Chang Y, Liu QY, Zhang Q, Rong YM, Lu CZ, Li H. Role of nutritional status and nutritional support in outcome of hepatitis B virus-associated acute-on-chronic liver failure. World J Gastroenterol 2020; 26(29): 4288-4301 [PMID: 32848334 DOI: 10.3748/wjg.v26.i29.4288]
Corresponding Author of This Article
Hai Li, MD, PhD, Professor, Division of Gastroenterology and Hepatology, Tianjin Xiqing Hospital, No. 403 Xiqing Road, Xiqing District, Tianjin 300380, China. haili_tj@sina.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Clinical and Translational Research
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Aug 7, 2020; 26(29): 4288-4301 Published online Aug 7, 2020. doi: 10.3748/wjg.v26.i29.4288
Role of nutritional status and nutritional support in outcome of hepatitis B virus-associated acute-on-chronic liver failure
Yue Chang, Qin-Yu Liu, Qing Zhang, Ya-Mei Rong, Cheng-Zhen Lu, Hai Li
Yue Chang, Qing Zhang, Hai Li, Division of Gastroenterology and Hepatology, Tianjin Xiqing Hospital, Tianjin 300380, China
Yue Chang, Qin-Yu Liu, Qing Zhang, Ya-Mei Rong, Hai Li, Tianjin Key Laboratory of Hepatopancreatic Fibrosis and Molecular Diagnosis and Treatment, Tianjin 300162, China
Yue Chang, Qin-Yu Liu, Ya-Mei Rong, Hai Li, Department of Hepatopancreatobiliary and Splenic Medicine, Characteristic Medical Center of People's Armed Police Force, Tianjin 300162, China
Cheng-Zhen Lu, Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin 300192, China
Author contributions: Chang Y and Li H provided the ideas; Chang Y and Liu QY drafted the report; Chang Y, Zhang Q, Rong YM, Lu CZ, and Li H delivered experimental data; all authors have read and contributed to editing this manuscript and presentation of the paper.
Institutional review board statement: This study was approved by the Characteristic Medical Center of People's Armed Police Force, Tianjin, China.
Clinical trial registration statement: This study was registered with ClinicalTrials.gov (NCT03108794 and NCT01938820).
Informed consent statement: All participants provided informed written consent.
Conflict-of-interest statement: No conflicts of interest, financial or otherwise, are declared by the authors.
Data sharing statement: The dataset is available from the corresponding author via email (haili_tj@sina.com).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hai Li, MD, PhD, Professor, Division of Gastroenterology and Hepatology, Tianjin Xiqing Hospital, No. 403 Xiqing Road, Xiqing District, Tianjin 300380, China. haili_tj@sina.com
Received: April 11, 2020 Revised: July 4, 2020 Accepted: July 15, 2020 Published online: August 7, 2020 Processing time: 117 Days and 21.4 Hours
ARTICLE HIGHLIGHTS
Research background
Patients with hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) have inadequate nutrient intake and malnutrition at admission or diagnosis. However, the nutritional status of HBV-ACLF patients has been poorly studied.
Research motivation
We have found that HBV-ACLF patients had inadequate nutrient intake and malnutrition. Little is known about the impact of nutritional support on the outcome and function of the gastrointestinal barrier.
Research objectives
To investigate the nutritional risk and nutritional status of HBV-ACLF patients and evaluated the impact of nutritional support on the gastrointestinal barrier and 28-d mortality.
Research methods
The nutritional risk screening assessment, baseline characteristics, and biomarkers of the gastrointestinal barrier of patients with HBV-ACLF (n = 234) and patients with compensatory cirrhosis (n = 234) were analyzed. The 28-d survival of the nutritional support group (n = 234) and non-nutritional support group (n = 207) was compared.
Research results
The nutritional risk of the HBV-ACLF patients was significantly higher than that of the control group. The coccus-bacillus ratio, secretory immunoglobulin A, and serum D-lactate were significantly increased in HBV-ACLF patients. Interleukin-10 may be a potential predictor of death in HBV-ACLF patients. The 28-d survival of the nutritional support group was better than that of the non-nutritional support group (P = 0.016).
Research conclusions
This is the first study to investigate the nutritional risk and status of HBV-ACLF patients and evaluated the impact of nutritional support. We found that nutritional support initiated promptly for malnourished HBV-ACLF patients was associated with a better prognosis of 28-d mortality and improved the status of the gastrointestinal barrier.
Research perspectives
More attention should be paid to nutritional risk screening and corresponding nutritional support for HBV-ACLF patients. Nutritional support initiated promptly for malnourished HBV-ACLF patients is associated with a better prognosis.
