Autoimmune Hepatitis, Cirrhosis
Conditions
Brief summary
Autoimmune hepatitis is a chronic disease of the liver caused by an alteration of the immune response that attacks the body's own hepatocytes, progressively, leading to cirrhosis and liver failure. There are few studies on dietary management in hepatitis and most of theme have focused on micronutrients specifically vitamin D to prevent osteoporosis, and decreased symptoms of other diseases associated, but few recommendations have been made regarding a complete dietary approach. Fiber has been proven to increase the excretion of nitrogen products and consequently reduce its blood levels and an adequate protein intake (1.2g/kg) has shown to decrease endogenous catabolism in cirrhotics patients. The implementation of a high protein high fiber nutrition plan and improves nutritional status of patients with autoimmune cirrhosis.
Detailed description
Each participant will receive a high protein (1.2g/kg/day) and high fiber (30g/day) dietary plan. The monitoring of adherence to the diet will be once a month for the duration of the study period. There will be an nutritional assessment by anthropometric techniques: arm circumference, triceps skinfold, weight, height and body mass index as parameters of malnutrition by taking the standard for cirrhotic patients. Body composition was measured by bioelectric impedance to obtain fat mass, lean and total fluid content. The presence of minimal hepatic encephalopathy will be assessed by PHES and CFF and applied three times during the study and the quality of life questionnaire SF-36 CLDQ and will be held in direct interview at the first visit and at study end. Were also measured serum concentrations of ammonium, TNF-alpha, IL-1, IL-6, IL-10, renin, angiotensin and aldosterone.
Interventions
DIETARY_SUPPLEMENTHigh protein high fiber diet
A personalized high protein high fiber dietary plan will be provided to each participant from both groups. Each participant will receive nutritional counseling once a month during six months. Each participant will receive nutritional counseling once month during six months.
Sponsors
Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
20 Years to 70 Years
Healthy volunteers
Yes
Inclusion criteria
Autoimmune hepatitis (Non cirrhotic) * Diagnose of Autoimmune hepatitis * Presence of antinuclear antibody (ANA, SMA) * Biochemical evidence, based on elevation of transaminases * Biopsy compatible with Autoimmune hepatitis * Ambulatory patients Autoimmune hepatitis (Cirrhotic) * Presence of antinuclear antibody (ANA, SMA) * Biochemical evidence, based on elevation of transaminases * Biopsy compatible with autoimmune cirrhosis * Hepatic cirrhosis by USD * Ambulatory patients * Diagnose of Autoimmune cirrhosis by two or more of the following criteria: * Albumin \<3.4g/dl * INR\>1.2 * Total bilirubin \>2mg/dl * Presence of esophageal varices by endoscopy
Exclusion criteria
* Hospitalized patients * Overlapping syndrome with predominant primary biliary cirrhosis * Chronic renal failure * Hepatocellular carcinoma * Neuropsychiatric disorders
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Nutritional Status | Participants will be assessed for six months | Measured with the following parameters:body weight and height (to calculate BMI), triceps skinfold and mid-arm circumference (to calculated mid-arm muscle circumference, fat mass, fat free mass total, intracellular and extracellular body water obtained by bioelectrical impedance analysis and individual vectors obtained by bioelectrical impedance vector analysis. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Minimal hepatic encephalopathy | Participants will be assessed for six months | Assessed by psychometric Hepatic Encephalopathy (PHES) and Critical Flicker Frequency (CFF), at visit 0 months and 6 months visit. |
| Quality of life | Participants will be assessed for six months | Assessed by CLDQ and SF-36 questionnaires, at visit 0 months and 6 months visit. |
Countries
Mexico
Outcome results
None listed