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Cheng C, England E. Nutrition: Chronic Disease Management. FP Essent 2024; 539:23-34. [PMID: 38648172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Dietary modifications can help to prevent and manage many chronic diseases. The Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets emphasize consumption of fruits and vegetables while reducing intake of red meat. These diets are supported by well-established evidence for patients with cardiovascular disease and hypertension, respectively. Whole-food, plant-based diets have been shown to result in reduced body weight, lower A1c levels, and decreased insulin resistance in patients with diabetes. Patients with diabetes and hypertension should adhere to a heart-healthy diet, such as the DASH diet. For patients with diabetes and at risk of diabetes, key nutritional recommendations include emphasizing intake of nonstarchy vegetables, minimizing intake of added sugars and refined grains, and choosing whole foods instead of processed foods. The Dietary Guidelines for Americans, 2020-2025 recommend that adults limit sodium intake to less than 2,300 mg/day. Patients with chronic kidney or liver disease should follow sodium restriction and protein intake guidelines. Patients with irritable bowel syndrome should follow a low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet with fiber supplementation. For patients with gastrointestinal symptoms, fiber can effectively manage constipation and stool irregularity. Probiotic supplements or foods can be useful for digestive problems.
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Affiliation(s)
- Cynthia Cheng
- Department of Family and Community Medicine - Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia
| | - Erin England
- Division of Endocrinology Diabetes and Metabolic Diseases - Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia
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Mariqueo TA, Zúñiga-Hernández J. Omega-3 derivatives, specialized pro-resolving mediators: Promising therapeutic tools for the treatment of pain in chronic liver disease. Prostaglandins Leukot Essent Fatty Acids 2020; 158:102095. [PMID: 32450460 DOI: 10.1016/j.plefa.2020.102095] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/02/2020] [Accepted: 03/23/2020] [Indexed: 12/12/2022]
Abstract
The main causes of liver injury are associated with inflammation and permanent damage. They can cause chronic liver disease (CLD), which is mainly related to viral hepatitis, alcohol consumption and non-alcoholic steatohepatitis, leading to fibrosis, cirrhosis and hepatocellular carcinoma. These conditions prevent the liver from working normally and make it begin to fail, which in turn may prompt a liver transplant. CLD and cirrhosis are the eleventh cause of death worldwide. At present, there are no approved pharmacological treatments to prevent, treat or resolve liver fibrosis. The prevalence of pain in the hepatic disease is elevated with ranges between 30% and 40%. Most of the pain drugs require hepatic function; therefore, the suitable control of pain is still a clinical challenge. Specialized pro-resolving mediators (SPM): lipoxins, resolvins, protectins and maresins, are potent endogenous molecules (nM concentrations) that modulate inflammatory body responses by reducing neutrophil infiltration, macrophage activity and pain sensitization. SPM have anti-inflammatory properties, stimulate tissue resolution, repair and regeneration, and exhibit anti-nociceptive actions. Furthermore, SPM were tried on different cellular, animal models and human observational data of liver injury, improving the pathogenesis of inflammation and fibrosis. In the present work, we will describe recent evidence that suggests that SPM can be used as a therapeutic option for CLD. Additionally, we will examine the role of SPM in the control of pain in pathologies associated with liver injury.
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Affiliation(s)
- T A Mariqueo
- Centro de Investigaciones Medicas, Escuela de Medicina, Universidad de Talca, Talca, Chile
| | - J Zúñiga-Hernández
- Centro de Investigaciones Medicas, Escuela de Medicina, Universidad de Talca, Talca, Chile.
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Yzydorczyk C, Li N, Rigal E, Chehade H, Mosig D, Armengaud JB, Rolle T, Krishnasamy A, Orozco E, Siddeek B, Juvet C, Vergely C, Simeoni U. Calorie Restriction in Adulthood Reduces Hepatic Disorders Induced by Transient Postnatal Overfeeding in Mice. Nutrients 2019; 11:nu11112796. [PMID: 31744052 PMCID: PMC6893580 DOI: 10.3390/nu11112796] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/12/2019] [Accepted: 11/14/2019] [Indexed: 12/22/2022] Open
Abstract
Impaired early nutrition influences the risk of developing metabolic disorders in later life. We observed that transient postnatal overfeeding (OF) in mice induces long-term hepatic alterations, characterized by microsteatosis, fibrosis associated with oxidative stress (OS), and stress-induced premature senescence (SIPS). In this study, we investigated whether such changes can be reversed by moderate calorie restriction (CR). C57BL/6 male mice pups were maintained during lactation in litters adjusted to nine pups in the normal feeding (NF) group and three pups in the transient postnatal OF group. At six months of age, adult mice from the NF and OF groups were randomly assigned to an ad libitum diet or CR (daily energy supply reduced by 20%) for one month. In each group, at the age of seven months, analysis of liver structure, liver markers of OS (superoxide anion, antioxidant defenses), and SIPS (lipofuscin, p53, p21, p16, pRb/Rb, Acp53, sirtuin-1) were performed. CR in the OF group reduced microsteatosis, decreased levels of superoxide anion, and increased protein expression of catalase and superoxide dismutase. Moreover, CR decreased lipofuscin staining, p21, p53, Acp53, and p16 but increased pRb/Rb and sirtuin-1 protein expression. CR did not affect the NF group. These results suggest that CR reduces hepatic disorders induced by OF.
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Affiliation(s)
- Catherine Yzydorczyk
- DOHaD Laboratory, Woman-Mother-Child Department, Division of Pediatrics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, 1011 Lausanne, Switzerland; (H.C.); (D.M.); (J.B.A.); (T.R.); (A.K.); (E.O.); (B.S.); (C.J.); (U.S.)
