Avaliação do estado nutricional pelo índice de gordura corporal e o efeito da suplementação noturna na recuperação e/ou na manutenção do estado nutricional de pacientes com cirrose hepática

• Ano de defesa: 2017
• Autor(a) principal: Mendonca, Elisa Grossi [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Cirrhosis of the liver; Nutritional status; Body fat index; Nutritional supplementation at night; Protein-calorie malnutrition; Desnutrição proteico-calórica; Cirrose hepática; Estado nutricional; Indice de gordura corporal; Suplementação nutricional noturna
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=5264826; http://repositorio.unifesp.br/handle/11600/50092

Introduction: The hepatic cirrhosis, regardless of its etiology, results in a great impact on the nutritional status. The Protein-Calorie Malnutrition (PCM) is frequent in 20% to 80% of the patient cases, depending on the method of nutritional evaluation and on the severity of the disease. Providing late night snacks may prevent the progression of the catabolic state and diminish the prolonged physiological fasting length. Objective: To study the nutritional status of cirrhotic patients using the Fat Mass Index (FMI) and to evaluate the effect of the nocturnal caloric nutritional supplementation, during the period of 12 months in the recovering of the body fat. Methods: This study was divided into two articles, a retrospective one and a clinical assay, with cirrhotic patients and healthy individuals. Initially, cirrhotic and control subjects have been compared in relation to their body composition by FMI. Later, from the total of cirrhotic patients, 48 subjects who had been classified by the FMI as malnourished and eutrophic participated on the second phase of the study, when they randomly received or not nocturnal caloric oral supplementation. These two groups were divided into control without supplementation and supplemented patients. Results: Eighty six cirrhotic patients (64,7% male, average age 54,5 ± 11,0 years old) and sixty seven healthy controls (52,5% male, average age 52,0 ± 14,7 years old) have been included in this study. The majority of the patients from the control group were classified as overweight or obese subjects (67,5%). On the other hand, the cirrhotic group was frequently classified as presenting fat deficit (19% versus 6%, p= 0,035). Through multivariate linear regression analysis, we have noticed that male cirrhotic patients showed FMI deficiency (p= 0,009), the severity of the disease did not influence it (p= 0,08) and the absence of ascites influenced on the FMI increase (p= 0,007), apart from other variables. When the groups of supplemented and non-supplemented patients were isolated to evaluate the FMI gain, from the first evaluation day to after one year of intervention, none of them presented a significant alteration on the body fat gain at the end of the study (p= 0,192). Conclusion: The FMI in cirrhotic patients was influenced by their gender and by the existence of ascites. The nocturnal supplementation did not influence on the recovery and maintenance of the body fat.