exhibit a significant difference from the original English version in terms of social, linguistic, and cultural differences between the Western world and Republic of Korea.

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