Dissemin is shutting down on January 1st, 2025

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MDPI, Nutrients, 1(16), p. 35, 2023

DOI: 10.3390/nu16010035

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Portal Hypertension in Malnutrition and Sarcopenia in Decompensated Cirrhosis—Pathogenesis, Implications and Therapeutic Opportunities

Journal article published in 2023 by Ryma Terbah, Adam Testro, Paul Gow, Avik Majumdar ORCID, Marie Sinclair ORCID
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

Malnutrition and sarcopenia are highly prevalent in patients with decompensated cirrhosis and are associated with poorer clinical outcomes. Their pathophysiology is complex and multifactorial, with protein-calorie malnutrition, systemic inflammation, reduced glycogen stores and hormonal imbalances all well reported. The direct contribution of portal hypertension to these driving factors is however not widely documented in the literature. This review details the specific mechanisms by which portal hypertension directly contributes to the development of malnutrition and sarcopenia in cirrhosis. We summarise the existing literature describing treatment strategies that specifically aim to reduce portal pressures and their impact on nutritional and muscle outcomes, which is particularly relevant to those with end-stage disease awaiting liver transplantation.