Effects of supplementary parenteral nutrition on thyroid hormone patterns in surgical patients with liver cirrhosis.
The relationship between nutritional intervention and circulating thyroid hormones and rapid-turnover proteins was investigated in surgical patients with liver cirrhosis. Fourteen patients with well-compensated liver cirrhosis who were subjected to operations for esophageal varices or hepatoma were divided into two groups. The oral group was offered an oral diet containing 2200 kcal/day before surgery and conventional intravenous infusions of 5% glucose after the operation (500-600 kcal/day). The supplementary parenteral nutrition (SPN) group was offered the same oral diet as the oral group, combined with intravenous 50% glucose, fat emulsion, and branched-chain enriched amino acid solution, 600-1000 kcal and 7.32 g nitrogen/day during the 10 days before surgery and 800-1800 kcal and 7.32-9.76 g nitrogen/day during the first 2 wk postoperative. Plasma triiodothyronine (T3) was higher in the SPN group (1.26 +/- 0.09 ng/ml) than in the oral group (0.91 +/- 0.08 ng/ml) (P less than 0.001), and reverse T3 (rT3) was lower in the SPN group (297 +/- 33 pg/ml) than in the oral group (351 +/- 29 pg/ml (P less than 0.01) on the day of surgery. In addition, SPN significantly attenuated the low T3 and high rT3 levels found in the oral group throughout the 2 postoperative wk. In addition, attenuation of decreases in rapid-turnover proteins was achieved in the SPN group. It is likely that the SPN contributed to the partial correction of liver dysfunction and metabolic imbalance in traumatized cirrhotic patients.
Ouchi
K
K
Department of Surgery, Tohoku University School of Medicine, Sendai, Japan.
Matsubara
S
S
Matsuno
S
S
D000328:Adult; D000597:Amino Acids, Branched-Chain / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D002149:Energy Intake; D004932:Esophageal and Gastric Varices / Q000601:surgery; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage; D005260:Female; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition; D013963:Thyroid Hormones / Q000097:blood*; D014284:Triiodothyronine / Q000097:blood; D014285:Triiodothyronine, Reverse / Q000097:blood
D000597:Amino Acids, Branched-Chain; D005217:Fat Emulsions, Intravenous; D013963:Thyroid Hormones; D014284:Triiodothyronine; D014285:Triiodothyronine, Reverse; D005947:Glucose