- Correspondence: ; Tel.: +41-(0)21-314-32-19
| | - Na Li
- Equipe Physiopathologie et Epidémiologie Cérébro-Cardiovasculaires (PEC2, EA7460), UFR Sciences de Santé, Université de Bourgogne Franche-Comté, 21000 Dijon, France; (N.L.); (C.V.)
| | - Eve Rigal
- Equipe Physiopathologie et Epidémiologie Cérébro-Cardiovasculaires (PEC2, EA7460), UFR Sciences de Santé, Université de Bourgogne Franche-Comté, 21000 Dijon, France; (N.L.); (C.V.)
| | - Hassib Chehade
- DOHaD Laboratory, Woman-Mother-Child Department, Division of Pediatrics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, 1011 Lausanne, Switzerland; (H.C.); (D.M.); (J.B.A.); (T.R.); (A.K.); (E.O.); (B.S.); (C.J.); (U.S.)
| | - Dolores Mosig
- DOHaD Laboratory, Woman-Mother-Child Department, Division of Pediatrics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, 1011 Lausanne, Switzerland; (H.C.); (D.M.); (J.B.A.); (T.R.); (A.K.); (E.O.); (B.S.); (C.J.); (U.S.)
| | - Jean Baptiste Armengaud
- DOHaD Laboratory, Woman-Mother-Child Department, Division of Pediatrics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, 1011 Lausanne, Switzerland; (H.C.); (D.M.); (J.B.A.); (T.R.); (A.K.); (E.O.); (B.S.); (C.J.); (U.S.)
| | - Thibaud. Rolle
- DOHaD Laboratory, Woman-Mother-Child Department, Division of Pediatrics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, 1011 Lausanne, Switzerland; (H.C.); (D.M.); (J.B.A.); (T.R.); (A.K.); (E.O.); (B.S.); (C.J.); (U.S.)
| | - Anithan Krishnasamy
- DOHaD Laboratory, Woman-Mother-Child Department, Division of Pediatrics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, 1011 Lausanne, Switzerland; (H.C.); (D.M.); (J.B.A.); (T.R.); (A.K.); (E.O.); (B.S.); (C.J.); (U.S.)
| | - Eulalia Orozco
- DOHaD Laboratory, Woman-Mother-Child Department, Division of Pediatrics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, 1011 Lausanne, Switzerland; (H.C.); (D.M.); (J.B.A.); (T.R.); (A.K.); (E.O.); (B.S.); (C.J.); (U.S.)
| | - Benazir Siddeek
- DOHaD Laboratory, Woman-Mother-Child Department, Division of Pediatrics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, 1011 Lausanne, Switzerland; (H.C.); (D.M.); (J.B.A.); (T.R.); (A.K.); (E.O.); (B.S.); (C.J.); (U.S.)
| | - Christian Juvet
- DOHaD Laboratory, Woman-Mother-Child Department, Division of Pediatrics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, 1011 Lausanne, Switzerland; (H.C.); (D.M.); (J.B.A.); (T.R.); (A.K.); (E.O.); (B.S.); (C.J.); (U.S.)
| | - Catherine Vergely
- Equipe Physiopathologie et Epidémiologie Cérébro-Cardiovasculaires (PEC2, EA7460), UFR Sciences de Santé, Université de Bourgogne Franche-Comté, 21000 Dijon, France; (N.L.); (C.V.)
| | - Umberto Simeoni
- DOHaD Laboratory, Woman-Mother-Child Department, Division of Pediatrics, Centre Hospitalier Universitaire Vaudois and University of Lausanne, 1011 Lausanne, Switzerland; (H.C.); (D.M.); (J.B.A.); (T.R.); (A.K.); (E.O.); (B.S.); (C.J.); (U.S.)
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Abstract
More than one-half of children with chronic liver disease suffer from malnutrition, which leads not only to a poor quality of life and even possibly catastrophic complications, but also to poor outcomes after a liver transplantation. These children have increased metabolic demands but often decreased intake with malabsorption and altered nutrient utilization, all of which make it difficult to keep up with nutritional demands. Assessment of a patient's nutritional status should be timely, and it should be performed routinely and proactively. When specific nutritional needs are identified, these should be addressed with a multidisciplinary team approach and with the close guidance of an experienced pediatric dietician. The assessment includes anthropometric and laboratory assessments, in addition to a careful physical examination and a detailed patient history. The specific nutritional needs vary, but generally dietary intervention focuses on increasing caloric intake, supplementation with medium-chain triglycerides, and prevention of essential fatty acid and fat-soluble vitamin deficiencies. [Pediatr Ann. 2018;47(11):e445-e451.].
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Bonomini F, Borsani E, Favero G, Rodella LF, Rezzani R. Dietary Melatonin Supplementation Could Be a Promising Preventing/Therapeutic Approach for a Variety of Liver Diseases. Nutrients 2018; 10:nu10091135. [PMID: 30134592 PMCID: PMC6164189 DOI: 10.3390/nu10091135] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 08/14/2018] [Accepted: 08/17/2018] [Indexed: 02/07/2023] Open
Abstract
In the therapeutic strategies, the role of diet is a well-established factor that can also have an important role in liver diseases. Melatonin, identified in animals, has many antioxidant properties and it was after discovered also in plants, named phytomelatonin. These substances have a positive effect during aging and in pathological conditions too. In particular, it is important to underline that the amount of melatonin produced by pineal gland in human decreases during lifetime and its reduction in blood could be related to pathological conditions in which mitochondria and oxidative stress play a pivotal role. Moreover, it has been indicated that melatonin/phytomelatonin containing foods may provide dietary melatonin, so their ingestion through balanced diets could be sufficient to confer health benefits. In this review, the classification of liver diseases and an overview of the most important aspects of melatonin/phytomelatonin, concerning the differences among their synthesis, their presence in foods and their role in health and diseases, are summarized. The findings suggest that melatonin/phytomelatonin supplementation with diet should be considered important in preventing different disease settings, in particular in liver. Currently, more studies are needed to strengthen the potential beneficial effects of melatonin/phytomelatonin in liver diseases and to better clarify the molecular mechanisms of action.
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Affiliation(s)
- Francesca Bonomini
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
- Interdipartimental University Center of Research "Adaption and Regeneration of Tissues and Organs-(ARTO)", University of Brescia, 25123 Brescia, Italy.
| | - Elisa Borsani
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
- Interdipartimental University Center of Research "Adaption and Regeneration of Tissues and Organs-(ARTO)", University of Brescia, 25123 Brescia, Italy.
| | - Gaia Favero
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
| | - Luigi F Rodella
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
- Interdipartimental University Center of Research "Adaption and Regeneration of Tissues and Organs-(ARTO)", University of Brescia, 25123 Brescia, Italy.
| | - Rita Rezzani
- Anatomy and Physiopathology Division, Department of Clinical and Experimental Sciences, University of Brescia, Viale Europa 11, 25123 Brescia, Italy.
- Interdipartimental University Center of Research "Adaption and Regeneration of Tissues and Organs-(ARTO)", University of Brescia, 25123 Brescia, Italy.
