Skip to main content
SpringerLink
Log in

Usefulness of Simplified Nutritional Appetite Questionnaire (SNAQ) in Appetite Assessment in Elder Patients with Liver Cirrhosis

  • Published:
The journal of nutrition, health & aging

Abstract

Background

Appetite has received little attention in health care and researches in liver cirrhosis. The Simplified Nutritional Appetite Questionnaire (SNAQ), a self-assessment nutritional screening tool, could be used to screen the risk of malnutrition and weight loss. Our objective was to assess the usefulness of SNAQ in appetite assessment in patients with liver cirrhosis.

Methods

Seventy patients were enrolled. Appetite assessment was applied in the enrolled patients by completing SNAQ. Weight, hemoglobin, albumin, pro-albumin and Child-Pugh class were evaluated and recorded. The correlation between SNAQ score and these indexes was also evaluated. The most discriminating SNAQ value was calculated, which separated the participant at risk of weight loss.

Results

In participants with SNAQ < 14, the BMI, hemoglobin, albumin and pro-albumin were significantly less than those in participants with SNAQ ≥ 14. The correlation between SNAQ and these indexes were also observed (hemoglobin: r = 0.334, p = 0.005; albumin: r = 0.384, p = 0.001; pro-albumin: r = 0.342, p = 0.004; BMI: r = 0.550, p = 0.000). The SNAQ scores reduced along with the increase of Child-Pugh class. An SNAQ score under 11.5 was the best clinical indicator of elder people at risk of weight loss.

Conclusions

SNAQ can be used to evaluate the appetite loss and predicting the weight loss in patients with liver cirrhosis. The SNAQ tool also can be used by clinicians and nurses to identify patients with a poor appetite who are at risk of weight loss.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table 1
Table 2
Figure 1
Table 3
Table 4

Similar content being viewed by others

References

  1. Tandon P, Raman M, Mourtzakis M, Merli M. A practical approach to nutritional screening and assessment in cirrhosis. Hepatology. 2017 Mar;65(3):1044–1057.

    Article  PubMed  Google Scholar 

  2. Thandassery RB, Montano-Loza AJ. Role of Nutrition and Muscle in Cirrhosis. Curr Treat Options Gastroenterol, 2016,Jun,14,2,257–73.

    Article  PubMed  Google Scholar 

  3. Rojas-Loureiro G, Servín-Caamaño A, Pérez-Reyes E, Servín-Abad L, Higuera-de la Tijera F. Malnutrition negatively impacts the quality of life of patients with cirrhosis: An observational study. World J Hepatol. 2017 9(5):263–269.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Haider S, Saleem S, Shameem S, Ahmed SP, Parveen T, Haleem DJ. Is anorexia in thioacetamide-induced cirrhosis related to an altered brain serotonin concentration? Pol J Pharmacol. 2004 56(1):73–8.

    PubMed  CAS  Google Scholar 

  5. Purnak T, Yilmaz. Liver disease and malnutrition. Best Pract Res Clin Gastroenterol. 2013 Aug;27(4):619–29.

    Article  PubMed  CAS  Google Scholar 

  6. Wilson MM, Thomas DR, Rubenstein LZ, Chibnall JT, Anderson S, Baxi A, Diebold MR, Morley JE. Appetite assessment: simple appetite questionnaire predicts weight loss in community-dwelling adults and nursing home residents. Am J Clin Nutr. 2005 Nov;82(5):1074–81.

    Article  PubMed  CAS  Google Scholar 

  7. Suzana S Jr, Hanis MY, Tang SY, Ayiesah R, Roslina AM. Changes in Nutritional, Functional Status and Quality of Life of COPD Out-patients after a Pulmonary Rehabilitation Programme in HUKM: a Pilot Study. Malays J Nutr. 2008 Sep;14(2):151–62.

    PubMed  Google Scholar 

  8. Dent E, Chapman I, Piantadosi C, Visvanathan R. Nutritional screening tools and anthropometric measures associate with hospital discharge outcomes in older people. Australas J Ageing. 2015 Mar;34(1):E1–6.

    Article  PubMed  Google Scholar 

  9. Fukui H, Saito H, Ueno Y, Uto H, Obara K, Sakaida I, Shibuya A, Seike M, Nagoshi S, Segawa M, Tsubouchi H. Evidence-based clinical practice guidelines for liver cirrhosis 2015. J Gastroenterol. 2016 Jul;51(7):629–50.

