Association between nutritional screening via the C ontrolling N utritional S tatus index and bone mineral density in chronic liver disease of various etiologies

Aim Bone density disorders are prevalent in patients with chronic liver disease ( CLD ), who commonly present with hepatic osteodystrophy. However, the relationship between nutritional status and bone mineral density ( BMD ) has been scarcely studied in CLD . Methods This single‐center, cross‐sectional study included outpatients consecutively diagnosed with CLD during a 1.5‐year period. The nutritional status was assessed with the C ontrolling N utritional S tatus ( CONUT ) index; dual‐energy X‐ray absorptiometry scans and parameters of bone mineral metabolism were carried out. Bone fracture risk was estimated with the W orld H ealth O rganization FRAX tool. Results Among the 126 patients recruited (58.7% male), osteopenia and osteoporosis were present in 31.1% and 10.7%, respectively. The 10‐year fracture risk was significantly higher among women. Malnutrition estimated with the CONUT index was present in 29.9% of patients and was significantly more frequent in cirrhotic patients, 63.4% of whom were malnourished. Malnutrition stage directly correlated with hepatic function as expressed by the M odel for E nd‐ S tage L iver D isease index. A non‐significant relationship between CONUT ‐assessed nutritional status and BMD was documented. 25‐Hydroxyvitamin‐D3 (25[ OH ]‐ D3 ) and fracture risk correlated positively with the CONUT stage, and total cholesterol had an inverse relationship with BMD . Conclusion Malnutrition assessed by the CONUT was very frequent in patients with liver cirrhosis. The CONUT score inversely correlated with liver function, while malnutrition stage directly correlated with BMD , fracture risk and 25( OH )‐ D3 . Total cholesterol showed a negative association with BMD in this population.