Primary Study Of The Nutritional Status And Serum Metabolomics Of Patients With Hepatitis B Cirrhosis

Objective:The liver is the central organ for metabolism in the human body.When cirrhosis develops,liver structure abnormalities occur,liver functions change and barriers develop within metabolic pathways.To evaluate the nutritional risk,nutritional status and the characteristics of metabolism combined with the analysis of body composition,anthropometric,laboratory examination and Ultra-high-performance liquid chromatography data combined with mass spectrometry(UPLC-MS)in patients with liver cirrhosis of hepatitis B.The metabolic model was established by analyzing the metabolic profiles of patients and healthy controls.Characteristic ions in the model were screened by the pattern recognition method.Then explore the molecular mechanism of malnutrition in patients with hepatitis B liver cirrhosis and evaluate the nutritional value of small molecule metabolites.Methods :Eighty-three patients of hepatitis B cirrhosis were divided into three groups according to their Child-Pugh score and thirty-five healthy people were as controls.Nutritional risk of the patients were evaluated by NRS-2002.Body mass index(BMI),triceps skinfold thickness(TSF),mid arm muscle circumference(MAMC)and grip strength were measured in patients and controls.Intracellular water(ICW),extracellular water(ECW),total body water(TBW),extracellular water / total body water(ECW/TBW),protein content,skeletal muscle content and fat content were detected by the human body composition analyzer.Serum samples were analyzed by ultra performance liquid chromatography and mass spectrometry(UPLC-MS).Results :According to the Child-Pugh classification,the A,B,C three groups of patients with nutritional risk ratio were 54.5%,79.3% and 90.5% respectively.The differences in TSF and grip strength between patients and controls were statistically significant.There were negative correlations between grip strength and the scores of Child-Pugh as well as NRS2002.The indicators of ECW/TBW,skeletal muscle content,body fat content were significantly different between male patients and controls.There were significantly different in ECW /TBW and body fat content between female patients and controls.Lysophosphatidylcholines(LysoPCs),glycerophosphocholine,ornithine and glucuronic acid were reduced in the serum of patients with hepatitis B cirrhosis(P<0.001).However,glycerophosphoserine and taurocholic acid levels were higher than in the control group(P<0.001).Serum albumin,total cholesterol,LDL,LysoPCs,glycerophosphocholine,ornithine,glucuronic acid,glycerophosphoserine and taurocholic acid were correlated with the Child-Pugh score(P<0.01).Conclusion:There was high incidence of nutritional risk in patients with liver cirrhosis.The indicators of TSF,grip strength,ECW/TBW,skeletal muscle content and body fat content were sensitive in the evaluation of nutritional status in cirrhosis.Bioelectric impedance analysis(BIA)can play an important role in the assessment of cirrhosis patients nutritional status especially in the early stage,but is inaccurate when patients retain fluid.The selected 13 small molecular substances might be considered as sensitive and important indexes for evaluating nutritional status and metabolic characteristics of patients with hepatitis B cirrhosis,which may help assess prognosis and adjust nutritional treatment.