&lt;p&gt;Improvement of energy substrate metabolism by late evening snack supplementation in patients with liver cirrhosis: a meta-analysis&lt;/p&gt;

Background The prevalence of primary biliary cholangitis (PBC), which is an autoimmune liver disease, has increased over time. PBC often leads to severe consequences, such as liver failure and death. Stratification tools using biochemical liver tests are needed to assess and predict the progression of this disease at the time of PBC diagnosis. Methods We searched PubMed, Cochrane Library, Web of Science, and Embase for studies focused on the relationship between positive rates of Gp210 antibodies and poor prognosis of PBC. The primary end point was the number of PBC patients with poor outcome in the Gp210 antibody (+) and Gp210 antibody (−) groups. The secondary end point was the basic serum level of alanine aminotransferase (ALT), alkaline phosphatase (ALP), total bilirubin (TBIL), and IgM in the two groups. The age and number of female patients were also measured. Results A total of 5 studies, comprising 737 patients, were included in this analysis. A positive rate of Gp210 antibodies was positively correlated with poor outcomes and with many types of progression in PBC, especially liver failure. Mortality was also higher in the Gp210 antibody (+) group. Furthermore, the serum levels of ALP and IgM were associated with the positive rate of Gp210 antibodies, while the serum levels of ALT and TBIL were not. The age and number of female patients were also not associated with the positive rate of Gp210 antibodies. Conclusion PBC-specific Gp120 antibodies are optimal predictors of PBC prognosis at the time of diagnosis. Some other liver function indicators, such as ALP and IgM, can be used as predictors to complement Gp210 antibodies to establish a stratification tool to predict the prognosis of PBC at the time of diagnosis.

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“…We followed the methods of a published article by Yao et al [9]. The processes of study retrieval and analysis were as follows.…”

Section: Methodsmentioning

confidence: 99%

Early Prognostic Utility of Gp210 Antibody-Positive Rate in Primary Biliary Cholangitis: A Meta-Analysis

et al. 2019

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“…Patients with liver cirrhosis have poor glycogen reserves and abnormal metabolism of energy substrates, meaning their states of starvation after 10 h are comparable to starvations lasting 2–3 days for healthy individuals ( 2 ). Nighttime snacking is an effective intervention to avoid abnormal protein consumption caused by prolonged fasting ( 3 ). At present, domestic and foreign guidelines recommend that patients with liver cirrhosis should not undergo more than 12 h of fasting, and that their daily calorie intake should be divided into 4–6 meals, including nighttime snacks ( 1 , 2 ).…”

Section: Introductionmentioning

confidence: 99%

“…At present, domestic and foreign guidelines recommend that patients with liver cirrhosis should not undergo more than 12 h of fasting, and that their daily calorie intake should be divided into 4–6 meals, including nighttime snacks ( 1 , 2 ). Nighttime snacking has been proven to improve the energy metabolism, hepatic functional reserve and sarcopenia in patients with cirrhosis, all of which increase the patients' chances of survival ( 3 , 4 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical effect of nighttime snacking on patients with hepatitis B cirrhosis

Han

Zhang

et al. 2023

Front. Nutr.

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ObjectiveNighttime snacking is an effective intervention to avoid abnormal protein consumption caused by prolonged fasting. This article aims to evaluate the clinical efficacy of nighttime snacking on patients with hepatitis B cirrhosis and to provide new ideas for clinical nutritional intervention.MethodsThe study participants were randomly assigned to the control group (n = 30) and the observation group (n = 30); the former was administered medical system treatment and routine dietary intervention, and the latter was administered the same treatment with the addition of nighttime snacking. After 3 months of intervention with different dietary guidance, the dry body weight body mass index (BMI), upper arm muscle circumference (AMC), grip strength, triceps skinfold thickness (TSF), third lumbar skeletal muscle index (L3-SMI), albumin (ALB), total bilirubin (T-BIL), cholinesterase (CHE), Fried's frailty phenotype score, Child–Pugh score and various cirrhosis complication rates were compared between the two groups.ResultsThere was no significant difference in the baseline data between the two groups before the dietary intervention. After 3 months of regular dietary guidance in the control group, the grip strength increased compared with the baseline data (p < 0.05), while the dry body weight BMI, AMC, TSF, L3-SMI, ALB, T-BIL, CHE, prothrombin time, international normalized ratio, prothrombin activity, and Child–Pugh scores were not significantly different (p > 0.05). After 3 months of dietary guidance with nighttime snacking in the observation group, the dry body weight BMI, grip strength, TSF, L3-SMI, and CHE scores all increased, compared with the baseline data, while the Child–Pugh score decreased compared with the baseline level (all p < 0.05). After 3 months of intervention, the Child–Pugh score of the observation group showed a more significant decrease than the control group, while the dry body weight BMI, grip strength, ALB and CHE scores were all significantly higher than those in the control group (all p < 0.05). Overall, the improvement rate was significantly higher in the observation group than in the control group (p < 0.05).ConclusionNighttime snacking for hepatitis B cirrhosis patients with nutritional risk is beneficial in terms of the recovery of liver synthesis functions, improvements in clinical indicators, sarcopenia corrections and improvements in malnutrition-related complications.

