Energy metabolism in patients with acute-on-chronic liver failure

ZHAO Juan; WANG Jin-huan; LI Juan; HOU Wei; YU Hong-wei; MENG Qing-hua

Abstract：Objective To investigate the dynamic energy metabolism in acute -on -chronic liver failure ( ACLF) patients during hospitalization , and to provide a theoretical basis for individualized clinical nutrition support . Methods CCM/D nutrition metabolism investigation system was adopted to measure the energy metabolism indexes and biochemical indexes in 33 HBV-ACLF patients (24 for the survival group, 9 for the death group) at admission, in hospi-talization and at discharge or before death .Results REE/pREE(%) at admission, in hospitalization and at discharge in the survival group were (94.50 ±31.88)%, (90.25 ±23.71)% and (81.04 ±26.88)%, respectively; those in the death group were (113.78 ±17.35)%, (114.00 ±24.42)% and (102.78 ±20.87)%, respectively; while there was significant difference in REE/pREE in hospitalization between the two groups ( P =0.008).At admission, RQ and CHO% in the two groups were low , with no significant difference .At discharge in the survival group , significant increases in RQ (to 0.84 ±0.06) and CHO% [to (43.96 ±20.49)%] were observed compared with those at admission (P=0.025 and 0.008, respectively).Before death in the death group, significant reduction in RQ (to 0.78 ±0.05) and CHO%[(21.56 ±14.66)%] were revealed compared with those at discharge in the survival group (P=0.006).Pear-son correlation analysis showed that REE/pREE(%) was negatively correlated with PTA , while RQ and CHO%were pos-itively correlated with PTA and TC .Conclusion Low metabolism is helpful for improvement of prognosis in ACLF pa-tients.RQ and the substrate oxidation rates are better monitoring indexes than REE .PTA and TC can indirectly reflect the energy metabolism in the patients .