酗酒者和慢性肝病患者的生活质量与营养状况

Panagaria N, Varma K, Nijhawan S, Mathur A, Rai R R

Department of Gastroenterology, SMS Medical College & Hospital, Department of Home Science, University of Rajasthan, Jaipur.

Trop Gastroenterol. 2007 Oct-Dec;28(4):171-5.

OBJECTIVE

The aim of the study was to assess and compare the nutritional status and quality of life in chronic liver disease (alcoholic and non-alcoholic) patients and alcohol addicts.

METHODS

Patients with alcoholic liver disease (n=41), nonalcoholic liver disease (n=40), alcohol addicts (n=25) without liver disease and healthy controls (n=25) were randomly selected. Nutritional status was assessed using anthropometric measurements viz. skin fold thickness, arm muscle circumference and area. Biochemical estimations included liver function tests. Food intake was assessed using 48 hour recall and macro-nutrient intake was calculated. Quality of life was assessed using the SF-36 questionnaire.

RESULTS

The mean value of mid-arm muscle area was significantly lower in patients from the non-alcoholic liver disease group when compared with the other 2 groups (p= 0.0). Body fat store depletion was significantly lower in the alcohol addict group when set against the alcoholic liver disease and non-alcoholic liver disease groups (p= 0.0). The mean percentages of ideal calories (p= 0.0) and proteins (p= 0.0) were significantly higher in alcohol addicts but no significant differences in the mean percentage of fat intake (p= 0.1) was observed. The frequency of macro-nutrient deficiency was highest in the non-alcoholic liver disease group (p= 0.0). Ethanol consumption was not significantly different between alcohol addicts and patients suffering from alcoholic liver disease (p=0.06). Patients with liver disease (irrespective of aetiology) scored significantly lower on the quality of life scale when compared to alcohol addicts.

CONCLUSIONS

Malnutrition is more frequent and severe in patients suffering from chronic liver disease in comparison to alcohol addicts. The health status is significantly poorer in patients suffering from alcoholic liver disease. Alcohol does not seem to play a primary role in the pathogenesis of liver disease and malnutrition.

目的

本研究旨在评估并比较慢性肝病（酒精性和非酒精性）患者及酒精成瘾者的营养状况和生活质量。

方法

随机选取酒精性肝病患者（n = 41）、非酒精性肝病患者（n = 40）、无肝病的酒精成瘾者（n = 25）以及健康对照者（n = 25）。通过人体测量评估营养状况，即皮褶厚度、上臂肌肉周长和面积。生化检测包括肝功能测试。通过48小时回顾法评估食物摄入量并计算常量营养素摄入量。使用SF - 36问卷评估生活质量。

结果

与其他两组相比，非酒精性肝病组患者的上臂中部肌肉面积平均值显著更低（p = 0.0）。与酒精性肝病组和非酒精性肝病组相比，酒精成瘾组的体脂储备消耗显著更低（p = 0.0）。酒精成瘾者的理想卡路里平均百分比（p = 0.0）和蛋白质平均百分比（p = 0.0）显著更高，但脂肪摄入平均百分比无显著差异（p = 0.1）。非酒精性肝病组的常量营养素缺乏频率最高（p = 0.0）。酒精成瘾者与酒精性肝病患者的乙醇消耗量无显著差异（p = 0.06）。与酒精成瘾者相比，患有肝病（无论病因）的患者在生活质量量表上的得分显著更低。