Prognostic value of energy metabolism in patients with viral liver cirrhosis

被引:209
作者
Tajika, M
Kato, M
Mohri, H
Miwa, Y
Kato, T
Ohnishi, H
Moriwaki, H
机构
[1] Gifu Univ, Sch Med, Dept Internal Med 1, Gifu 5008705, Japan
[2] Gifu Prefectural Gifu Hosp, Dept Gastroenterol, Gifu, Japan
关键词
viral liver cirrhosis; energy metabolism; indirect calorimetry; resting energy expenditure; non-protein respiratory quotient; survival;
D O I
10.1016/S0899-9007(01)00754-7
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
The effect of energy malnutrition on survival in patients with non-alcoholic viral liver cirrhosis has not been well defined. We characterized energy metabolism at study entrance and prospectively analyzed its effect on subsequent survival in cirrhotics. One hundred nine consecutive patients with viral liver cirrhosis and 22 healthy control subjects participated in the study. By indirect calorimetry after overnight bedrest and fasting, resting energy expenditure (REE) was measured and non-protein respiratory quotient (npRQ) was calculated. Survival of cirrhotics were followed for up to 8 y. Survival rate was estimated with the Kaplan-Meier method. REE at entrance was significantly higher than the predicted basal metabolic rate (BMR) in cirrhotics (P < 0.001). NpRQ was significantly lower in cirrhotics than in controls (P < 0.001). Survival rate was significantly lower in patients with low npRQ ( < 0.85) than in patients with scores above 0.85 (P < 0.01) and was significantly higher in normal metabolic patients (0.9 < REE/BMR < 1.1) than in hypometabolic (REE/BMR < 0.9) or hypermetabolic (1.1 < REE/BMR) patients (P < 0.05). The proportional hazards model showed that npRQ (relative risk = 0.0003, 95% confidence interval = 0.0000-0.0970), REE/BMR (0.0199, 0.0007-0.5652), prothrombin time, and ammonia were independent significant factors determining survival. Thus evaluation of energy metabolism can be used to predict survival in patients with viral liver cirrhosis. (C) Elsevier Science Inc. 2002.
引用
收藏
页码:229 / 234
页数:6
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