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Mule A, Sirohi P, Ram N. Prevalence of Chronic Liver Disease Among the Patients of Celiac Disease and Effect of Gluten-Free Diet on Outcome of Liver Disease: A Prospective Study. J Assoc Physicians India 2018; 66:34-36. [PMID: 30341866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Descriptive reports of liver involvement in celiac disease (CD) are sparse, and the effect of a strict gluten-free diet (GFD) on the course of liver injury is also poorly understood. We conducted a study on 94 adult patients with CD and found that 39 of them were having chronic liver disease as well. We further followed patients of 'CD with CLD' with strict Gluten-free diet (GFD) for six months. METHODS We screened 94 patients of CD for CLD and found 39 patients to have CLD as well. We further followed these 39 patients of 'CD with CLD' for six month with strict gluten-free diet. Follow up was done in terms of Child Pugh score. We recorded their clinical as well as laboratory findings after 1 month, 3 months and 6 months and compared them with those at the time of recruitment. RESULTS The liver involvement was found in 39(41.5%) out of 94 patients celiac disease. Mean Child-Pugh score on admission was 10.22±1.09 and on first follow-up mean Child-Pugh score was 7.38±1.47 was found to be statistically highly significant (p <0.001) Mean Child-Pugh score on admission was 10.15±1.09 and on second follow-up 7.33±1.33 respectively and was statistically highly significant (p <0.001) Mean Child-Pugh score on admission was 10.12±1.09 and on third follow-up mean Child-Pugh score was 6.31±0.93 respectively was statistically highly significant (p <0.001).
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Arslan N, Guzel O, Kose E, Yılmaz U, Kuyum P, Aksoy B, Çalık T. Is ketogenic diet treatment hepatotoxic for children with intractable epilepsy? Seizure 2016; 43:32-38. [PMID: 27866088 DOI: 10.1016/j.seizure.2016.10.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 09/23/2016] [Accepted: 10/27/2016] [Indexed: 12/19/2022] Open
Abstract
PURPOSE Long-term ketogenic diet (KD) treatment has been shown to induce liver steatosis and gallstone formation in some in vivo and clinical studies. The aim of this retrospective study was to evaluate the hepatic side effects of KD in epileptic children. METHOD A total of 141 patients (mean age: 7.1±4.1years [2-18 years], 45.4% girls), receiving KD at least one year for intractable epilepsy due to different diagnoses (congenital brain defects, GLUT-1 deficiency, West syndrome, tuberous sclerosis, hypoxic brain injury, etc.) were included in the study. Serum triglyceride, cholesterol, aminotransferase, bilirubin, protein and albumin levels and abdominal ultrasonography were recorded before and at 1, 3, 6, and 12 months following after diet initiation. RESULTS The mean duration of KD was 15.9±4.3months. At one month of therapy, three patients had elevated alanine and aspartate aminotransferase levels. These patients were receiving ketogenic diet for Doose syndrome, idiopathic epilepsy and GLUT-1 deficiency. Hepatosteatosis was detected in three patients at 6 months of treatment. Two of these patients were treated with KD for the primary diagnosis of tuberous sclerosis and one for Landau Kleffner syndrome. Cholelithiasis was detected in two patients at 12 months of treatment. They were receiving treatment for West syndrome and hypoxic brain injury sequelae. CONCLUSION Long-term ketogenic diet treatment stimulates liver parenchymal injury, hepatic steatosis and gallstone formation. Patients should be monitored by screening liver enzymes and abdominal ultrasonography in order to detect these side effects.
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Affiliation(s)
- Nur Arslan
- Dokuz Eylul University, Division of Pediatric Metabolism and Nutrition, Izmir, Turkey; Dokuz Eylul University, Izmir Biomedicine and Genome Center, Izmir, Turkey.
| | - Orkide Guzel
- Behçet Uz Children Hospital, Division of Pediatric Neurology, Izmir, Turkey
| | - Engin Kose
- Dokuz Eylul University, Division of Pediatric Metabolism and Nutrition, Izmir, Turkey
| | - Unsal Yılmaz
- Behçet Uz Children Hospital, Division of Pediatric Neurology, Izmir, Turkey
| | - Pınar Kuyum
- Dokuz Eylul University, Division of Pediatric Gastroenterology, Izmir, Turkey
| | - Betül Aksoy
- Dokuz Eylul University, Division of Pediatric Gastroenterology, Izmir, Turkey
| | - Tansel Çalık
- Behçet Uz Children Hospital, Division of Pediatric Neurology, Izmir, Turkey
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Bozeman MC, Benns MV, McClave SA, Miller KR, Jones CM. When can nutritional therapy impact liver disease? Curr Gastroenterol Rep 2014; 16:411. [PMID: 25183578 DOI: 10.1007/s11894-014-0411-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This article reviews the current literature regarding nutritional therapy in liver disease, with an emphasis on patients progressing to liver failure as well as surgical patients. Mechanisms of malnutrition and sarcopenia in liver failure patients as well as nutritional assessment, nutritional requirements of this patient population, and goals and methods of therapy are discussed. Additionally, recommendations for feeding, micronutrient, branched chain amino acid supplementation, and the use of pre- and probiotics are included. The impact of these methods can have on patients with advanced disease and those undergoing surgical procedures will be emphasized.
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Affiliation(s)
- Matthew C Bozeman
- Hiram C. Polk Jr., MD Department of Surgery, University of Louisville, Louisville, KY, 40202, USA
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Shaikh H, Kamani L. Diet and nutrition in liver disease patients. J Coll Physicians Surg Pak 2012; 22:269. [PMID: 22482391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2012] [Accepted: 04/01/2012] [Indexed: 05/31/2023]
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Watson P. Comparing two low-protein diets in the treatment of dogs with congenital portosystemic shunts. J Vet Intern Med 2010; 24:1-3. [PMID: 20391632 DOI: 10.1111/j.1939-1676.2009.0409.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
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Kaji S, Murayama K, Nagata I, Nagasaka H, Takayanagi M, Ohtake A, Iwasa H, Nishiyama M, Okazaki Y, Harashima H, Eitoku T, Yamamoto M, Matsushita H, Kitamoto K, Sakata S, Katayama T, Sugimoto S, Fujimoto Y, Murakami J, Kanzaki S, Shiraki K. Fluctuating liver functions in siblings with MPV17 mutations and possible improvement associated with dietary and pharmaceutical treatments targeting respiratory chain complex II. Mol Genet Metab 2009; 97:292-6. [PMID: 19520594 DOI: 10.1016/j.ymgme.2009.04.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Revised: 04/27/2009] [Accepted: 04/27/2009] [Indexed: 12/25/2022]
Abstract
BACKGROUND/AIMS To describe the clinical and biological findings of two Japanese siblings with novel MPV17 gene mutations (c.451insC/c.509C > T) manifesting hepatic mitochondrial DNA depletion syndrome. METHODS We observed these brothers and sought to determine the efficacy of treatment targeting respiratory chain complex II for the younger brother. RESULTS A 3-month-old boy had presented with profound liver dysfunction, failure to thrive, and watery diarrhea. Although he was then placed on a carbohydrate-rich diet, his liver function thereafter fluctuated greatly in association with viral infections, and rapidly deteriorated to liver failure. He underwent liver transplantation at 17 months of age but died at 22 months of age. The younger brother, aged 47 months at the time of this writing, presented with liver dysfunction from 8 months of age. His transaminase levels also fluctuated considerably fluctuations in association with viral infections. At 31 months of age, treatment with succinate and ubiquinone was initiated together with a lipid-rich diet using ketone milk. Thereafter, his transaminase levels normalized and never fluctuated, and the liver histology improved. CONCLUSIONS These cases suggested that the clinical courses of patients with MPV17 mutations are greatly influenced by viral infections and that dietary and pharmaceutical treatments targeting the mitochondrial respiratory chain complex II may be beneficial in the clinical management of MPV17 mutant patients.
