Influence of liver failure, ascites, and energy expenditure on the response to oral nutrition in alcoholic liver cirrhosis

Campillo, Bernard; Bories, Phuong Nhi; Pornin, Béatrice; Devanlay, M

doi:10.1016/s0899-9007(97)83001-8

Cited by 63 publications

(36 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…weight loss, was independently correlated with the GSRS indigestion score indicating a possible role of gastrointestinal symptoms in the poor food intake frequently observed in cirrhotics [9,11,14]. In accordance with this assumption, we have recently shown that upper gastrointestinal symptoms in patients with cirrhosis are associated with a decreased intake of calories as measured by a caloric satiety drinking test [155].…”

Section: Gastrointestinal Symptoms (I)mentioning

confidence: 63%

“…Malnutrition is common in patients with liver cirrhosis with a reported prevalence as high as 80% depending on the patient population studied and disease severity [9,[11][12][13][14]. It has been reported to correlate with etiology of liver disease (higher in alcoholic than in non-alcoholic cirrhosis) [13], but some controversy exists [15].…”

Section: Malnutrion In Liver Cirrhosismentioning

confidence: 99%

“…It has been demonstrated that triceps skinfold thickness and mid-arm muscle circumference can be measured fairly accurately in patients with advanced liver disease and that they are only mildly affected by fluid retention [9]. Anthropometric measurements have been proposed as the most practical objective indices of nutritional depletion in chronic liver disease [9] and they are widely used in the nutritional evaluation of patients with cirrhosis [9,[11][12][13][14]. In study III, skinfold thickness at the biceps, subscapular, and suprailiac sites were also measured and percent body fat was calculated [143], a method shown to have comparable results with dual energy x-ray absorptiometry in cirrhotics without overt fluid retention [144].…”

Section: Nutritional Status Assessment (I II Iii)mentioning

confidence: 99%

See 2 more Smart Citations

Intestinal permeability in cirrhotic patients with and without ascites

Kalaitzakis

Johansson

Bjarnason³

et al. 2006

Scandinavian Journal of Gastroenterology

View full text Add to dashboard Cite

Malnutrition is a common finding in patients with liver cirrhosis. Malnutrition has been shown to be associated with increased morbidity and mortality. Its pathogenesis remains unclear but both poor dietary intake and increased energy expenditure have been reported.Spontaneous bacterial peritonitis is an important clinical problem in cirrhotics. It may occur as a consequence of repeated access of bacteria from the intestinal lumen (translocation) to the mesenteric lymph nodes. One of the mechanisms proposed to explain bacterial translocation in cirrhosis includes increased intestinal permeability.The aims of the present study were to evaluate GI symptoms in cirrhotic patients and their possible relation to nutritional status, to assess whether gastric sensorimotor dysfunction or metabolic disturbances are associated with reduced food intake, and to investigate the role of ascites in intestinal permeability in patients with liver cirrhosis.Gastrointestinal symptoms and health-related quality of life (HRQOL) were assessed with the aid of two questionnaires. Gastric sensorimotor function was measured by means of an electronic barostat. Food intake, as assessed with a food diary, was related to fasting and postprandial glucose, insulin, leptin, and ghrelin concentrations. Intestinal permeability was evaluated by a 51 Cr-EDTA permeability test. Cirrhotics were found to have increased severity of GI symptoms compared with reference values from the general population. A relationship between GI symptoms and compromised HRQOL as well as weight loss was observed.Proximal stomach relaxation to a meal was increased in patients with liver cirrhosis as compared with healthy controls but the relation between gastric accommodation and energy intake was found to be disturbed in these patients. Gastric sensitivity to distension was shown to be related to GI symptom severity and to liver cirrhosis severity scores.Patients with liver cirrhosis exhibited higher postprandial insulin and glucose concentrations compared to controls. Cirrhotics had higher fasting leptin that fell significantly postmeal and they showed an attenuated increase of ghrelin before the next expected meal. Altered glucose and hormonal levels in patients with cirrhosis were associated with poor food intake.Only a few patients with cirrhosis had increased intestinal permeability, as assessed by a 51 Cr-EDTA test, which was not influenced to a major extent by ascites. Conclusions: In patients with liver cirrhosis GI symptom severity is high and it is associated with impaired HRQOL and weight loss. Gastric accommodation is not involved in the poor food intake observed in cirrhotics and gastric sensitivity seems to be a relevant factor for GI symptom generation in these patients. Altered postprandial glucose, leptin, and ghrelin levels are correlated to reduced energy intake in this patient group. Increased intestinal permeability is probably of limited importance in the pathophysiology of bacterial infections in patients with liver cirrhosis and ascites.

