Evidence-Based Medicine
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. May 18, 2017; 9(14): 667-676
Published online May 18, 2017. doi: 10.4254/wjh.v9.i14.667
Protein tolerance to standard and high protein meals in patients with liver cirrhosis
Octavio Campollo, Dirk Sprengers, Gitte Dam, Hendrik Vilstrup, Neil McIntyre
Octavio Campollo, Center of Studies on Alcohol and Addictions, Antigüo Hospital Civil de Guadalajara, Universidad de Guadalajara, Guadalajara, Jal CP 44280, Mexico
Dirk Sprengers, Department of Gastroenterology and Hepatology, Gasthuis Zusters Antwerpen, B 2610 Wilrijk-Antwerpen, Belgium
Gitte Dam, Hendrik Vilstrup, Department of Medicine V (Gastroenterology and Hepatology), Aarhus University Hospital, DK-8200 Aarhus, Denmark
Neil McIntyre, University College Royal Free School of Medicine, London NW32QG, United Kingdorm
Author contributions: Sprengers D and Campollo O planned, designed, and selected the patients, and conducted the clinical experiment; McIntyre N planned and designed the experiment; McIntyre N, Dam G and Campollo O analyzed the data; McIntyre N, Dam G, Vilstrup H and Campollo O wrote the manuscript; Sprengers D, Dam G and Vilstrup H reviewed the manuscript; Vilstrup H also edited the manuscript.
Conflict-of-interest statement: There are no conflicts of interest arising from this work.
Data sharing statement: No additional data are available.
Open-Access: 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/
Correspondence to: Dr. Octavio Campollo, Professor and Researcher, Center of studies on Alcohol and Addictions, Antigüo Hospital Civil de Guadalajara, Universidad de Guadalajara, Calle Hospital 278, Col. El Retiro, Guadalajara, Jal CP 44280, Mexico. calcohol@hotmail.com
Telephone: +52-33-36142179
Received: October 27, 2016
Peer-review started: October 31, 2016
First decision: December 1, 2016
Revised: February 21, 2017
Accepted: April 23, 2017
Article in press: April 24, 2017
Published online: May 18, 2017
Core Tip

Core tip: In this study we investigated the plasma amino acid response to standard and high protein meals in patients with liver cirrhosis and looked for evidence of protein intolerance by testing for the presence of either covert or overt hepatic encephalopathy. We sought to improve on previous methodology by selecting a more homogeneous group of patients with biopsy proven cirrhosis, and by using natural mixed protein meals at two protein levels: A standard (20 g) meal and a high (1 g/kg per body weight) protein meal. We found small differences in the plasma amino acid changes after the standard protein meal but there were marked increments in most amino acids after the high protein meal. Noteworthy no patient showed overt clinical sings of encephalopathy and minor electroencephalo-graph changes were seen in only one patient after the high protein meal. These results present experimental evidence to support current nutritional guidelines for patients with cirrhosis.