Improvement of fuel metabolism by nocturnal energy supplementation in patients with liver cirrhosis

Miwa, Yoshiyuki; Shiraki, Makoto; Kato, Masahiko; Tajika, Masahiro; Mohri, Hiromi; Murakami, Nobuo; Kato, Tomohiro; Ohnishi, Hiroo; Morioku, Toshie; Muto, Yasutoshi; Moriwaki, Hisataka

doi:10.1016/s1386-6346(99)00100-x

Cited by 77 publications

(85 citation statements)

References 12 publications

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“…In the previous studies with cirrhosis patients, LES has been shown to improve fuel utilization (Chang et al, 1997;Verboeket-van de Venne et al, 1995) and nitrogen economy (Zillikens et al, 1993;Swart et al, 1989). Late evening snack with liquid nutrient (Ensure Liquid) increased RQ and carbohydrate oxidation rates (Miwa et al, 2000). Acarbose, an a-glucosidase inhibitor given with LES, reduced the fasting b-hydroxybutyrate levels the next morning in alcoholic cirrhotic patients .…”

Section: Discussionmentioning

confidence: 99%

Effect of late evening snack with rice ball on energy metabolism in liver cirrhosis

et al. 2006

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Objective: This study investigates the effects of a late evening snack (LES), of 200 kcal of rice ball, on energy metabolism in cirrhotic patients. Impaired nutritional metabolism has been associated with cirrhosis, and frequent intake of small meals may prevent early-onset starvation, and maintain nourishment in these patients. Subjects: Twenty-one cirrhotic patients and 26 control subjects (Control) were recruited for this study. Patients were subsequently treated by LES (LC-LES) and by a non-LES regimen (LC-NLES).Method: Resting energy expenditure and respiratory quotient (RQ) were assessed by indirect calorimetry at 0830, 1130 and 1430. Blood glucose and non-esterified fatty acids (NEFA) were measured just before the energy metabolism measurements. The regular diet included three major meals and LES, at 0900, 1200, 1800 and 2100, respectively. The Control and LC-NLES groups received only the major meals, whereas the LC-LES group received three meals plus 200 kcal LES for 7 days. There was no difference in the total energy intake among Control, LC-NLES and LC-LES groups. Results: Respiratory quotient in LC-NLES was significantly lower than that of Control at 0830. Respiratory quotient value in LC-LES significantly elevated from that in LC-NLES. The RQ values did not differ among Control, LC-NLES and LC-LES at 2 h after the meal (1130 and 1430). Non-esterified fatty acids in LC-LES were lower than that in LC-NLES after overnight fasting. Conclusions: The ingestion of a 200 kcal rice ball LES can improve the nutritional metabolism in cirrhotic patients.

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Section: Discussionmentioning

confidence: 99%

Effect of late evening snack with rice ball on energy metabolism in liver cirrhosis

et al. 2006

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“…Similar findings have also been reported by other studies. Miwa et al (27) indicated that the respiratory quotient in patients with liver cirrhosis was significantly lower than that of healthy controls, with a marked increase in fat oxidation rate and lower carbohydrate oxidation rate. The energy metabolism of these changes is similar to the starvation status, which may lead to malnutrition.…”

Section: Discussionmentioning

confidence: 99%

Resting Energy Expenditure and Substrate Metabolism in Chinese Patients with Acute or Chronic Hepatitis B or Liver Cirrhosis

Meng

Wang

et al. 2010

Intern. Med.

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Objective Patients with liver disease usually have an imbalanced nutrient and energy metabolism that leads to malnutrition and seriously affects their prognosis. Therefore, it is of great clinical interest to understand the resting energy expenditure (REE) and oxidation rates of glucose, fat, and protein in these patients. Methods A total of 315 patients with liver diseases caused by hepatitis B virus were categorized into three groups: 20 acute hepatitis patients, 142 chronic hepatitis patients and 153 liver cirrhosis patients. The REE and the oxidation rates of glucose, fat and protein were assessed by indirect heat measurement. Energy intake data were also collected which were compared with the REE results. Results The REE per kg (REE/kg) were 27.34 ± 5.46 kJ/kg, 21.67 ± 5.01 kJ/kg and 19.07 ± 4.45 kJ/kg in acute, chronic hepatitis and liver cirrhosis patients (p=0.000), respectively. Respiratory quotient (RQ) tended to be lower in patients with chronic hepatitis and liver cirrhosis than that in acute hepatitis patients (p= 0.023). Energy, protein and carbohydrate intakes were lower in liver cirrhosis patients. Conclusion These data demonstrated that Chinese patients with chronic hepatitis B and liver cirrhosis had lower energy expenditure and abnormal substrate metabolism. Patients with chronic hepatitis and cirrhosis had a higher protein oxidation rate and a lower carbohydrate oxidation rate compared with acute hepatitis patients.

