Resting energy expenditure and glucose, protein and fat oxidation in severe chronic virus hepatitis B patients.
OBJECTIVE
To study and determine the resting energy expenditure (REE) and oxidation rates of glucose, fat and protein in severe chronic hepatitis B patients.


METHODS
A total of 100 patients with liver diseases were categorized into three groups: 16 in the acute hepatitis group, 56 in the severe chronic hepatitis group, and 28 in the cirrhosis group. The REE and the oxidation rates of glucose, fat and protein were assessed by indirect heat measurement using the CCM-D nutritive metabolic investigation system.


RESULTS
The REE of the severe chronic hepatitis group (20.7 +/- 6.1 kcal/d per kg) was significantly lower than that of the acute hepatitis group (P = 0.014). The respiratory quotient (RQ) of the severe chronic hepatitis group (0.84 +/- 0.06) was significantly lower than that of the acute hepatitis and cirrhosis groups (P = 0.001). The glucose oxidation rate of the severe hepatitis group (39.2%) was significantly lower than that of the acute hepatitis group and the cirrhosis group (P < 0.05), while the fat oxidation rate (39.8%) in the severe hepatitis group was markedly higher than that of the other two groups (P < 0.05). With improvement of liver function, the glucose oxidation rate increased from 41.7% to 60.1%, while the fat oxidation rate decreased from 26.3% to 7.6%.


CONCLUSIONS
The glucose oxidation rate is significantly decreased, and a high proportion of energy is provided by fat in severe chronic hepatitis. These results warrant a large clinical trail to assess the optimal nutritive support therapy for patients with severe liver disease.
Fan
Chun-Lei
CL
Department of Gastroenterology and Hepatology, Beijing You'an Hospital, Capital Medical University, Beijing 100069, China.
Wu
Yan-Jing
YJ
Duan
Zhong-Ping
ZP
Zhang
Bin
B
Dong
Pei-Ling
PL
Ding
Hui-Guo
HG
D000328:Adult; D018450:Disease Progression; D004734:Energy Metabolism; D005223:Fats / Q000378:metabolism*; D005260:Female; D005947:Glucose / Q000378:metabolism*; D019694:Hepatitis B, Chronic / Q000378:metabolism* / Q000821:virology; D006801:Humans; D008099:Liver / Q000378:metabolism; D008107:Liver Diseases / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D010100:Oxygen / Q000378:metabolism*; D011506:Proteins / Q000378:metabolism*
D005223:Fats; D011506:Proteins; D005947:Glucose; D010100:Oxygen