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Hepatol Res. 2003 Sep;27(1):45-50.

Effect of a late evening snack on the blood glucose level and energy metabolism in patients with liver cirrhosis.

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Department of Gastroenterology and Hepatology, Yamaguchi University School of Medicine, Minami Kogushi 1-1-1, 755-8505, Yamaguchi Pref., Ube, Japan



Patients with liver cirrhosis suffer from energy malnutrition. Late evening snacks (LESs) have been recently reported to be effective for this. However, it is known that a significant proportion of patients with liver cirrhosis have glucose intolerance as a complication. For this reason, the influence of LES on the blood glucose level should be examined.


We administered an oral supplement with branched-chain amino acids (Aminoleban EN) to patients with liver cirrhosis at 10 P.M. to investigate the changes of the blood glucose level and energy metabolism with an indirect calorimeter. Ten patients (average age, 70; Child A/B/C, 5/4/1) participated in this study. The administration period was 7 days. Blood glucose levels were examined before and after breakfast, lunch, supper and at 10 P.M.


(1) The fat oxidation rate was significantly decreased and the carbohydrate oxidation rate significantly increased. As a result, RQ was significantly improved. (2) With many cases, an increase of glucose level after meals seemed to reduce with LES administration for 1 week. (3) BTR was significantly improved.


LES could improve energy malnutrition, correct amino acid imbalance, and ultimately may improve glucose intolerance in patients with liver cirrhosis.

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