Role of nutritional status and nutritional support in outcome of hepatitis B virus-associated acute-on-chronic liver failure.

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Abstrakt

Tytuł:: Role of nutritional status and nutritional support in outcome of hepatitis B virus-associated acute-on-chronic liver failure.
Autorzy:: Chang Y; Division of Gastroenterology and Hepatology, Tianjin Xiqing Hospital, Tianjin 300380, China.
Liu QY; Tianjin Key Laboratory of Hepatopancreatic Fibrosis and Molecular Diagnosis and Treatment, Tianjin 300162, China.
Zhang Q; Division of Gastroenterology and Hepatology, Tianjin Xiqing Hospital, Tianjin 300380, China.
Rong YM; Tianjin Key Laboratory of Hepatopancreatic Fibrosis and Molecular Diagnosis and Treatment, Tianjin 300162, China.
Lu CZ; Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin 300192, China.
Li H; Division of Gastroenterology and Hepatology, Tianjin Xiqing Hospital, Tianjin 300380, China.
Źródło:: World journal of gastroenterology [World J Gastroenterol] 2020 Aug 07; Vol. 26 (29), pp. 4288-4301.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: 2014- : Pleasanton, CA : Baishideng Publishing Group
Original Publication: Beijing : WJG Press, c1998-
MeSH Terms:: Acute-On-Chronic Liver Failure*/diagnosis
Acute-On-Chronic Liver Failure*/therapy
Hepatitis B, Chronic*/complications
Hepatitis B, Chronic*/diagnosis
Asia ; Hepatitis B virus ; Humans ; Nutritional Status ; Nutritional Support
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Contributed Indexing:: Keywords: Cytokine; Hepatitis B; Intestinal host defense; Liver failure; Nutrition therapy; Prognosis
Entry Date(s):: Date Created: 20200828 Date Completed: 20210514 Latest Revision: 20210514
Update Code:: 20240105
PubMed Central ID:: PMC7422541
DOI:: 10.3748/wjg.v26.i29.4288
PMID:: 32848334
: Czasopismo naukowe

Background: Hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) is an important type of liver failure in Asia. There is a direct relationship between HBV-ACLF and gastrointestinal barrier function. However, the nutritional status of HBV-ACLF patients has been poorly studied.
Aim: To investigate the nutritional risk and nutritional status of HBV-ACLF patients and evaluated the impact of nutritional support on the gastrointestinal barrier and 28-d mortality.
Methods: Nutritional risk screening assessment and gastrointestinal barrier biomarkers of patients with HBV-ACLF ( n = 234) and patients in the compensatory period of liver cirrhosis (the control group) ( n = 234) were compared during the period between 2016 and 2018. Changes were analyzed after nutritional support in HBV-ACLF patients. Valuable biomarkers have been explored to predict 28-d death. The 28-d survival between HBV-ACLF patients with nutritional support ( n = 234) or no nutritional support (2014-2016) ( n = 207) was compared.
Results: The nutritional risk of the HBV-ACLF patients was significantly higher than that of the control group. The nutritional intake of the patients with HBV-ACLF was lower than that of the control group. The decrease in skeletal muscle and fat content and the deficiency of fat intake were more obvious ( P < 0.001). The coccus-bacillus ratio, secretory immunoglobulin A, and serum D-lactate were significantly increased in HBV-ACLF patients. The survival group had a lower nutritional risk, lower D-lactate, and cytokine levels (endotoxin, tumor necrosis factor alpha, interleukin-10, and interleukin-1). Interleukin-10 may be a potential predictor of death in HBV-ACLF patients. The 28-d survival of the nutritional support group was better than that of the non-nutritional support group ( P = 0.016).
Conclusion: Patients with HBV-ACLF have insufficient nutritional intake and high nutritional risk, and their intestinal barrier function is impaired. Individualized and dynamic nutritional support is associated with a better prognosis of 28-d mortality in HBV-ACLF patients.
Competing Interests: Conflict-of-interest statement: No conflicts of interest, financial or otherwise, are declared by the authors.
(©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)

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