Original Articles
Effect of late night snack on nutritional status and quality of life in cirrhotic patients
Jinling Dong, Yuying Liu, Lizhen Sun, Meiying He, Jianfeng Huang, Ming Hu, Ying Li, Haimei Wang, Zhongying Bao, Hongwei Yu, Shengli Li, Juan Zhao, Shuyun Shi, Juan Li, Qinghua Meng
Published 2016-12-30
Cite as Chin J Clin Nutr, 2016, 24(6): 342-348. DOI: 10.3760/cma.j.issn.1674-635X.2016.06.004
Abstract
ObjectiveTo investigate the changes in energy metabolism, disease status and quality of life in liver cirrhosis patients after 3 months of nutrition intervention in the form of late night snack.
MethodsThis study is a prospective, open-label, multicenter study with a total of 105 patients with HBV-related cirrhosis in 8 city and suburban hospital in Beijing. All the patients received the intervention of 836.4 kJ of late night snacks for 3 months. The nutritional status was evaluated with Nutritional Risk Screening 2002 (NRS 2002), Subjective Global Assessment, traditional nutrition index, metabolic cart, and WHOQOL-BREF questionnaire. We compared the nutritional status, liver function index, complications and quality of life of the patients before (baseline) and 3 months after the intervention.
ResultsChild-Pugh A, B, C grade accounted for 60.00% (63/105), 31.43% (33/105), and 8.57% (9/105), respectively of the 105 patients with hepatitis B cirrhosis. 91 cases with albumin (ALB) >30 g/L were assessed using NRS2002, 37.36% (34/91) of whom had NRS 2002≥3.According to Subjective Global Assessment, the prevalence of malnutrition was 34.39% before and 10.47% after the intervention (P<0.05). Liver function indexes were significantly improved after intervention compared with the baseline: serum total protein (TP) [(66.59 ±8.73)g/L vs. (68.25± 7.89)g/L], albumin (ALB)[(38.52 ± 6.60)g/L vs. (39.82 ±5.79)g/L], pre albumin (PALB)[(1 519.70±690.40)mg/L vs. (1 731.10±651.10)mg/L], cholinesterase (CHE)[(5 273.17±2 358.85)U/L vs. (5 569.81 ±2 110.41)U/L], total cholesterol (TC)[(3.86±1.02)mmol/L vs.(4.03 ± 0.92)mmol/L] (all P<0.05). After the intervention, the proportion of Child-Pugh grade A patients increased from 60% to 72.38%, and the proportion of Child-Pugh grade C patients reduced from 8.57% to 1.90% (both P<0.05). In terms of complications, the prevalence of ascites (26.67% vs. 12.38%) and spontaneous bacterial peritonitis (10.48% vs. 1.90%) were reduced (both P<0.05). Compared with before the intervention, the quality of life of the patients was improved [(73.81±10.07) vs. (76.95±10.20), P<0.05]. Baseline and 3-month measurement of energy metabolism were completed in 46 patients: respiratory quotient (0.80±0.07 vs. 0.84±0.07) and carbohydrate oxidation rate [(41.93±11.33)% vs. (51.11±8.96)%] were significantly higher after intervention (both P<0.05), while protein oxidation rate [(22.13±4.34)% vs. (18.76±2.90)%] and fat oxidation rate [(35.93±11.01)% vs. (30.35±8.60)%] were significantly lower (both P<0.05).
ConclusionThe continuous intervention with 836.4 kJ of carbohydrates may reduce the decomposition of protein and fat in patients with cirrhosis, improve liver function, reduce complications, and improve patient quality of life.
Key words:
Liver cirrhosis; Nutritional support; Late night snack
Contributor Information
Jinling Dong
Department of Severe Liver Diseases, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China
Yuying Liu
Lizhen Sun
Meiying He
Jianfeng Huang
Ming Hu
Ying Li
Haimei Wang
Zhongying Bao
Hongwei Yu
Shengli Li
Juan Zhao
Shuyun Shi
Juan Li
Qinghua Meng