UNC Liver Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
UNC Liver Center, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
Clin Ther. 2022 May;44(5):682-696. doi: 10.1016/j.clinthera.2022.04.012. Epub 2022 May 25.
The importance of nutrition is often underrecognized in the routine clinical care of patients with chronic liver disease. Nutrition therapy plays a significant role in the management of alcohol-related liver disease and nonalcoholic fatty liver disease. In patients with cirrhosis from any etiology, malnutrition and sarcopenia are directly related to mortality, and nutritional interventions play an important role in the management of these patients. This review explores the role of nutritional intervention as adjuvant therapy across all chronic liver disease.
A narrative, qualitative systematic review was performed via searches of PubMed for nutritional aspects in the care of chronic liver disease.
Nutritional therapy plays a critical role in the management of chronic liver disease. In nonalcoholic fatty liver disease, specific macronutrient management can lead to weight loss and improved outcomes in these patients. In patients with alcohol-related liver disease, chronic cholestatic liver disease, and decompensated cirrhosis, caloric and protein intake plays a vital role improving outcomes in these patients. Micronutrient deficencies are also common in these patients and require supplementation to prevent other complications of malnutrition. Assessment and management of nutrition should accompany the typical care plan of patients with chronic liver disease.
This review of nutritional therapy in chronic liver disease highlights the current evidence-based and societal recommendations of macronutrient and micronutrient management across the spectrum of all chronic liver disease.
在慢性肝病患者的常规临床护理中，营养的重要性常常被低估。营养疗法在酒精性肝病和非酒精性脂肪性肝病的治疗中起着重要作用。对于任何病因引起的肝硬化患者，营养不良和肌肉减少症与死亡率直接相关，营养干预在这些患者的治疗中起着重要作用。本综述探讨了营养干预作为辅助治疗在所有慢性肝病中的作用。
通过在 PubMed 上搜索慢性肝病护理方面的营养问题，进行了叙述性定性系统评价。
营养疗法在慢性肝病的治疗中起着关键作用。在非酒精性脂肪性肝病中，特定的宏量营养素管理可以导致这些患者体重减轻和改善结局。在酒精性肝病、慢性胆汁淤积性肝病和失代偿性肝硬化患者中，热量和蛋白质的摄入对改善这些患者的结局至关重要。这些患者也常出现微量营养素缺乏，需要补充以预防营养不良的其他并发症。对营养的评估和管理应伴随慢性肝病患者的典型治疗计划。
本综述强调了当前慢性肝病中营养疗法的证据基础和社会推荐，涵盖了所有慢性肝病中宏量营养素和微量营养素管理的建议。
