Cirrhosis is an end-stage liver disease resulting from chronic liver injury due to a variety of causes, including viral hepatitis, alcohol consumption, and non-alcoholic fatty liver disease (NAFLD) [2, 4, 8]. It is characterized by fibrosis and the replacement of normal liver architecture with regenerative nodules, leading to liver dysfunction. Biochemical markers and nutritional deficiencies are critical in assessing the severity of cirrhosis and guiding therapeutic interventions [5, 9].

The liver plays a central role in various metabolic processes, including protein synthesis, iron storage, and vitamin metabolism. In cirrhosis, these functions are significantly impaired, leading to a cascade of metabolic derangements [6, 7]. Iron overload, hypoalbuminemia, and vitamin B12 deficiency are frequently observed in cirrhotic patients and are associated with disease progression and poor outcomes [10, 12].

Previous studies have highlighted the association between nutritional deficiencies and increased risk of complications in cirrhosis, such as hepatic encephalopathy and infections [1, 9]. However, there is limited data on the simultaneous assessment of biochemical and nutritional profiles in these patients. This study aims to bridge this gap by providing a comprehensive evaluation of liver function tests, iron profile, and vitamin B12 levels in cirrhosis.

The findings of this study could help clinicians better understand the metabolic alterations in cirrhosis and implement appropriate nutritional and therapeutic interventions. By addressing these deficiencies early, it may be possible to improve the quality of life and clinical outcomes for patients with cirrhosis [5, 12].

MATERIALS AND METHODS

Study Design

This is a cross-sectional observational study conducted on patients diagnosed with cirrhosis of the liver. Informed consent was collected from all participants.

Inclusion Criteria

1. Adults aged 18 years and above.
2. Patients diagnosed with cirrhosis based on clinical, biochemical, and imaging findings [4].
3. Stable patients without acute liver failure or infections.

Exclusion Criteria

1. Patients with comorbid conditions affecting biochemical or nutritional parameters, such as chronic kidney disease or malignancy.
2. Pregnant or lactating women.

Parameters Assessed

1. Biochemical Profile: Liver function tests (serum bilirubin, alanine aminotransferase [ALT], aspartate aminotransferase [AST], alkaline phosphatase [ALP], total protein, and albumin).
2. Nutritional Profile: Iron status (serum ferritin, transferrin saturation, and serum iron) and vitamin B12 levels.
3. Other Investigations: Complete blood count and coagulation profile[6,11].

Data Collection and Analysis

Blood samples were collected after overnight fasting. The biochemical and nutritional parameters were measured using standard laboratory techniques. Data were analyzed using appropriate statistical tools, with significance set at p < 0.05.

RESULTS

A total of 100 patients were enrolled in the study, with a mean age of 54.2 ± 12.8 years and a male-to-female ratio of 3:1. Alcoholic liver disease was the most common etiology, observed in 45% of patients, followed by viral hepatitis (30%) and NAFLD (20%)[4,8]. The biochemical profile showed significant abnormalities in liver function tests, including elevated bilirubin and reduced albumin levels. Nutritional deficiencies, particularly in vitamin B12 and iron metabolism, were also notable, especially in patients with advanced cirrhosis.

Patient Demographics

Biochemical Profile

Nutritional Profile

DISCUSSION

Biochemical Derangements

The elevated bilirubin, transaminases, and ALP levels reflect the ongoing hepatic damage and cholestasis in cirrhosis [2,4]. Hypoalbuminemia is a hallmark of liver dysfunction, indicating impaired protein synthesis. These findings are consistent with the progression of liver disease [1, 5]. The degree of derangement in these parameters is closely related to the severity of cirrhosis, highlighting their utility in disease monitoring.

Nutritional Deficiencies

Iron metabolism abnormalities are common in cirrhosis, with iron overload being a frequent finding [10]. Elevated ferritin levels could result from systemic inflammation, while low serum iron levels in some patients may reflect functional iron deficiency. Vitamin B12 deficiency, observed in a significant number of patients, can be attributed to impaired hepatic storage and metabolic dysfunction [6, 11]. Deficiencies in these micronutrients can exacerbate the complications of cirrhosis, including fatigue, anemia, and cognitive impairment.

Clinical Implications

The results underscore the importance of regular monitoring of biochemical and nutritional profiles in cirrhotic patients. Addressing nutritional deficiencies, particularly iron and vitamin B12, could improve patient outcomes and quality of life. Interventions such as dietary modification, supplementation, and close follow-up are critical. Furthermore, these findings emphasize the role of a multidisciplinary approach involving hepatologists, nutritionists, and primary care physicians in managing cirrhosis effectively.

This study highlights the significant biochemical and nutritional alterations in patients with cirrhosis of the liver. Regular assessment of liver function tests, iron status, and vitamin B12 levels is crucial for comprehensive management. Early identification and correction of these abnormalities can potentially mitigate disease progression and enhance overall patient care. Future research should focus on longitudinal studies to better understand the impact of correcting these deficiencies on long-term outcomes in cirrhotic patients. By addressing both biochemical and nutritional derangements, clinicians can improve survival rates and enhance the quality of life for these patients.

Acknowledgements

The authors would like to express their gratitude to the Department of Medicine at LNCT Medical College and Sewakunj Hospital, Indore for their invaluable support during the study. We are also thankful to the laboratory staff for their assistance in sample collection and analysis. Special thanks to all the participants who generously contributed their time and consent to make this study possible.

Conflict of Interest: The authors declare no conflict of interest regarding the publication of this study.

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