The Effect of a Regular Oral Diet on: Nutritional Status, Hepatic Function and Serum Lipid Pattern in Alcoholic Cirrhotic Patients

摘要

The effect of a regular oral diet supplying 167 kJ/kg per d. on nutritional status, liver function and serum lipid profile was assessed in thirty severely malnourished alcoholic cirrhotic impatients. Their diet was monitored by a trained dietitian and they were vigorously encouraged to eat all meals served. One month after their entry into the study, protein and energy intakes were significantly higher in keeping with an improvement of their nutritional status as evaluated by means of height-creatinine index, muscular mid-arm circumference, tricipital skinfold thickness and fat mass. Assessment of liver function tests showed that levels of aspartate aminotransferase, 7-glutamyl transferase and biliru-bin decreased, while, prothrombin time values increased. Similarly, serum albumin increased modestly while transthyretin did not change. Or-osomucoid and C-reactive protein decreased indicating an improvement of the inflammatory state. Apolipoprotein Al and high-density-lipoprotein (HDL) - cholesterol correlated with serveral tests of liver function and improved significantly during the study period. Moreover, changes in cholesterol and HDL - cholesterol correlated with those in transthyretin. The changes in Apo Al and HDL - cholesterol were greater in patients whose fat mass increased significantly. Findings obtained showed that adequate oral nutrition resulted in a better nutritional status in cirrhotics after 1 month of hospitalization. The serum lipid variables appeared to be more useful indicators of functional liver improvement than the classic liver function tests which rather indicate liver damage.