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“…1,3,5 Studies indicate that malnutrition is present in 20% to 80% of the patients with liver disease depending on the clinical stage of the disease. There is a high prevalence of malnutrition, especially in those with decompensated cirrhosis.…”

Section: 3mentioning

confidence: 99%

“…1,3 Other changes present in chronic liver diseases include those related to the Intermediary metabolism of carbohydrates, lipids, proteins, vitamins and minerals that oscillate according to the degree of impairment of liver function, which negatively influences the nutritional status of these patients. 1,3,5 Studies indicate that malnutrition is present in 20% to 80% of the patients with liver disease depending on the clinical stage of the disease. There is a high prevalence of malnutrition, especially in those with decompensated cirrhosis.…”

Section: Mini Reviewmentioning

confidence: 99%

Nutritional Implications in Chronic Liver Diseases

Fortes¹

2017

JLRDT

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Abbreviations: SGA, subjective global assessment; MI, maastricht index; NRI, nutritional risk index; BMI, body mass index; ESPEN, european society for parenteral and enteral nutrition; NT, nutritional therapy; BCAA, branched-chain amino acids; AAA, aromatic amino acids; MNTT, multiprofessional nutritional therapy team Mini reviewChronic liver disease-an inflammatory reaction in the liver of variable etiology and severity, with a progressive evolution characterized by the presence of fibrosis and alteration of the normal hepatic structure-presents with great nutritional impact, since the liver is the organ responsible for several biochemical pathways related to the production, modification and use of nutrients, among other important metabolic substances. 1Early stage liver disease may be asymptomatic or with nonspecific symptoms such as fatigue, anorexia/hyporexia, fever and malaise, easily confused with other diseases. As the disease progresses, hepatic insufficiency and portal hypertension may present with a symptomatic picture characterized by ascites, gastric/esophageal veins hemorrhage and hepatic encephalopathy. Chronic liver failure represents a continuous aggression to the hepatic parenchyma and has a multifactorial etiology, such as alcoholism, viral infections and accumulation of cytoplasmic fat and/or autoimmune disease.3 When the disease is irreversible and symptomatic, the prospect of survival is less than one year and, in these cases, liver transplantation may be indicated, since there are no clinical and/or surgical therapeutic alternatives. 4 The high mortality rate is present in chronic liver failure in detriment of the reduced functional capacity of the liver that can exceed 80%, a condition characterized by liver failure. In addition, this insufficiency is associated with an increased risk of developing hepatic encephalopathy. 3Hepatic encephalopathy, a neuropsychiatric syndrome characterized by changes in personality, behavior, reduction of cognition, motor function and level of consciousness is potentially reversible. However, during this clinical situation, an unfavorable prognosis with a high mortality rate is observed. 2,3Changes in anthropometric, biochemical and clinical indicators, associated with inadequate food intake are common in chronic liver disease. Changes in water compartments-ascites and peripheral edema-related to hypoalbuminemia and malnutrition are also present in the decompensated disease.1,3 Other changes present in chronic liver diseases include those related to the Intermediary metabolism of carbohydrates, lipids, proteins, vitamins and minerals that oscillate according to the degree of impairment of liver function, which negatively influences the nutritional status of these patients. 1,3,5 Studies indicate that malnutrition is present in 20% to 80% of the patients with liver disease depending on the clinical stage of the disease. There is a high prevalence of malnutrition, especially in those with decompensated cirrhosis. Already, in patients on a liver transplant list...

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Improvement of fuel metabolism by nocturnal energy supplementation in patients with liver cirrhosis

Cited by 77 publications

References 12 publications

Effect of late evening snack with rice ball on energy metabolism in liver cirrhosis

Effect of late evening snack with rice ball on energy metabolism in liver cirrhosis

Resting Energy Expenditure and Substrate Metabolism in Chinese Patients with Acute or Chronic Hepatitis B or Liver Cirrhosis

Nutritional Implications in Chronic Liver Diseases

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