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Affiliation(s)
- Shunsaku Kaji
- Department of Pediatrics, Tsuyama Central Hospital, Tsuyama-shi, Okayama 708-0841, Japan.
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Abstract
Minimal encephalopathy was originally associated with chronic liver disease but is increasingly associated with most other chronic diseases and particularly with diabetes and also chronic disorders in other organs: kidneys, lungs, thyroid and with obesity. It is increasingly with dramatically increased and more or less permanent increase in systemic inflammation, most likely a result of Western lifestyle. Frequent physical exercise and intake of foods rich in vitamins, antioxidants, fibres, lactic acid bacteria etc in combination with reduction in intake of refined and processed foods is known to reduce systemic inflammation and prevent chronic diseases. Some lactic acid bacteria, especially Lb paracasei, lb plantarum and pediococcus pentosaceus have proven effective to reduce inflammation and eliminate encephalopathy. Significant reduction in blood ammonia levels and endotoxin levels were reported in parallel to improvement of liver disease. Subsequent studies with other lactic acid bacteria seem to demonstrate suppression of inflammation and in one study also evidence of clinical improvement.
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Pavlovskaia EV, Strokova TV, Topil'skaia NV, Isakova VA. [Dietotherapy children with liver diseases]. Vopr Pitan 2009; 78:11-19. [PMID: 20120964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
In children with liver diseases disorders of the nutritional status appear more quickly and delay normal growth and development. Administration of the nutritional support based on nosological and syndromal approaches lets provide optimal conditions for normalization of the liver functions, improves efficiency of therapy and prognosis of the disease. The article contents modern recommendations on the organization of nutrition in children with different liver diseases, correction of metabolic disorders during complications of liver pathology.
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Kato A, Suzuki K. [Nutritional management for liver disease]. Nihon Shokakibyo Gakkai Zasshi 2007; 104:1714-1721. [PMID: 18057847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Abstract
BACKGROUND Probiotics, defined as live micro-organisms with beneficial effects for the host, are widely applied in gastrointestinal and liver diseases. AIM AND METHOD To review the available evidence of clinical trials on probiotics in gastrointestinal and liver diseases, with a major focus on irritable bowel syndrome, inflammatory bowel disease, pancreatitis and chronic liver diseases. RESULTS Evidence for the therapeutic or preventive application of particular probiotic strains is available for antibiotic-associated diarrhoea, rota-virus-associated diarrhoea and pouchitis. Results are encouraging for irritable bowel syndrome, ulcerative colitis and for reducing side effects by Helicobacter pylori eradication therapies, but are less clear for Crohn's disease, lactose intolerance and constipation. In general, for most of these patient groups, more placebo-controlled methodologically well-designed studies that pay attention to both clinical outcome and mechanistic aspects are required. The application in liver disease and pancreatitis is promising, but more human trials have to be awaited. Possible mechanisms of probiotics include modulation of the intestinal microbiota and the immune system, but different bacterial may have different effects. CONCLUSION Further insight into disease entities and the functioning of probiotic strains is required to be able to select disease-specific strains, which have to be tested in well-designed placebo-controlled studies.
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Affiliation(s)
- D Jonkers
- Div. Gastroenterology-Hepatology, University Hospital Maastricht, Maastricht, The Netherlands.
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Kuwahata M, Yoshimura T, Sawai Y, Amano S, Tomoe Y, Segawa H, Tatsumi S, Ito M, Ishizaki S, Ijichi C, Sonaka I, Oka T, Miyamoto KI. Localization of polypyrimidine-tract-binding protein is involved in the regulation of albumin synthesis by branched-chain amino acids in HepG2 cells. J Nutr Biochem 2007; 19:438-47. [PMID: 17707630 DOI: 10.1016/j.jnutbio.2007.05.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2007] [Accepted: 05/23/2007] [Indexed: 02/04/2023]
Abstract
Long-term supplementation of branched-chain amino acids (BCAA) improves hypoalbuminemia in patients with cirrhosis. Our previous findings have suggested that the binding of polypyrimidine-tract-binding protein (PTB) to rat albumin mRNA attenuates its translation. The aim of the present study was to investigate the role of PTB in the regulation of albumin synthesis by BCAA in human hepatoma cells. HepG2 cells were cultured in a medium containing no amino acids (AA-free medium), a medium containing only 1 amino acid (a BCAA: valine, leucine or isoleucine) or a medium containing all 20 amino acids (AA-complete medium). HepG2 cells cultured in AA-complete medium secreted much more albumin than cells cultured in AA-free medium, with no difference in albumin mRNA levels. In cells cultured in AA-free medium, nuclear export of PTB was observed, and the level of the albumin mRNA-PTB complex was greater than in cells cultured in AA-complete medium. Addition of amino acids stimulated nuclear import of PTB. However, addition of amino acids with rapamycin inhibited the nuclear import of PTB. The addition of leucine, but not of valine or isoleucine, to AA-free medium increased albumin secretion and stimulated the nuclear import of PTB. These data indicate that the mammalian target of rapamycin is involved in the regulation of PTB localization and that leucine promotes albumin synthesis by inhibiting the formation of the albumin mRNA-PTB complex.
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Affiliation(s)
- Masashi Kuwahata
- Department of Molecular Nutrition, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima 770-8503, Japan.