    Article  PubMed  CAS  Google Scholar 

  10. de van der Schueren MAE, de Smoker M, Leistra E, Kruizenga HM. The association of weight loss with one-year mortality in hospital patients, stratified by BMI and FFMI subgroups. Clin Nutr. 2017 Aug 31. pii:S0261–5614(17)30307–2.[Epub ahead of print]

    Google Scholar 

  11. Pilgrim AL, Baylis D, Jameson KA, Cooper C, Sayer AA, Robinson SM, Roberts HC. Measuring appetite with the simplified nutritional appetite questionnaire identifies hospitalized older people at risk of worse health outcomes. J Nutr Health Aging. 2016 Jan;20(1):3–7.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  12. Wheelwright S, Darlington AS, Hopkinson JB, Fitzsimmons D, White A, Johnson CD. A systematic review of health-related quality of life instruments in patients with cancer cachexia. Support Care Cancer. 2013Sep;21(9):2625–36.

    Article  PubMed  Google Scholar 

  13. Savina C, Donini LM, Anzivino R, De Felice MR, De Bernardini L, Cannella C. Administering the «AHSP Questionnaire» (appetite, hunger, sensory perception) in a geriatric rehabilitation care. J Nutr Health Aging. 2003;7(6):385–9.

    PubMed  CAS  Google Scholar 

  14. Rachakonda V, Borhani AA, Dunn MA, Andrzejewski M, Martin K, Behari J. Serum Leptin Is a Biomarker of Malnutrition in Decompensated Cirrhosis. PLoS One. 2016 Sep 1;11(9):e0159142.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  15. Chiari MM, Bagnoli R, De Luca PD, Monti M, Rampoldi E, Cunietti E. Influence of acute inflammation on iron and nutritional status indexes in older inpatients. J Am Geriatr Soc. 1995 Jul;43(7):767–71.

    Article  PubMed  CAS  Google Scholar 

  16. Barkoukis H. Nutrition Recommendations in Elderly and Aging. Med Clin North Am, 2016,Nov,100,6,1237–1250.

    Article  PubMed  Google Scholar 

  17. Helfenstein SF, Uster A, Rühlin M, Pless M, Ballmer PE, Imoberdorf R. Are four simple questions able to predict weight loss in outpatients with metastatic cancer? A prospective cohort study assessing the simplified nutritional appetite questionnaire. Nutr Cancer. 2016 Jul;68(5):743–9.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Nho JH, Kim SR, Kwon YS. Depression and appetite: predictors of malnutrition in gynecologic cancer. Support Care Cancer. 2014 Nov;22(11):3081–8.

    Article  PubMed  Google Scholar 

  19. Engel JH, Siewerdt F, Jackson R, Akobundu U, Wait C, Sahyoun N. Hardiness, depression, and emotional well-being and their association with appetite in older adults. J Am Geriatr Soc. 2011 Mar;59(3):482–7.

    Article  PubMed  Google Scholar 

  20. Akner G, Cederholm T. Treatment of protein-energy malnutrition in chronic nonmalignant disorders. Am J Clin Nutr. 2001 Jul;74(1):6–24.

    Article  PubMed  CAS  Google Scholar 

  21. Durazzo M, Campion D, Fagoonee S, Pellicano R. Gastrointestinal tract disorders in the elderly. Minerva Med. 2017 Sep 22. [Epub ahead of print]

    Google Scholar 

  22. Vlahcevic ZR, Buhac I, Bell CC Jr, Swell L. Abnormal metabolism of secondary bile acids in patients with cirrhosis. Gut. 1970 May;11(5):420–2.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  23. Nardone R, Höller Y, Storti M, Lochner P, Tezzon F, Golaszewski S, Brigo F, Trinka E. Spinal cord involvement in patients with cirrhosis. World J Gastroenterol, 2014,Mar,20,10,2578–85.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Kalaitzakis E. Gastrointestinal dysfunction in liver cirrhosis. World J Gastroenterol. 2014 Oct 28;20(40):14686–95.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Infectious Diseases and Hepatic Diseases, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Canglang District, Suzhou, 215006, Jiangsu Province, China

    T. Wang

  2. Department of Gastroenterology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Canglang District, Suzhou, 215006, Jiangsu Province, China

    Jiaqing Shen

Authors
  1. T. Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jiaqing Shen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jiaqing Shen.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wang, T., Shen, J. Usefulness of Simplified Nutritional Appetite Questionnaire (SNAQ) in Appetite Assessment in Elder Patients with Liver Cirrhosis. J Nutr Health Aging 22, 911–915 (2018). https://doi.org/10.1007/s12603-018-1086-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-018-1086-5

Key words

Search

Navigation