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“…Researchers have previously demonstrated LES was the benefit for liver function and malnutrition in cirrhotic patients. [11,12] However, the efficacy of LES supplementation on blood glucose in cirrhotic patients with impaired insulin resistance (IR) or even HD is yet to be fully confirmed. Furthermore, existing guidelines do not provide a consensus on the dietary requirements for HD.…”

Section: Introductionmentioning

confidence: 99%

Effects of late evening snacks on glucose homeostasis in cirrhotic patients: A meta-analysis

et al. 2023

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Background: Insulin resistance and hepatogenic diabetes are common complications in patients with liver cirrhosis. Previous studies have shown that reducing the fasting phase by supplying a late evening snack (LES) is a potential intervention to improve substrate utilization and liver function. However, the underlying mechanisms need to be further elucidated. The purpose of current meta-analysis is to evaluate effects of LES on glucose homeostasis in cirrhotic patients.Methods: Electronic databases including PubMed, Web of Science, and major scientific conference sessions were searched without language restriction and carried out on March 1, 2022 with an additional manual search of bibliographies of relevant articles. A total of 4145 studies were identified, and 10 studies were eligible for the meta-analysis, comprising 631 patients (319 in the LES group and 312 in the non-LES group). Subgroup analyses were performed to investigate the effect of LES on cirrhotic patients with or without diabetes.Results: Analysis showed that LES intervention had significant effects in cirrhotic patients for glycemic parameters on fasting plasma glucose, fasting insulin, and glycosylated hemoglobin respective effect sizes of −8.7, −0.86, and −0.76. Subgroup result revealed that the effect of LES on fasting plasma glucose is higher in cirrhotic patients with diabetes group than cirrhotic patients without diabetes group, and long-term LES supplementation (>2 months) was more beneficial to maintain glucose homeostasis in cirrhotic patients than that of short-term supplementation (<2 months). LES also had significant effect on nutritional metabolic parameters like including albumin and non-protein respiratory quotient.Conclusion: Meta-analysis indicated that LES not only improved malnutrition in cirrhotic patients with or without diabetes but also maintain glucose homeostasis in cirrhotic patients with diabetes. LES is a promising and simple intervention that beneficial to maintain glucose homeostasis in cirrhotic patients.Abbreviations: ALB = albumin, BCAA = branched-chain amino acid, CI = confidence interval, FINS = fasting serum insulin, FPG = fasting plasma glucose, HbA1c = glycosylated hemoglobin, HD = hepatogenic diabetes, HOMA-IR = homeostasis model assessment method for IR, IR = insulin resistance, LC = liver cirrhosis, LES = late evening snack, MD = mean difference, npRQ = non-protein respiratory quotient.

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<p>Improvement of energy substrate metabolism by late evening snack supplementation in patients with liver cirrhosis: a meta-analysis</p>

Cited by 6 publications

References 29 publications

Early Prognostic Utility of Gp210 Antibody-Positive Rate in Primary Biliary Cholangitis: A Meta-Analysis

Early Prognostic Utility of Gp210 Antibody-Positive Rate in Primary Biliary Cholangitis: A Meta-Analysis

Clinical effect of nighttime snacking on patients with hepatitis B cirrhosis

Effects of late evening snacks on glucose homeostasis in cirrhotic patients: A meta-analysis

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