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17
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Abstract
BACKGROUND AND AIMS Despite the benefits of modest weight reduction for overweight patients with chronic liver disease, long-term maintenance of weight loss is difficult to achieve in clinical practice. The aims of this study were to determine if a nutrition research protocol could be translated into clinical practice and meet the demand for dietetic service, to evaluate the effectiveness and resource implications of intensive lifestyle intervention for weight loss, and to assess the effectiveness of standard dietetic therapy as a treatment option for patients unable to attend the program. METHOD Using a modified research protocol, an intensive weight reduction program was introduced into standard clinical care for overweight patients attending a tertiary hospital liver outpatient clinic. An audit of weight loss and cost outcomes was conducted. RESULTS Ninety-three patients were referred to the dietetic service for weight management. Of these, 50 enrolled in an intensive lifestyle intervention, 18 received standard dietetic therapy and 25 refused any intervention. After 6 months, 83% of patients in the intensive intervention achieved weight loss with a significant decrease in weight (P < 0.001) and waist circumference (P < 0.001). In contrast, only 24% of patients receiving standard dietetic therapy achieved weight loss with no significant change in mean weight or waist circumference. Cost per kilogram weight loss after intensive intervention was $AU31 and continuation of lifestyle intervention was calculated to be less than $AU100 per patient per year. CONCLUSIONS A clinically based, intensive lifestyle intervention is a feasible treatment option for outpatient weight management in overweight patients with chronic liver disease. Providing patients who are unable to participate in intensive programs with standard dietetic therapy is not cost-effective.
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Affiliation(s)
- Emma J Osland
- Department of Nutrition Services, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
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18
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19
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Stiefelhagen P. [New strategies for the damaged liver]. MMW Fortschr Med 2007; 149:10-2, 14. [PMID: 17612224 DOI: 10.1007/bf03364953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
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20
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Tokaev ES, Blokhina NP, Nekrasov EA. [Bioactive substance used for treatment and preventive maintenance of liver diseases]. Vopr Pitan 2007; 76:4-9. [PMID: 17802767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
In the present article the review of bioactive substances rendering beneficial effect on an organism at diseases of a liver is resulted. Action of such classes of bioactive substances as amino acids and their derivatives, vitamins, macro- and microelements, herbal bioactive substances, cytamins is described. Bioactive substances can be used in manufacture food supplements or foodstuffs of a medical and prophylactic feed.
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21
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Pazo M, Abdulkader I, Otero-Antón E, Tomé S, Villamil I, González-Quintela A. Alteraciones hepáticas en la enfermedad celíaca del adulto. Caracterización clínico-patológica y evolución. Gastroenterología y Hepatología 2006; 29:383-9. [PMID: 16938252 DOI: 10.1157/13091450] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND AIM The clinical manifestations of adult celiac disease are highly varied and may include liver disease. The present study aimed to characterize liver abnormalities and outcome after a gluten-free diet in patients with celiac disease diagnosed in a hepatology clinic. MATERIAL AND METHOD The clinical records of patients diagnosed with celiac disease during a 7-year period were reviewed. RESULTS Of 1916 patients attending a first consultation at the clinic, 10 were finally diagnosed with celiac disease. All patients had been referred for evaluation of persistent elevation of liver enzyme levels. All patients were young (mean age 30 years, range 21-39 years) and there were more women than men (eight women, 80%). Six patients (60%) had additional manifestations attributable to undiagnosed celiac disease, sometimes since childhood. In all patients, elevation of liver enzyme levels was moderate and overall liver function was preserved. Liver biopsy was performed in five patients and all showed chronic periportal infiltrate. Immunohistochemical studies revealed that the infiltrate was mainly composed of CD8-positive T lymphocytes. In all patients, a gluten-free diet was followed by normalization of liver enzyme levels. CONCLUSIONS Although celiac disease is not highly frequent, it should be considered in the differential diagnosis of patients with persistent abnormalities of liver markers. The most conspicuous histopathological change is periportal T-cell infiltrate. Liver abnormalities in celiac disease are generally mild and improve after a gluten-free diet.
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Affiliation(s)
- María Pazo
- Servicio de Medicina Interna. Hospital Clínico Universitario. Santiago de Compostela. A Coruña. España
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22
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Méndez Romero YDC. [Nutrimental deficiencies in hepatobiliar diseases]. Rev Gastroenterol Mex 2005; 70 Suppl 3:90. [PMID: 17471873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
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23
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Abstract
PURPOSE OF REVIEW The aim of this paper is to describe the relevant medical literature published between spring 2003 and spring 2005 in the field of malnutrition in liver disease and its management. RECENT FINDINGS The most relevant articles covered in this paper provide data regarding the absence of energy imbalance in patients with stable cirrhosis, thus arguing against its potential role in the development of malnutrition; the increase in body cell mass and muscle mass as the major components of weight gain after portal-systemic shunting; the largest published randomized controlled trial of the positive effect of branched-chain amino acid supplements on the long-term outcome of patients with cirrhosis; studies using stable isotope labeled substrates, suggesting that dietary fat could be absorbed via the portal vein in patients with cirrhosis; and a randomized controlled trial suggesting the possibility that probiotics may decrease the infection rate after liver transplantation. SUMMARY In spite of the data provided by these and other articles described in the review, the major controversial issues in the field of nutritional management of liver disease remain open. Particularly remarkable is the lack of consensus regarding the nutritional management of acute liver failure.
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Affiliation(s)
- Eduard Cabré
- Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain.
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24
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McQuaid TS. Medical management of a patent ductus venosus in a dog. Can Vet J 2005; 46:352-6. [PMID: 15943124 PMCID: PMC1082881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
A 2.5-year-old dog with signs of weight loss, vomiting, and hepatic encephalopathy was diagnosed with a patent ductus venosus, based on serum biochemical analysis, jejunal portography, and biopsies, and treated with lactulose, antibiotics, and a reduced protein diet. Two years after initial presentation, the dog is still being managed medically.
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Affiliation(s)
- Timothy S McQuaid
- Atlantic Veterinary College, University of Prince Edward Island, 550 University Avenue, Charlottetown, Prince Edward Island
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25
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de Luis Román D, Aller de la Fuente R, de Luis Román J. [Usefulness of oral nutritional supplements]. Rev Clin Esp 2002; 202:602-3. [PMID: 12392649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Affiliation(s)
- D de Luis Román
- Sección de Endocrinología y Nutrición Clínica. Hospital del Río Hortega. Valladolid. Spain.
