Avaliação do efeito da suplementação proteica na qualidade de vida dos pacientes na fase pré transplante hepático

Abstract

Chronic liver disease is associated with changes in nutritional status that negatively impact patients' quality of life (QoL). Thus, the use of dietary supplements may be an alternative to improve the QoL. Objective: To evaluate the effect of supplementation of different protein sources on the quality of life, nutritional status and functional of patients in the pre-transplant period. Methods: This is a clinical trial with patients who are candidates for liver transplantation. Patients were randomized to receive daily supplementation of whey protein (WP) or casein (20 g in the morning and 20 g in the evening) for 15 days. The nutritional status was evaluated through subjective global assessment (SGA), triceps skinfold (TS), arm circumference (AC) and functionality through palmar pressure strength, measured by dynamometry and six-minute walk test (TC6). To evaluate the quality of life the chronic liver disease questionnaire (CLDQ) was applied. All evaluations were performed before and after the intervention. Statistical analysis included paired t test (p <0.05). Data were analyzed in Stata Statistical Software, version 12.0. Results: A total of 56 patients were evaluated, being 72.4% male, with a mean age of 51.90 ± 11.33 years. Ethanolic cirrhosis was the most frequent cause (25.9%) of liver disease. According to SGA, 56.9% of the patients were classified as malnourished, of which 33.4% were severe malnutrition and 66.6% were moderate malnutrition. There was no change in the nutritional status of the patients after supplementation (p> 0.05). Quality of life increased in the WP group (3.73 ± 0.98 to 4.70 ± 0.62) and in the Casein group (3.70 ± 1.08 to 4.70 ± 0.73) (p <0.001), with no significant difference between groups. Regarding dynamometry, the tightening force before intervention in the WP group was 28.99 ± 2.04 and evolved to 29.78 ± 2.17 and in the Casein group it was 29.96 ± 2.67 evolved to 31.20 ± 2.42 kg), however, there was no significant difference (p> 0.05). The initial mean of the 6MWT in the WP group was 446.0 ± 20.75, increasing to 454.61 ± 19.63, whereas the casein group was 433.5m4 ± 21.35 and increased to 449.62m ± 16, 61(p> 0.05). Conclusion: Chronic liver disease substantially reduces QOL and the present study suggests that protein supplementation, regardless of source, improves HRQoL in patients for TxH.