Ren Meixin, Li Juan, Xue Ran, Wang Zhongying, Coll Shengli Li, Meng Qinghua
Department of Critical Care Medicine of Liver Disease, Beijing You-An Hospital.
Department of Gastroenterology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Medicine (Baltimore). 2019 May;98(19):e15528. doi: 10.1097/MD.0000000000015528.
Energy metabolism in patients with Hepatocellular carcinoma (HCC) accompanying by hepatitis B cirrhosis is unknown.To compare the differences in liver functions and energy metabolism between patients with hepatitis B-related cirrhosis and patients with HCC.This was a retrospective study of patients with hepatitis B-related cirrhosis (LC group, n = 75) and patients with HCC accompanying by hepatitis B cirrhosis (HCC group, n = 80) treated in Beijing You'an Hospital between January 2013 and June 2017. The resting energy expenditure (REE), respiratory quotient (RQ), carbohydrate oxidation rate (CHO%), fat oxidation rate (FAT%), and protein oxidation rate (PRO%) were measured using a metabolic cart. Liver function, renal function, blood coagulation, etc. were collected.Compared to the LC group, patients with HCC had normal metabolism, but RQ (0.83 ± 0.07 vs 0.85 ± 0.08, P = .073) and CHO% (35.5% vs 49%, P = .013) were lower and FAT% was higher (41% vs 33%, P = .030). Compared with patients with LC group, albumin (ALB), γ-glutamyltranspeptadase (GGT), alkaline phosphatase (AKP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and prothrombin time activity (PTA) were elevated in the HCC group, while total bilirubin (TB), total bile acid (TBA), and international normalized ratio (INR) were reduced (P < .05). Cholinesterase (CHE) was positively correlated with RQ, CHO, and CHO% (P < .05), while negatively correlated with FAT and FAT% (P < .05). AKP was negatively correlated with RQ, CHO, and CHO% (P < .05), while positively correlated with FAT and FAT% (P < .05). TBA was negatively correlated with RQ and CHO (P < .05), while positively correlated with FAT (P < .05).HCC leads to increased liver synthetic function and improve the liver functions of patients with LC, at least to some extent, but the nutritional metabolism was poor.
伴有乙型肝炎肝硬化的肝细胞癌（HCC）患者的能量代谢情况尚不清楚。为比较乙型肝炎相关性肝硬化患者与HCC患者的肝功能及能量代谢差异。这是一项对2013年1月至2017年6月在北京佑安医院接受治疗的乙型肝炎相关性肝硬化患者（LC组，n = 75）和伴有乙型肝炎肝硬化的HCC患者（HCC组，n = 80）的回顾性研究。使用代谢车测量静息能量消耗（REE）、呼吸商（RQ）、碳水化合物氧化率（CHO%）、脂肪氧化率（FAT%）和蛋白质氧化率（PRO%）。收集肝功能、肾功能、凝血等指标。与LC组相比，HCC患者代谢正常，但RQ（0.83±0.07 vs 0.85±0.08，P = 0.073）和CHO%（35.5% vs 49%，P = 0.013）较低，FAT%较高（41% vs 33%，P = 0.030）。与LC组患者相比，HCC组白蛋白（ALB）、γ-谷氨酰转肽酶（GGT）﹑碱性磷酸酶（AKP）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）和凝血酶原时间活动度（PTA）升高，而总胆红素（TB）、总胆汁酸（TBA）和国际标准化比值（INR）降低（P < 0.05）。胆碱酯酶（CHE）与RQ、CHO及CHO%呈正相关（P < 0.05），而与FAT及FAT%呈负相关（P < 0.05）。AKP与RQ、CHO及CHO%呈负相关（P < 0.05），而与FAT及FAT%呈正相关（P < 0.05）。TBA与RQ和CHO呈负相关（P < 0.05），而与FAT呈正相关（P < 0.05）。HCC导致肝脏合成功能增强，至少在一定程度上改善了LC患者的肝功能，但营养代谢较差。