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26
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Miggiano G, Guerrera C. [Nutritional evaluation and diet therapy of patients with chronic liver disease]. Clin Ter 2002; 153:351-4. [PMID: 12510422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Malnutrition is prevalent in patients with advanced chronic liver disease and may be associated with a worse prognosis. Treatments often include many dietary restrictions (regarding fluids, sodium and proteins), which may further limit energy intake in addition to other factors limiting food intake (e.g. anorexia, encefalopathy). Guidelines for an optimal diet therapy in patients with different liver diseases, above all in presence of encefalopathy, are briefly reported.
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Affiliation(s)
- G Miggiano
- Centro di Ricerche in Nutrizione Umana, Facoltà di Medicina e Chirurgia, A. Gemelli, Roma, Italia
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27
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Florez DA, Aranda-Michel J. Nutritional management of acute and chronic liver disease. Semin Gastrointest Dis 2002; 13:169-78. [PMID: 12230320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Malnutrition is a common problem in patients with acute and chronic liver disease, and it is near universal in patients undergoing liver transplantation. The cause of malnutrition in liver disease is multifactorial. This article reviews the prevalence of malnutrition, its pathophysiology, modalities of assessing nutritional status, and general guidelines for nutritional support in this patient population.
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Affiliation(s)
- David A Florez
- Division of Digestive Diseases, University of Cincinnati, OH 45267-0595, USA
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28
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Abstract
Liver has a central role in nutritional homeostasis and any liver disease leads to abnormalities in nutrient metabolism and subsequent malnutrition. All children with chronic liver disease (CLD) must undergo a periodic nutritional assessment--medical history, anthropometry esp. skinfold thickness and mid-arm circumference, and biochemical estimation of body nutrients. Nutritional rehabilitation is catered to the individual child but generally the caloric intake is increased to 130% of RDA by adding glucose polymers and/or MCT oil (coconut oil) with essential fatty acid supplementation (sunflower oil). The enteral route is preferred and occasionally nasogastric and/or nocturnal feeding are required to ensure an adequate intake. Proteins rich in branched chain amino acids are given in moderation (2-3 gm/kg/day) in compensated cirrhotics unless encephalopathy occurs when protein restriction may be necessary (1 gm/kg/day). Fat-soluble vitamins are supplemented in large quantities esp. in cholestasis along with other vitamins and minerals. Dietary therapy is the mainstay of management of some metabolic liver diseases and may be curative in disorders like galactosemia, fructosemia and glycogen storage disorders. Pre and postoperative nutritional support is an important factor in improving survival after liver transplantation.
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29
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Holm E, Breitkreutz R, Tokus M. Metabolic encephalopathies: liver disease, renal failure, critical illness. Nestle Nutr Workshop Ser Clin Perform Programme 2002; 5:283-303; discussion 303-6. [PMID: 11510445 DOI: 10.1159/000061839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- E Holm
- Department of Pathophysiology, Medical Clinic I Mannheim, University of Heidelberg, Germany
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30
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Venegas E, Soto A, Cózar MV, Pereira JL, Romero H, García-Luna PP. [Oral nutritional supplements. Are they useful?]. NUTR HOSP 2001; 15 Suppl 1:49-57. [PMID: 11220002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
Oral nutritional supplements are products included in enteral nutrition, preferably used in hospital settings, although their use in the community is gradually increasing and in the United Kingdom has doubled in the last seven years, with prescriptions covering a wide range of the population from children to the elderly, and different pathologies affecting their nutritional status. There is, however, no consensus on the usefulness of oral nutritional supplements among these patients, so we do not have any recommendations for use. In this paper we have reviewed the various studies available in the literature in order to clarify the usefulness of these supplements in different contexts or pathologies.
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Affiliation(s)
- E Venegas
- Hospitales Universitarios Virgen del Rocío, Sevilla, España
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31
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Pfaffenbach B, Lux G. [Improving prognosis of chronic liver diseases with specific nutrition]. MMW Fortschr Med 2001; 143:26-9. [PMID: 11268735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
A sensible diet is capable of reducing the complications of chronic liver disease and improving the patient's prognosis. In patients with compensated liver disease, adequate nutrition should be ensured, but specific therapeutic measures are not generally required. Patients with decompensated liver disease often have deficient nutrition or malnutrition. In these patients specific dietary measures make good sense.
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Affiliation(s)
- B Pfaffenbach
- Medizinische Klinik 1, Städtisches Klinikum Solingen.
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32
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Ilan Y, Sobol T, Sasson O, Ashur Y, Berry EM. A balanced 5:1 carbohydrate:protein diet: a new method for supplementing protein to patients with chronic liver disease. J Gastroenterol Hepatol 2000; 15:1436-41. [PMID: 11197057 DOI: 10.1046/j.1440-1746.2000.02281.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND AIMS Protein malnutrition in patients with chronic liver disease contributes to bone and muscle weakness and compromises immune function and survival. In contrast, high-protein diets may induce or exacerbate hepatic encephalopathy. The aim of the present study was to test whether increased amounts of protein, balanced by dietary carbohydrate in a 1:5 ratio, may be given to chronic liver disease patients in order to minimize postprandial increases in plasma amino acid (AA) concentrations. METHODS Eight patients with chronic liver disease were studied. Each received, in a randomized order, three different diets of 2510 kJ of either high protein (37:50:28, carbohydrate:protein:fat), high carbohydrate (126:10:6) or a balanced 5:1 carbohydrate:protein diet (105:21:11). All patients were followed for plasma AA, glucose and insulin levels, as well as for cognitive and behavioral changes. RESULTS Following the high protein diet, AA concentrations were significantly increased. In contrast, after the balanced diet, AA levels were practically constant enabled. All diets was well tolerated and no cognitive or behavioral changes appeared. CONCLUSION The administration of a balanced 5:1 carbohydrate:protein diet may enable patients with chronic liver disease to tolerate increased amounts of dietary protein, without altering plasma amino acid concentrations.
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Affiliation(s)
- Y Ilan
- Liver Unit, Department of Medicine, Hadassah Hebrew-University Medical School, Jerusalem, Israel.
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33
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Christiansen JS, Hottinger HA, Allen L, Phillips L, Aronson LR. Hepatic microvascular dysplasia in dogs: a retrospective study of 24 cases (1987-1995). J Am Anim Hosp Assoc 2000; 36:385-9. [PMID: 10997512 DOI: 10.5326/15473317-36-5-385] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Hepatic microvascular dysplasia (HMD) is a disease involving a microscopic shunting of blood through the liver without the presence of a macroscopic portosystemic shunt (PSS). Data was collected from medical records and telephone conversations with referring veterinarians and owners of 24 dogs diagnosed with HMD. Criteria for diagnosis included histopathological evidence of microvascular dysplasia on hepatic biopsy as well as surgical exploration and a normal mesenteric portogram to rule out a macroscopic PSS. Dogs with HMD frequently have less severe clinical signs and a better long-term prognosis than do those with a PSS that are managed medically.
