Clinical and Translational Research
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 7, 2020; 26(29): 4288-4301
Published online Aug 7, 2020. doi: 10.3748/wjg.v26.i29.4288
Role of nutritional status and nutritional support in outcome of hepatitis B virus-associated acute-on-chronic liver failure
Yue Chang, Qin-Yu Liu, Qing Zhang, Ya-Mei Rong, Cheng-Zhen Lu, Hai Li
Yue Chang, Qing Zhang, Hai Li, Division of Gastroenterology and Hepatology, Tianjin Xiqing Hospital, Tianjin 300380, China
Yue Chang, Qin-Yu Liu, Qing Zhang, Ya-Mei Rong, Hai Li, Tianjin Key Laboratory of Hepatopancreatic Fibrosis and Molecular Diagnosis and Treatment, Tianjin 300162, China
Yue Chang, Qin-Yu Liu, Ya-Mei Rong, Hai Li, Department of Hepatopancreatobiliary and Splenic Medicine, Characteristic Medical Center of People's Armed Police Force, Tianjin 300162, China
Cheng-Zhen Lu, Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin 300192, China
Author contributions: Chang Y and Li H provided the ideas; Chang Y and Liu QY drafted the report; Chang Y, Zhang Q, Rong YM, Lu CZ, and Li H delivered experimental data; all authors have read and contributed to editing this manuscript and presentation of the paper.
Supported by the Tianjin Science and Technology Project, No. 15ZXLCSY00040; and National Major Science and Technology Projects in the 13th Five-Year Plan, No. 2018ZX10732-202-004-005.
Institutional review board statement: This study was approved by the Characteristic Medical Center of People's Armed Police Force, Tianjin, China.
Clinical trial registration statement: This study was registered with (NCT03108794 and NCT01938820).
Informed consent statement: All participants provided informed written consent.
Conflict-of-interest statement: No conflicts of interest, financial or otherwise, are declared by the authors.
Data sharing statement: The dataset is available from the corresponding author via email (
CONSORT 2010 statement: The manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Hai Li, MD, PhD, Professor, Division of Gastroenterology and Hepatology, Tianjin Xiqing Hospital, No. 403 Xiqing Road, Xiqing District, Tianjin 300380, China.
Received: April 11, 2020
Peer-review started: April 11, 2020
First decision: May 21, 2020
Revised: July 4, 2020
Accepted: July 15, 2020
Article in press: July 15, 2020
Published online: August 7, 2020
Core Tip

Core tip: In this study, we investigated the nutritional risk, nutritional status, and the biomarkers of the gastrointestinal barrier in patients with hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF). We found poor nutritional intake and high nutritional risk, with some markers of impaired gastrointestinal barrier function, in HBV-ACLF patients. Blood cytokines, endotoxin, and D-lactate seemed potential predictors of death. Individualized and dynamic nutritional support was associated with a better prognosis of 28-d mortality. Moreover, nutritional support can also improve the gastrointestinal barrier function in survivors. Thus, nutritional status is not only the prognostic factor but also the therapeutic target in HBV-ACLF.