Background: Hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) is an important type of liver failure in Asia. There is a direct relationship between HBV-ACLF and gastrointestinal barrier function. However, the nutritional status of HBV-ACLF patients has been poorly studied.
Aim: 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.
Methods: Nutritional risk screening assessment and gastrointestinal barrier biomarkers of patients with HBV-ACLF ( = 234) and patients in the compensatory period of liver cirrhosis (the control group) ( = 234) were compared during the period between 2016 and 2018. Changes were analyzed after nutritional support in HBV-ACLF patients. Valuable biomarkers have been explored to predict 28-d death. The 28-d survival between HBV-ACLF patients with nutritional support ( = 234) or no nutritional support (2014-2016) ( = 207) was compared.
Results: The nutritional risk of the HBV-ACLF patients was significantly higher than that of the control group. The nutritional intake of the patients with HBV-ACLF was lower than that of the control group. The decrease in skeletal muscle and fat content and the deficiency of fat intake were more obvious ( < 0.001). The coccus-bacillus ratio, secretory immunoglobulin A, and serum D-lactate were significantly increased in HBV-ACLF patients. The survival group had a lower nutritional risk, lower D-lactate, and cytokine levels (endotoxin, tumor necrosis factor alpha, interleukin-10, and interleukin-1). 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 ( = 0.016).
Conclusion: Patients with HBV-ACLF have insufficient nutritional intake and high nutritional risk, and their intestinal barrier function is impaired. Individualized and dynamic nutritional support is associated with a better prognosis of 28-d mortality in HBV-ACLF patients.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7422541 | PMC |
| http://dx.doi.org/10.3748/wjg.v26.i29.4288 | DOI Listing |
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- * The developed nomogram demonstrated high predictive accuracy (AUC of 0.885) compared to existing models, indicating its potential to effectively assess clinical prognosis for HBV-ACLF patients.
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