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34
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Affiliation(s)
- A J McCullough
- MetroHealth Medical Center and Case Western Reserve University, Cleveland, Ohio, US.
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35
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Plauth M, Weimann A, Holm E, Müller MJ. [Guidelines of GASL for nutrition in liver diseases and liver transplantation]. Z Gastroenterol 1999; 37:301-12. [PMID: 10378367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Affiliation(s)
- M Plauth
- Medizinische Klinik mit Schwerpunkt Gastroenterologie, Hepatologie und Endokrinologie, Humboldt-Universität zu Berlin
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36
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Esteban FJ, Sánchez-López AM, Del Moral ML, Camacho MV, Hernández R, Jiménez A, Pedrosa JA, Peinado MA. Effect of thioacetamide and dexamethasone on serum lipids in rats fed on high-fat sunflower or olive oil diets. J Nutr Sci Vitaminol (Tokyo) 1999; 45:231-8. [PMID: 10450564 DOI: 10.3177/jnsv.45.231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
We have previously reported that high-fat diets develop hepatic steatosis and, depending on the fat quality, affect serum lipid levels differently (J Nutr Sci Vitaminol, 1997, 43, 155-160). The aim of this work is to study the influence of high-fat diets (14% sunflower or olive oils) on serum lipids in a model of hepatic acute damage induced by thioacetamide, and their influence when dexamethasone is administered before thioacetamide injection. Serum lipids and hepatic collagen have been evaluated using biochemical methods, and the steatotic process by histological staining. The results showed that hepatic steatosis and fibrosis are developed either by high-fat diets or thioacetamide injection. Pretreatment with dexamethasone did not decrease the hepatic collagen content. Thioacetamide injection alone or pretreatment with dexamethasone produced increase in serum tryglicerides (TG), total cholesterol (TC) and LDL-C in both high-fat diet groups, and a HDL-C increase in the olive-oil group, even though the atherogenic indices (HDL/TC and HDL/TG) were different depending on the enriched diet. The administration of high-fat diets to study the influence of the fat quality on health and disease should be interpreted carefully due to the ability of the diets themselves to cause hepatic damage.
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Affiliation(s)
- F J Esteban
- Department of Experimental Biology, Faculty of Experimental Sciences, University of Jaén, Spain
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37
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Kabeer NA, Fathima S, Shoba B. Dietary protein in liver diseases. J Assoc Physicians India 1999; 47:354-5. [PMID: 10999147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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38
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Kawamura-Yasui N, Kaito M, Nakagawa N, Fujita N, Ikoma J, Gabazza EC, Watanabe S, Adachi Y. Evaluating response to nutritional therapy using the branched-chain amino acid/tyrosine ratio in patients with chronic liver disease. J Clin Lab Anal 1999; 13:31-4. [PMID: 10025735 PMCID: PMC6808106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/1998] [Accepted: 09/25/1998] [Indexed: 02/10/2023] Open
Abstract
The branched-chain amino acid (BCAA)/tyrosine (Tyr) ratio (BTR) recently has been reported to be a good indicator of the severity of hepatic parenchymal injury in patients with chronic liver disease. In the present study, sequential changes of BTR after BCAA administration were determined in patients with chronic liver disease to evaluate the value of BTR as a marker of the clinical response to nutritional therapy in these patients. This study comprised 75 patients with chronic hepatitis and 96 with liver cirrhosis. BTR was significantly decreased in patients with cirrhosis and hepatitis compared with healthy subjects. BTR was significantly correlated with the Child-Pugh score and with other liver function tests. BCAA increased significantly 2 hr after BCAA administration and decreased gradually thereafter. Tyr significantly decreased 4 hr after BCAA administration. BTR significantly increased 2 and 4 hr after BCAA therapy. The increase in BTR 3 hr after BCAA administration was low in patients with decreased basal BTR. The results of this study showed that BTR is a good index of the hepatic parenchymal damage and that it may be a useful marker for monitoring response to nutritional therapy in patients with chronic liver disease.
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Affiliation(s)
- N Kawamura-Yasui
- Third Department of Internal Medicine, Mie University School of Medicine, Tsu, Japan.
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39
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Abstract
Malnutrition frequently occurs in patients with chronic liver disease, and may influence both short and long term clinical outcome in these patients. Therefore, nutritional intervention may play an important role in the management of chronic liver disease patients. Recent progress in nutritional assessment, principles of nutrition management and the impact of malnutrition upon the clinical outcome of chronic liver disease are reviewed and summarized. Recommendations on how to manage/prevent malnutrition in these patients will be presented.
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40
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Abstract
Nutritional management of the infant and child with liver disease is highly dependent upon the type of liver disease. Acute liver disease, such as that secondary to viral hepatitis, requires no specific nutritional therapy with the exception that branched-chain amino acid supplements may be indicated in the management of hepatic encephalopathy. Nutritional management of the child with chronic liver disease depends upon whether or not cholestasis is present, since in that condition, large amounts of fat-soluble vitamin supplements and medium-chain triglycerides are usually required for optimum growth. However, anicteric cirrhotic liver disease also presents nutritional challenges because of hypermetabolism, enteropathy, and increased protein oxidation. Certain inborn errors of metabolism that result in liver disease (including galactosemia, hepatorenal tyrosinemia, hereditary fructose intolerance, and Wilson's disease) have specific nutritional requirements. And, finally, the advent of pediatric liver transplantation has placed new emphasis on the importance of optimum nutritional management of the child with chronic liver disease, since improvement of nutritional status in the pretransplant period maximizes success of the transplant. This review will focus on the pathogenesis of malnutrition in childhood liver disease and will provide recommendations for nutritional assessment and monitoring as well as nutritional management of cholestatic liver disease, anicteric cirrhotic liver disease, and the inborn errors of metabolism enumerated above. Specific recommendations for nutritional management of the child awaiting liver transplantation will be provided.
