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[Protein catabolism and malnutrition in liver cirrhosis - impact of oral nutritional therapy].
Z Gastroenterol 2010; 48(7):763-70ZG

Abstract

Malnutrition with loss of muscle is common in patients with liver cirrhosis and has negative impact on morbidity and mortality. The aetiology of malnutrition is multifactorial and includes inflammation, early onset of gluconeogenesis due to impaired glycogen storage and sometimes hypermetabolism. Reduced nutritional intake, however, plays the most important role in the pathogenesis of malnutrition. There is, however, ample evidence that nutritional intake and therapy are inadequate in liver cirrhosis although studies have clearly shown that dietary counselling and nutritional therapy with oral supplements improve intake in these patients. Protein requirement is considered to be increased in liver cirrhosis and high protein intake has been shown to be well tolerated and associated with an improvement of liver function and nutritional status. Protein intolerance on the other hand is uncommon and hepatic encephalopathy can thus rarely be attributed to high protein consumption. Recommendations for general protein restriction must therefore be considered obsolete and rather a risk factor for an impaired clinical outcome. Furthermore, the administration of late evening meals is highly beneficial in patients with liver disease since the rapid onset of the overnight catabolic state is counteracted. The serum concentration of branched-chain amino acids (BCAA) is decreased in patients with liver cirrhosis and long-term supplementation of BCAA has been shown to improve nutritional status and prolong event-free survival and quality of life.

Authors+Show Affiliations

Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Charité - Universitätsmedizin Berlin.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article
Review

Language

ger

PubMed ID

20607635

Citation

Norman, K, et al. "[Protein Catabolism and Malnutrition in Liver Cirrhosis - Impact of Oral Nutritional Therapy]." Zeitschrift Fur Gastroenterologie, vol. 48, no. 7, 2010, pp. 763-70.
Norman K, Valentini L, Lochs H, et al. [Protein catabolism and malnutrition in liver cirrhosis - impact of oral nutritional therapy]. Z Gastroenterol. 2010;48(7):763-70.
Norman, K., Valentini, L., Lochs, H., & Pirlich, M. (2010). [Protein catabolism and malnutrition in liver cirrhosis - impact of oral nutritional therapy]. Zeitschrift Fur Gastroenterologie, 48(7), pp. 763-70. doi:10.1055/s-0029-1245388.
Norman K, et al. [Protein Catabolism and Malnutrition in Liver Cirrhosis - Impact of Oral Nutritional Therapy]. Z Gastroenterol. 2010;48(7):763-70. PubMed PMID: 20607635.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Protein catabolism and malnutrition in liver cirrhosis - impact of oral nutritional therapy]. AU - Norman,K, AU - Valentini,L, AU - Lochs,H, AU - Pirlich,M, Y1 - 2010/07/06/ PY - 2010/7/8/entrez PY - 2010/7/8/pubmed PY - 2010/12/14/medline SP - 763 EP - 70 JF - Zeitschrift fur Gastroenterologie JO - Z Gastroenterol VL - 48 IS - 7 N2 - Malnutrition with loss of muscle is common in patients with liver cirrhosis and has negative impact on morbidity and mortality. The aetiology of malnutrition is multifactorial and includes inflammation, early onset of gluconeogenesis due to impaired glycogen storage and sometimes hypermetabolism. Reduced nutritional intake, however, plays the most important role in the pathogenesis of malnutrition. There is, however, ample evidence that nutritional intake and therapy are inadequate in liver cirrhosis although studies have clearly shown that dietary counselling and nutritional therapy with oral supplements improve intake in these patients. Protein requirement is considered to be increased in liver cirrhosis and high protein intake has been shown to be well tolerated and associated with an improvement of liver function and nutritional status. Protein intolerance on the other hand is uncommon and hepatic encephalopathy can thus rarely be attributed to high protein consumption. Recommendations for general protein restriction must therefore be considered obsolete and rather a risk factor for an impaired clinical outcome. Furthermore, the administration of late evening meals is highly beneficial in patients with liver disease since the rapid onset of the overnight catabolic state is counteracted. The serum concentration of branched-chain amino acids (BCAA) is decreased in patients with liver cirrhosis and long-term supplementation of BCAA has been shown to improve nutritional status and prolong event-free survival and quality of life. SN - 1439-7803 UR - https://www.unboundmedicine.com/medline/citation/20607635/[Protein_catabolism_and_malnutrition_in_liver_cirrhosis___impact_of_oral_nutritional_therapy]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0029-1245388 DB - PRIME DP - Unbound Medicine ER -