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.
Similar content being viewed by others
References
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.
Thandassery RB, Montano-Loza AJ. Role of Nutrition and Muscle in Cirrhosis. Curr Treat Options Gastroenterol, 2016,Jun,14,2,257–73.
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.
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.
Purnak T, Yilmaz. Liver disease and malnutrition. Best Pract Res Clin Gastroenterol. 2013 Aug;27(4):619–29.
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.
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.
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.
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.
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]
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.
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.
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.
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.
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.
Barkoukis H. Nutrition Recommendations in Elderly and Aging. Med Clin North Am, 2016,Nov,100,6,1237–1250.
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.
Nho JH, Kim SR, Kwon YS. Depression and appetite: predictors of malnutrition in gynecologic cancer. Support Care Cancer. 2014 Nov;22(11):3081–8.
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.
Akner G, Cederholm T. Treatment of protein-energy malnutrition in chronic nonmalignant disorders. Am J Clin Nutr. 2001 Jul;74(1):6–24.
Durazzo M, Campion D, Fagoonee S, Pellicano R. Gastrointestinal tract disorders in the elderly. Minerva Med. 2017 Sep 22. [Epub ahead of print]
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.
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.
Kalaitzakis E. Gastrointestinal dysfunction in liver cirrhosis. World J Gastroenterol. 2014 Oct 28;20(40):14686–95.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
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
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12603-018-1086-5