肝移植术后3年的营养摄入和饮食质量。

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-06-13 DOI:10.1016/j.clnesp.2025.06.026

Amal Trigui , Crystèle Hogue , Mélanie Tremblay , Geneviève Huard , Christopher F. Rose , Chantal Bémeur

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引用次数: 0

摘要

肝移植（LT）受者营养不良、肌肉减少症和心血管疾病的风险很高，但目前尚无肝移植后的长期饮食指南。本研究旨在描述移植后1年、2年和3年肝移植受者的营养摄入和饮食质量。方法：本横断面研究纳入了既往肝硬化接受肝移植的成年患者，分为三个队列：队列A（肝移植后1年）、队列B（肝移植后2年）和队列C（肝移植后3年）。使用基于网络的24小时膳食回忆（R24W）评估膳食摄入量，并与普通人群的可接受宏量营养素分布范围（AMDR）和微量营养素参考值进行比较。分别使用地中海（MED）评分和健康饮食食品指数(HEFI)-2019对地中海饮食和加拿大食品指南的依从性进行了评估。结果：本研究纳入了62名肝移植受体（62.9%为男性）：队列A (n=23)，队列B （n=14）和队列C （n=25）。在能量摄入方面，A、B和C组之间没有显著差异(2436.0；2097.5;1847.0 kcal)，蛋白质(90.3；75.2;85.6 g)，碳水化合物(267.6；269.1;227.4 g)和总脂肪(95.3 g；74.9;70.7 g)。在所有队列中，总脂肪摄入量都处于AMDR的上限。与男性相比，女性对碳水化合物的AMDR以及铁和钙的推荐摄入量的依从性较低(p=0.036；0.004;和0.002;分别)。纤维和维生素A、D和E的摄入量低于推荐水平，而钠的摄入量超过了男女的推荐水平。地中海饮食（得分18.0/44）和加拿大食物指南（得分39.0/80）的依从性相对较低。结论：肝移植患者的营养摄入和饮食质量指标在肝移植后三年内保持不变，但某些微量营养素明显缺乏。可以优化大量营养素的摄入，以更好地满足这一人群的特定需求。在术后早期阶段，肝移植受者需要量身定制的饮食指南。

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Nutritional intake and diet quality over three years following liver transplantation

Recipients of liver transplantation (LT) are at high risk of malnutrition, sarcopenia and cardiovascular disease, yet no long-term dietary guideline after LT exists. This study aims to describe the nutritional intake and diet quality of LT recipients at 1-, 2-, and 3-years post-transplantation.

Methods

This cross-sectional study included adult patients with previous cirrhosis who underwent LT, divided into three cohorts: Cohort A (1-year post-LT), cohort B (2-years post-LT) and cohort C (3-years post-LT). Dietary intakes were assessed using the web-based 24 h dietary recall (R24W) and compared to the Acceptable Macronutrient Distribution Ranges (AMDR) and micronutrient reference values for the general population. Adherence to the Mediterranean diet and to the Canada's Food Guide were assessed using the Mediterranean (MED) score and the Healthy Eating Food Index (HEFI)-2019, respectively.

Results

Sixty-two LT recipients (62.9 % male) were included in this study: Cohort A (n = 23), cohort B (n = 14) and cohort C (n = 25). No significant differences were found between cohorts A, B and C in terms of intake of energy (2436.0; 2097.5; 1847.0 kcal), protein (90.3; 75.2; 85.6 g), carbohydrate (267.6; 269.1; 227.4 g) and total fat (95.3; 74.9; 70.7 g), respectively. Total fat intake was at the upper limit of the AMDR across all cohorts. Compared to males, females showed lower adherence to the AMDR of carbohydrate and to the recommended intakes for iron and calcium (p = 0.036; 0.004; and 0.002; respectively). Fiber and vitamins A, D and E intakes were below recommended levels, while sodium exceeded the recommended level for both sexes. Adherence to the Mediterranean diet (score 18.0/44) and Canada's Food Guide (score 39.0/80) was relatively low.

Conclusions

Nutritional intakes and diet quality indices in LT recipient remained unchanged across the three years post-LT, with significant deficiencies in certain micronutrients. Macronutrients intake could be optimized to better meet the specific needs of this population. Tailored dietary guidelines are needed for LT recipients, after the early phase post-surgery.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.