show abstract

Section: Gastrointestinal Symptoms (I)mentioning

confidence: 63%

Section: Malnutrion In Liver Cirrhosismentioning

confidence: 99%

Section: Nutritional Status Assessment (I II Iii)mentioning

confidence: 99%

See 1 more Smart Citation

Intestinal permeability in cirrhotic patients with and without ascites

Kalaitzakis

Johansson

Bjarnason³

et al. 2006

Scandinavian Journal of Gastroenterology

View full text Add to dashboard Cite

show abstract

“…We had previously shown that FM increased with refeeding in cirrhotic patients while liver function improved (Campillo et al, 1997). In this study, we investigated change in serum leptin levels in a group of 22 cirrhotic patients after 1 month of refeeding.…”

Section: Discussionmentioning

confidence: 92%

Serum leptin levels in alcoholic liver cirrhosis: relationship with gender, nutritional status, liver function and energy metabolism

et al. 2001

View full text Add to dashboard Cite

Objective: To determine serum leptin levels in alcoholic liver cirrhosis and the relationship with gender, nutritional status, liver function, energy metabolism, inflammatory state and refeeding. Subjects: Thirty-seven hospitalized alcoholic cirrhotic patients (M=F: 24=13), 27 hospitalized patients at risk of malnutrition but with normal liver function (M=F: 15=12) as control patients, and 31 healthy control subjects (M=F: 17=14) participated. Design: Liver function was assessed from Child -Pugh classification; anthropometric parameters and resting energy expenditure (REE) were measured; caloric intake was evaluated over 5 days; and serum leptin and insulin were assayed. The same protocol was performed after 1 month refeeding in 22 patients. Healthy subjects were studied as controls for anthropometric parameters and serum leptin levels. Results: Serum leptin levels were higher in male cirrhotic patients than in the other two male groups (P ¼ 0.0079) and in the same range in the female groups. They were higher in female than in male subjects in the three groups. In female cirrhotic patients, logarithmically transformed serum leptin levels correlated significantly with fat mass (P ¼ 0.0043), insulin levels (P ¼ 0.0072), REE (P ¼ 0.0133), bilirubin levels (P < 0.0001), prothrombin time (P ¼ 0.0003) and Pugh score (P ¼ 0.0266) in simple regression analysis and with insulin levels (P ¼ 0.0137), but not with fat mass (P ¼ 0.0761), Pugh score (P ¼ 0.4472) and REE (P ¼ 0.4576) in multiple regression analysis. In the male cirrhotic and control patients, log (leptin) levels correlated with CRP (C reactive protein) (r ¼ 0.365, P ¼ 0.0223). Log (leptin) levels did not correlate with caloric intake in any of the groups. Leptin levels (P < 0.05) and fat mass (P < 0.02) increased with refeeding while liver function improved (P < 0.01). Conclusion: There is a gender difference in regulation of serum leptin level in alcoholic liver cirrhosis. Insulin level is the best determinant of leptin level in female patients while inflammatory state related to alcoholic hepatitis seems to have a greater influence in male patients. Although leptin levels positively correlated with REE in female patients, there is no evidence that leptin reduces caloric intake and fat stores in these patients. Descriptors: leptin; liver cirrhosis; nutritional status; liver failure; energy metabolism European Journal of Clinical Nutrition (2001) 55, 980-988

show abstract

“…[1][2][3][4] However, there remains some debate as to the impact of disease severity, primary cause, and metabolic indices on nutritional status. [5][6][7][8] It is clear that the presence of undernutrition will impact negatively on clinical outcome. [9][10] Given this significance of nutritional status, it is surprising that few studies have examined the relationship of chronic liver disease with anorexia, a factor contributing to poor nutritional status.…”

mentioning

confidence: 99%

Macronutrient preference, dietary intake, and substrate oxidation among stable cirrhotic patients

et al. 1999

View full text Add to dashboard Cite

Anorexia in liver disease is common; however, its association with aberrant metabolism and the type of cirrhosis has not been considered. Dietary intake, nutritional status, fasting substrate oxidation, and macronutrient preference were examined in controls (n ‫؍‬ 18) and 65 patients with hepatocellular (n ‫؍‬ 31) or biliary cirrhosis (n ‫؍‬ 34). Energy intakes were lowest in hepatocellular patients (

show abstract

Influence of liver failure, ascites, and energy expenditure on the response to oral nutrition in alcoholic liver cirrhosis

Cited by 63 publications

References 22 publications

Intestinal permeability in cirrhotic patients with and without ascites

Intestinal permeability in cirrhotic patients with and without ascites

Serum leptin levels in alcoholic liver cirrhosis: relationship with gender, nutritional status, liver function and energy metabolism

Macronutrient preference, dietary intake, and substrate oxidation among stable cirrhotic patients

Contact Info

Product

Resources

About