Department of Oncology and Vascular Intervention, First Hospital of Shanxi Medical University, Taiyuan, China.
The Third Hospital of Shanxi Medical University, Taiyuan, China.
Nutrition. 2021 Apr;84:111095. doi: 10.1016/j.nut.2020.111095. Epub 2020 Nov 30.
Liver cirrhosis is often accompanied by portal hypertension and malnutrition, two common complications that seriously affect treatment efficacy and quality of life. This study aimed to investigate the effect of transjugular intrahepatic portosystemic shunt (TIPS) on body mass index (BMI) and metabolism in individuals with cirrhotic portal hypertension, and the risk factors that affect changes of BMI.
A retrospective study was performed to collect basic information before and after TIPS. This study included 77 participants. For each participant, we assayed body nutrition parameters: change of weight and BMI, routine liver and kidney function tests, and free fatty acids. In addition, we evaluated glucose and biochemical indexes. We used analysis of variance and regression analysis to investigate the effect of TIPS on BMI and metabolism in individuals with cirrhotic portal hypertension, and the risk factors that affect changes of BMI and metabolic components.
After TIPS, there was significant improvement in weight, BMI, red blood cell count, blood platelet count, hemoglobin, and Child-Pugh score in individuals with cirrhotic portal hypertension. Average weight and BMI increased after TIPS by 3.2% and 3.4%, respectively (P < 0.05). After 36 months, there were no significant differences in weight and BMI between before and after TIPS. We also observed a dose-response association of pre-TIPS blood ammonia and increased post-TIPS BMI (P = 0.05) in men.
This study suggests that individuals with cirrhosis treated with TIPS may see improvement in overall clinical and physical status, as measured by increased weight and BMI. Our data also indicate that pre-TIPS blood ammonia is positively associated with post-TIPS BMI.
肝硬化常伴有门脉高压和营养不良,这两种常见并发症严重影响治疗效果和生活质量。本研究旨在探讨经颈静脉肝内门体分流术(TIPS)对肝硬化门脉高压患者体重指数(BMI)和代谢的影响,以及影响 BMI 变化的危险因素。
采用回顾性研究方法收集 TIPS 前后的基本资料。本研究共纳入 77 名参与者。对每位参与者,我们检测了体营养参数:体重和 BMI 的变化、常规肝功能和肾功能检查以及游离脂肪酸。此外,我们评估了血糖和生化指标。我们使用方差分析和回归分析来探讨 TIPS 对肝硬化门脉高压患者 BMI 和代谢的影响,以及影响 BMI 和代谢成分变化的危险因素。
TIPS 后,肝硬化门脉高压患者的体重、BMI、红细胞计数、血小板计数、血红蛋白和 Child-Pugh 评分均有显著改善。平均体重和 BMI 在 TIPS 后分别增加了 3.2%和 3.4%(P<0.05)。36 个月后,TIPS 前后的体重和 BMI 无显著差异。我们还观察到,男性 TIPS 前血氨与 TIPS 后 BMI 增加呈剂量反应关系(P=0.05)。
本研究表明,接受 TIPS 治疗的肝硬化患者整体临床和身体状况可能会改善,表现为体重和 BMI 的增加。我们的数据还表明,TIPS 前血氨与 TIPS 后 BMI 呈正相关。