Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2012 Jul;26(7):463-7.
doi: 10.1155/2012/945707.

A meta-analysis of nutritional supplementation for management of hospitalized alcoholic hepatitis

Ramy Antar  1 , Phil Wong, Peter Ghali
Affiliations
Meta-Analysis

A meta-analysis of nutritional supplementation for management of hospitalized alcoholic hepatitis

Ramy Antar et al. Can J Gastroenterol. 2012 Jul.

Abstract
in English, French

Background: Alcoholic liver disease (ALD) is associated with a high risk of morbidity and mortality. Malnutrition accompanies this condition and may be both a consequence of and contributor to the pathology. Many trials have investigated the benefits of providing supplemental nutrition in the management of patients with ALD. The present study is a meta-analysis of the available evidence.

Method: A meta-analysis of randomized controlled studies comparing nutritional supplementation plus a normal hospital diet versus diet alone.

Results: Seven randomized controlled studies including 262 patients with ALD were identified. Pooled analysis revealed no statistical difference in mortality between groups given special nutritional therapy versus a normal balanced diet (OR 0.80 [95% CI 0.42 to 1.52]). In addition, nutrition did not significantly improve ascites (OR 1.29 [95% CI 0.52 to 3.20]) or any biochemical parameters. However, encephalopathy showed a significant improvement or resolution (OR 0.24 [95% CI 0.06 to 0.93]).

Conclusion: Nutritional supplementation provided no mortality benefit in patients with ALD, and neither ascites nor biochemical parameters significantly improved. However, encephalopathy was significantly ameliorated and, therefore, nutritional supplementation should be encouraged in that setting.

HISTORIQUE :: L’hépatopathie alcoolique (HPA) s’associe à un risque élevé de morbidité et de mortalité. Elle s’accompagne de malnutrition, laquelle peut être à la fois une conséquence et un élément contributif de la pathologie. De nombreux essais ont porté sur les avantages des suppléments nutritionnels pour la prendre en charge. La présente étude est une méta-analyse des données probantes accessibles.

MÉTHODOLOGIE :: Méta-analyse d’essais aléatoires et contrôlés comparant un régime seul aux suppléments nutritionnels associés à un régime normal chez les patients hospitalisés.

RÉSULTATS :: Les chercheurs ont repéré sept essais aléatoires et contrôlés portant sur 262 patients ayant une HPA. L’analyse groupée n’a révélé aucune différence statistique du taux de mortalité entre les groupes ayant reçu une thérapie nutritionnelle spéciale et ceux ayant reçu un régime équilibré normal (RRR 0,80 [95 % IC 0,42 à 1,52]). En outre, les suppléments n’amélioraient pas les ascites (RRR 1,29 [95 % IC 0,52 à 3,20]) ou les paramètres biochimiques de manière significative. Cependant, les cas d’encéphalopathie se sont considérablement atténués ou se sont résolus (RRR 0,24 [95 % IC 0,06 à 0,93]).

CONCLUSION :: Les suppléments nutritionnels n’avaient aucun avantage sur le taux de mortalité dans les cas d’HPA, et ni les ascites ni les paramètres biochimiques ne se sont améliorés de manière significative. Cependant, les cas d’encéphalopathie se sont considérablement atténués. Par conséquent, il faut encourager l’administration de suppléments nutritionnels dans ce contexte.

PubMed Disclaimer

Figures

Figure 1)
Figure 1)
Mortality of patients with alcoholic liver disease from seven randomized clinical trials assessing supplemental nutrition during hospitalization
Figure 2)
Figure 2)
Funnel plot of included trials
Figure 3)
Figure 3)
Scatter plots comparing the change in several biochemical markers before and at the end of the study, between the control group (•) and experimental group (▪). The lines in the scatter plot represent the mean and the SEM. The P value has been provided. ALT Alanine aminotransferase; AST Aspartate aminotransferase
See this image and copyright information in PMC

References

    1. Lucey MR, Mathurin P, Morgan TR. Alcoholic hepatitis. N Engl J Med. 2009;360:2758–69. - PubMed
    1. Cohen SM, Ahn J. The diagnosis and management of alcoholic hepatitis. Aliment Pharmacol Ther. 2009;30:3–13. - PubMed
    1. Tome S, Lucey MR. Review Article: Current management of alcoholic liver disease. Aliment Pharmacol Ther. 2004;19:707–14. - PubMed
    1. Whitfield K, Rambaldi A, Wetterslev J, Gluud C. Pentoxifylline for alcoholic hepatitis. Cochrane Database Syst Rev. 2009;(4):CD007339. - PMC - PubMed
    1. Rambaldi A, Saconato HH, Christensen E, Thorlund K, Wetterslev J, Gluud C. Systematic review: Glucocorticosteroids for alcoholic hepatitis – a Cochrane Hepato-Biliary Group systematic review with meta-analyses and trial sequential analyses of randomized clinical trials. Aliment Pharmacol Ther. 2008;27:1167–78. - PubMed

Publication types

LinkOut - more resources