Association of Liver Immune Status Index With the Nutritional Status and Prognosis in Patients With Cirrhosis

BACKGROUND/AIM: In patients with cirrhosis, decreased immune function is observed and is considered to lead to various unfavorable clinical events. Although it is not easy to clinically evaluate the immune status of patients, the Liver Immune Status Index (LISI) was recently proposed as an indicator to estimate the immune status of patients after hepatectomy for hepatocellular carcinoma. We investigated the relationship between the LISI and liver function, nutritional status, and prognosis of patients with cirrhosis. PATIENTS AND METHODS: The present study analyzed 319 patients with cirrhosis who underwent nutritional assessment using indirect calorimetry at our institution. Associations between LISI values and liver functional parameters, nutritional status, and the prognosis of patients with cirrhosis were assessed. RESULTS: LISI values increased in line with disease severity and positively correlated with the Child-Pugh and albumin-bilirubin (ALBI) scores. The LISI was inversely associated with the geriatric nutritional risk index (GNRI) value, and the LISI values in patients with protein malnutrition were higher than in those without protein malnutrition. In addition, LISI values were higher in patients with energy malnutrition than in those without. When we classified the patients into two groups according to the median LISI, patients with a high LISI had a poorer prognosis than those with a low LISI. CONCLUSION: The LISI was associated with the severity of liver fibrosis, decreased liver function, and malnutrition. In addition, the LISI value was related to a poor prognosis.