Han Zuoqing, Li Rongkuan, Zhong Zhiwei, Piao Yuetong, Guo Rong
Graduate School, Dalian Medical University, Dalian, China.
Department of Infection, The Second Hospital of Dalian Medical University, Dalian, China.
Front Nutr. 2023 Jan 10;9:999462. doi: 10.3389/fnut.2022.999462. eCollection 2022.
Nighttime snacking is an effective intervention to avoid abnormal protein consumption caused by prolonged fasting. This article aims to evaluate the clinical efficacy of nighttime snacking on patients with hepatitis B cirrhosis and to provide new ideas for clinical nutritional intervention.
The study participants were randomly assigned to the control group ( = 30) and the observation group ( = 30); the former was administered medical system treatment and routine dietary intervention, and the latter was administered the same treatment with the addition of nighttime snacking. After 3 months of intervention with different dietary guidance, the dry body weight body mass index (BMI), upper arm muscle circumference (AMC), grip strength, triceps skinfold thickness (TSF), third lumbar skeletal muscle index (L3-SMI), albumin (ALB), total bilirubin (T-BIL), cholinesterase (CHE), Fried's frailty phenotype score, Child-Pugh score and various cirrhosis complication rates were compared between the two groups.
There was no significant difference in the baseline data between the two groups before the dietary intervention. After 3 months of regular dietary guidance in the control group, the grip strength increased compared with the baseline data ( < 0.05), while the dry body weight BMI, AMC, TSF, L3-SMI, ALB, T-BIL, CHE, prothrombin time, international normalized ratio, prothrombin activity, and Child-Pugh scores were not significantly different ( > 0.05). After 3 months of dietary guidance with nighttime snacking in the observation group, the dry body weight BMI, grip strength, TSF, L3-SMI, and CHE scores all increased, compared with the baseline data, while the Child-Pugh score decreased compared with the baseline level (all < 0.05). After 3 months of intervention, the Child-Pugh score of the observation group showed a more significant decrease than the control group, while the dry body weight BMI, grip strength, ALB and CHE scores were all significantly higher than those in the control group (all < 0.05). Overall, the improvement rate was significantly higher in the observation group than in the control group ( < 0.05).
Nighttime snacking for hepatitis B cirrhosis patients with nutritional risk is beneficial in terms of the recovery of liver synthesis functions, improvements in clinical indicators, sarcopenia corrections and improvements in malnutrition-related complications.
夜间加餐是避免长期禁食导致蛋白质摄入异常的有效干预措施。本文旨在评估夜间加餐对乙型肝炎肝硬化患者的临床疗效,并为临床营养干预提供新思路。
将研究参与者随机分为对照组(n = 30)和观察组(n = 30);前者给予医疗系统治疗和常规饮食干预,后者在相同治疗基础上增加夜间加餐。经过3个月不同饮食指导的干预后,比较两组的干体重、体重指数(BMI)、上臂肌肉周长(AMC)、握力、三头肌皮褶厚度(TSF)、第三腰椎骨骼肌指数(L3 - SMI)、白蛋白(ALB)、总胆红素(T - BIL)、胆碱酯酶(CHE)、弗里德衰弱表型评分、Child - Pugh评分及各种肝硬化并发症发生率。
饮食干预前两组基线数据无显著差异。对照组经过3个月常规饮食指导后,握力较基线数据增加(P < 0.05),而干体重BMI、AMC、TSF、L3 - SMI、ALB、T - BIL、CHE、凝血酶原时间、国际标准化比值、凝血酶原活动度及Child - Pugh评分无显著差异(P > 0.05)。观察组经过3个月夜间加餐饮食指导后,干体重BMI、握力、TSF、L3 - SMI及CHE评分均较基线数据增加,而Child - Pugh评分较基线水平降低(均P < 0.05)。干预3个月后,观察组的Child - Pugh评分下降幅度比对照组更显著,而干体重BMI、握力、ALB及CHE评分均显著高于对照组(均P < 0.05)。总体而言,观察组的改善率显著高于对照组(P < 0.05)。
对有营养风险的乙型肝炎肝硬化患者进行夜间加餐,有利于肝脏合成功能的恢复、临床指标的改善、肌肉减少症的纠正及营养不良相关并发症的改善。