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Affiliation(s)
- M A Novy
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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41
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Bauer JE. Diet selection and special considerations in the management of hepatic diseases. J Am Vet Med Assoc 1997; 210:625-9. [PMID: 9054989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- J E Bauer
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station 77843-4474, USA
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42
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Biourge VC. Nutrition and liver disease. Semin Vet Med Surg Small Anim 1997; 12:34-44. [PMID: 9057488 DOI: 10.1016/s1096-2867(97)80042-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Nutritional support is a key factor in the treatment of cats with hepatic disease. This is the only effective treatment in cats with hepatic lipidosis. The ideal diet would be one that fulfills all the basic energy and nutrient requirements of the patient, allows positive energy balance, provides all the nutrients necessary for liver regeneration, and prevents or aids the recovery from major complications of liver disease. Formulation of diets for cats with hepatobiliary diseases must also take into account their metabolic peculiarities. Anorexia is a common complication of liver disease and clinicians must take the necessary actions to ensure adequate energy and nutrient intake. No single diet will accommodate all patients and nutritional support must be adapted to each individual case based on the type of liver disease, extent of hepatic dysfunction, tolerance to dietary protein, and nutritional status.
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Affiliation(s)
- V C Biourge
- Centre de Recherche de Saint-Nolff, Royal Canin, France
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43
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Abstract
Although the normal liver has considerable ability to regenerate, advanced liver disease can significantly reduce this ability. In compensated liver disease, all efforts should be made to maintain nutrition status. In decompensated liver disease, symptoms of decompensation may require therapeutic dietetic intervention. Early nutrition assessment and dietetic intervention in the management of malnutrition, ascites, encephalopathy, and esophageal varices are mandatory and have shown reduced morbidity and mortality in these patients.
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Affiliation(s)
- C Corish
- St. Vincent's Hospital, Dublin, Ireland
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44
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Bauer JE. Hepatic disease, nutritional therapy, and the metabolic environment. J Am Vet Med Assoc 1996; 209:1850-4. [PMID: 8944796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- J E Bauer
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station 77843-4474, USA
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45
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O'Morain C, O'Sullivan M. The role of nutrition in liver disease. Ir Med J 1996; 89:208, 210. [PMID: 8996943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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46
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Brodanová M. [Diet in liver diseases]. Cas Lek Cesk 1996; 135:563-6. [PMID: 8964073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The liver is the metabolic centre of all nutrients. Liver disease can thus interfere with the metabolism of the whole organism, it can have a negative impact on the nutritional status and frequently lead to marked malnutrition. On the other hand, attempts to influence liver disease by dietetic provisions have an old tradition while actual evidence of a marked benefit of these prescriptions is lacking. Therefore we witness at present rather regression from strict dietetic provisions, and individual diets are favoured where frequently the main criterium is the tolerance of the recommended diet and suitable technology. The author submits a brief review of the main metabolic changes in the course of liver diseases which contributes to the understanding of reasons for the recommended dietetic provisions. Attention is drawn to pitfalls which may depretiate therapeutic efforts. The author differentiates the procedure in acute and chronic liver diseases. In cirrhosis special restrictions during decompensation are stressed, as then quite different dietetic provisions are needed. Details are given for encephalopathy and conditions of fluid retention with ascites.
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47
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Katayama T, Cheng CC, Egashira Y, Ohta T, Sanada H. Effect of dietary L-glutamine on the hepatotoxic action of D-galactosamine in rats. Biosci Biotechnol Biochem 1996; 60:1425-9. [PMID: 8987589 DOI: 10.1271/bbb.60.1425] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The protective effect of dietary L-glutamine against the hepatotoxic action of D-galactosamine (GaIN) was investigated by model experiments with rats. Rats fed with 20% casein diets containing 10% free amino acids were injected with GaIN, and the serum aspartate aminotransferase, alanine aminotransferase and lactate dehydrogenase activities and the hepatic glycogen content were assayed 20 hours after the injection. These enzyme activities in the group fed with 10% L-glutamine diet for 8 days were lower than those in the groups fed with the control, 10% L-glutamic acid and 10% L-alanine diets for 8 days. The more prolonged the feeding period with the 10% L-glutamine diet was, the more the serum activity levels of such enzymes were decreased. Although neomycin also lowered these enzyme activities, its simultaneous ingestion with neomycin did not show any additive or synergistic effect. The hepatic glycogen content in the 10% glutamine group still remained high after the GaIN treatment. It is therefore assumed that the effectiveness of glutamine intake would have been mediated by glycogen metabolism rather than by uridine metabolism.
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Affiliation(s)
- T Katayama
- Department of Bioproduction Science, Faculty of Horticulture, Chiba University, Japan
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Abstract
Orthotopic liver transplantation (OLT) is now a definitive treatment option for most cases of endstage liver disease (ESLD) in children. Efforts now focus on active supportive treatment to maintain, if not improve, the patient's clinical status before OLT and to ensure normal patterns of growth and development after OLT. Malnutrition adversely affects the outcome of OLT and is probably the single area in pre-operative management where the largest potential improvement can be made. Our studies indicate significant abnormalities of protein energy metabolism and body composition in children referred for OLT. We have shown that the use of enteral formulae, enriched with branched-chain amino acids, have significant advantages. Other adjunctive therapy, such as growth hormone, is the subject of current investigation. Following transplantation, catch-up weight and growth does occur with the advent of normal liver function, but patients at continuing risk for undernutrition, such as those with rejection and/or chronic infection, need to be targeted for specific nutritional therapy.
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Affiliation(s)
- R W Shepherd
- Royal Children's Hospital, Department of Child Health, University of Queensland, Brisbane, Australia
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Müller MJ. [Diet therapy in acute and chronic liver diseases]. Ther Umsch 1995; 52:528-35. [PMID: 7676398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Nutrition is an essential part of the therapy of patients with acute and chronic liver diseases. Special recommendations are given for patients with ascites, hepatorenal syndrome, encephalopathy, liver failure and secondary diabetes. Nutrition is an essential treatment in patients with hepatic encephalopathy. In acute liver failure, parenteral nutrition is basic for the restoration of homeostasis. This article provides detailed recommendations for nutrient supply for patients with acute and chronic liver diseases.
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Affiliation(s)
- M J Müller
- Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität, Kiel
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Abstract
The provision of adequate nutrition to the patient with liver disease is a challenge. The practitioner must avoid overwhelming the remaining metabolic capabilities of the damaged organ. The ability of the liver to regenerate and the patient to recover depends on the availability of sufficient nutrients. There is no default diet for the patient with liver disease. Each patient must be evaluated individually, with consideration given to the type and origin of the liver disease, the current extent of hepatic dysfunction, and the patient's previous dietary history. Efforts should be directed at the provision of an energy intake adequate to maintain body weight and a protein intake as close to normal as can be tolerated without precipitating signs of hepatic encephalopathy.
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Affiliation(s)
- K E Michel
- Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, USA
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