Nutritional Therapy in Patients with Liver Cirrhosis

Abstract

As an intervention for energy malnutrition in patients with liver cirrhosis, frequent meals or a late evening snack (LES) have recently been recommended. We investigated which would be better for the improvement of energy malnutrition and glucose intolerance in cirrhotic patients, treatment with an LES alone or an LES plus divided meals. We examined one group of cirrhotic patients that received oral supplementation with one pack of a branched-chain amino acid (BCAA)-enriched nutrient, Aminoleban EN (210Kcal), taken at 10 p.m. as an LES, and a second group that received two packs of Aminoleban EN (one pack as an LES, and one pack taken during the day) to determine the influence of the LES on the blood glucose level, biochemical parameters, and energy metabolism. The administration period was 7 days. Metabolic measurements were performed using indirect calorimetry. The fat oxidation rate was significantly decreased and the carbohydrate oxidation rate was significantly increased in both groups. As a result, the respiratory quotient (RQ) was significantly improved. There was also a significant correlation between the nonprotein respiratory quotient (npRQ) and the creatinine-height index. LES alone improved the energy malnutrition state and glucose intolerance equivalent to LES plus divided meals.