2 results for Peng, S

  • Body composition, muscle function, and energy expenditure in patients with liver cirrhosis: A comprehensive study

    McCall, JL; Peng, S; Plank, Lindsay; Gillanders, LK; McIlroy, K; Gane, EJ (2007)

    Journal article
    The University of Auckland Library

    Background: Data describing the nutritional status of patients with liver cirrhosis of diverse origin, as assessed by direct body-composition methods, are limited. Objective: We sought to provide a comprehensive assessment of nutritional status and metabolic activity in patients with liver cirrhosis by using the most accurate direct methods available. Design: Two hundred sixty-eight patients (179 M, 89 F; ?? SEM age: 50.1 ?? 0.6 y) with liver cirrhosis underwent measurements of total body protein by neutron activation analysis, of total body fat and bone mineral by dual-energy X-ray absorptiometry, of resting energy expenditure by indirect calorimetry, of grip strength by dynamometry, and of respiratory muscle strength by using a pressure transducer. Dietary intakes of energy and protein were assessed and indexed to resting energy expenditure and energy intake, respectively. Results: Significant protein depletion, seen in 51% of patients, was significantly (P < 0.0001) more prevalent in men (63%) than in women (28%). This sex difference occurred irrespective of disease severity or origin. The prevalence of protein depletion increased significantly (P < 0.0001) with disease severity. Protein depletion was associated with decreased muscle function but not with lower energy and protein intake. Energy intake was significantly (P = 0.002) higher in men than in women, whereas protein intakes did not differ significantly (P = 0.12). Hypermetabolism, seen in 15% of patients, was not associated with sex, origin or severity of disease, protein depletion, ascites, or presence of tumor. Conclusions: Poor nutritional status with protein depletion and reduced muscle function was a common finding, particularly in men, and was not related to the presence of hypermetabolism or reduced energy and protein intakes. The greater conservation of protein stores in women than in men warrants further investigation.

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  • Nocturnal nutritional supplementation improves total body protein status of patients with liver cirrhosis: A randomized 12-month trial

    Plank, Lindsay; Gane, Edward; Peng, S; Muthu, C; Mathur, S; Gillanders, L; McIlroy, K; Donaghy, AJ; McCall, John (2008-08)

    Journal article
    The University of Auckland Library

    Patients with liver cirrhosis exhibit early onset of gluconeogenesis after short-term fasting. This accelerated metabolic reaction to starvation may underlie their increased protein requirements and muscle depletion. A randomized controlled trial was conducted to test the hypothesis that provision of a late-evening nutritional supplement over a 12-month period would improve body protein stores in patients with cirrhosis. A total of 103 patients (68 male, 35 female; median age 51, range 28???74; Child-Pugh grading: 52A, 31B, 20C) were randomized to receive either daytime (between 0900 and 1900 hours) or nighttime (between 2100 and 0700 hours) supplementary nutrition (710 kcal/day). Primary etiology of liver disease was chronic viral hepatitis (67), alcohol (15), cholestatic (6), and other (15). Total body protein (TBP) was measured by neutron activation analysis at baseline, 3, 6, and 12 months. Total daily energy and protein intakes were assessed at baseline and at 3 months by comprehensive dietary recall. As a percentage of values predicted when well, TBP at baseline was similar for the daytime (85 ?? 2[standard error of the mean]%) and nighttime (84 ?? 2%) groups. For the nighttime group, significant increases in TBP were measured at 3 (0.38 ?? 0.10 kg, P = 0.0004), 6 (0.48 ?? 0.13 kg, P = 0.0007), and 12 months (0.53 ?? 0.17 kg, P = 0.003) compared to baseline. For the daytime group, no significant changes in TBP were seen. Daily energy and protein intakes at 3 months were higher than at baseline in both groups (P < 0.0001), and these changes did not differ between the groups. Conclusion: Provision of a nighttime feed to patients with cirrhosis results in body protein accretion equivalent to about 2 kg of lean tissue sustained over 12 months. This improved nutritional status may have important implications for the clinical course of these patients.

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