Objective To evaluate the pattern of energy metabolism and nutrients intake in patients with chronic viral hepatitis and posthepatitic cirrhosis to effectively direct their nutrition therapy.Methods Resting energy expenditure (REE) was measured with open-circuit indirect Jorimetry in 60 patients with chronic viral hepatitis and 60 patients with posthepatitic cirrhosis.Their normal basal energy expenditure (BEE) was predicted by Harris-Benedict equation and energy intake (EI) was determined by diet recall. Correlation between REE and indicators for nutrition assessment was analyzed.Results REE was (77± 21) kJ·kg~(-1)·d~(-1) in 60 patients with pusthepatitic cirrhosis,significantly lower than BEE[(95±16) kJ· kg~(-1)·d~(-1)(P0.01),and their EI was (102±33) kJ·kg~(-1)·d~(-1),1.42±0.61 times as REE,in which protein intake (PROI) was (0.84±0.31) g·kg~(-1)·d~(-1),0.85±0.52 times as resting protein expenditure (PROE) [(1.11±0.42) g·kg~(-1)·d~(-1)],indicating a negative nitrogen balance (-6.29± 4.62).In patients with chronic viral hepatitis,REE was (93±18) kJ·kg~(-1)·d~(-1),as compared to BEE of (98±8) kJ·kg~(-1)·d~(-1),P0.05,and their EI was (127±34) kJ·kg~(-1)·d~(-1),1.41±0.43 times as REE,in which PROI was (1.02±0.29) g·kg~(-1)·d~(-1),1.31±0.61 times as PROE (0.87±0.34) g·kg~(-1)·d~(-1),also indicating a negative nitrogen balance (-2.02±4.07).REE,EI and intake of three nutrients,serum level of albumin and prealbumin (PA) and body weight significantly decreased in patients with posthepatitic cirrhosis,as compared to those in patients with chronic viral hepatitis (P0.01), indicating a severely negative nitrogen balance (P0.01).In patients with posthepatitic cirrhosis,their EI positively correlated to REE/BEE (P0.05),and PA reversely correlated to protein oxidation rate (P0.05).Conclusions Hypometablosim of energy was found in patients with posthepatitic cirrhosis. Negative nitrogen balance was a common issue in patients with posthepatitic cirrhosis and chronic viral hepatitis.Early prevention of malnutrition in patients with chronic liver diseases could improve their prognosis in long term.

Energy metabolism in patients with chronic viral hepatitis and posthepatitic cirrhosis

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