Iwasa Motoh, Iwata Kazuko, Kaito Masahiko, Ikoma Jiro, Yamamoto Mika, Takeo Masaki, Kuroda Makoto, Fujita Naoki, Kobayashi Yoshinao, Adachi Yukihiko
Third Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan.
Nutrition. 2004 Apr;20(4):368-71. doi: 10.1016/j.nut.2003.12.009.
A diet restrictive in total calories, fat, iron, and protein intake reduces serum alanine aminotransferase levels in patients with long-term hepatitis C virus infection. However, whether long-term dietary therapy causes adverse effects such as malnutrition and anemia due to a shortage of energy intake is not clear. We evaluated the balance of energy intake and changes in physical and hematologic indices of nutrition after a long-term dietary therapy.
Twenty-two patients with long-term hepatitis C virus infection that did not respond to or who were able or unwilling to take interferon therapy were enrolled in this study. Our prescriptions included 7 mg/d or less of iron, 30 kcal. kg(-1). d(-1) of energy, 1.1 to 1.2 g. kg(-1). d(-1) of protein, and a fat energy fraction of 20%. Patients were followed for 24 mo.
Mean body fat percentage was 24.6% at entry and was significantly reduced after the diet prescription. Mean serum ferritin decreased significantly from 376 ng/mL at entry to 141 ng/mL after 24 mo. Mean serum alanine aminotransferase levels decreased significantly from 66 to 49 IU/L. Mean levels of hemoglobin, serum albumin, and cholinesterase did not change significantly during the follow-up period.
These results suggest that restriction of energy, fat, iron, and protein intakes is safely tolerated, so its long-term use should be recommended to patients with long-term infection with hepatitis C virus.
限制总热量、脂肪、铁和蛋白质摄入的饮食可降低长期丙型肝炎病毒感染患者的血清丙氨酸氨基转移酶水平。然而，长期饮食治疗是否会因能量摄入不足而导致营养不良和贫血等不良反应尚不清楚。我们评估了长期饮食治疗后能量摄入的平衡以及营养状况的身体和血液学指标变化。
本研究纳入了22例对干扰素治疗无反应或能够或不愿意接受干扰素治疗的长期丙型肝炎病毒感染患者。我们的处方包括铁摄入量7mg/d或更低、能量30kcal·kg⁻¹·d⁻¹、蛋白质1.1至1.2g·kg⁻¹·d⁻¹以及脂肪能量占比20%。对患者进行了24个月的随访。
入组时平均体脂百分比为24.6%，饮食处方后显著降低。平均血清铁蛋白从入组时的376ng/mL显著降至24个月后的141ng/mL。平均血清丙氨酸氨基转移酶水平从66IU/L显著降至49IU/L。血红蛋白、血清白蛋白和胆碱酯酶的平均水平在随访期间无显著变化。
这些结果表明，能量、脂肪、铁和蛋白质摄入的限制耐受性良好，因此应建议长期丙型肝炎病毒感染患者长期使用。
