Nutritional status and body composition dynamics with peginterferon alpha and ribavirin combination therapy in chronic hepatitis C patients

Masahiko Takahashi, M. Kikuchi, H. Ebinuma, H. Saito
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Abstract

Weight loss has been reported in patients treated with peginterferon alpha (Peg-IFN-") and ribavirin, however, the pathophysiological mechanism of this weight loss is unclear. We prospectively evaluated the nutritional status, body composition and dietary intake of 10 chronic hepatitis C patients treated with Peg-IFN-" and ribavirin, before, at the end of and at 6 months after treatment. Nutritional status and body composition were evaluated by using anthropometric analyses and Bioelectrical Impedance Analysis (BIA) with a body composition analyzer. Body weight, body mass index and total energy intake were significantly (p<0.05) reduced at the end of treatment compared with before treatment, however, at 6 months after treatment, they were recovered to before-treatment levels. In anthropometric analyses, percent Triceps Skinfold Thickness (TSF%) which represents body fat mass was significantly (p<0.05) decreased at the end of treatment compared with before treatment, whereas, percent Arm Muscle Circumference (AMC%) which represents body muscle was not. In the BIA, body fat mass was also significantly (p<0.05) decreased, whereas, skeletal muscle mass was not. There were no significant changes in grip strength and serum albumin level. Decreased TSF% and body fat mass were also recovered to before treatment values at 6 months after treatment. The body weight loss observed during Peg-IFN-"-2b and ribavirin was attributable to body fat mass decrease rather than skeletal muscle mass decrease. Decreased body weight and decreased body fat mass were recovered to before treatment values at 6 months after treatment without body composition change.
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聚乙二醇干扰素和利巴韦林联合治疗慢性丙型肝炎患者的营养状况和体成分动态变化
有报道称,接受聚乙二醇干扰素α (Peg-IFN-”)和利巴韦林治疗的患者体重减轻,然而,这种体重减轻的病理生理机制尚不清楚。我们前瞻性地评估了10例接受Peg-IFN-”和利巴韦林治疗的慢性丙型肝炎患者在治疗前、治疗结束时和治疗后6个月的营养状况、身体成分和饮食摄入量。采用人体测量法和生物阻抗分析法(BIA)评价营养状况和身体成分。治疗结束时体重、体重指数和总能量摄入较治疗前显著降低(p<0.05),但治疗6个月后恢复到治疗前水平。在人体测量学分析中,与治疗前相比,治疗结束时代表身体脂肪质量的三头肌皮褶厚度百分比(TSF%)显著(p<0.05)下降,而代表身体肌肉的手臂肌肉周长百分比(AMC%)则没有下降。BIA组体脂肪量显著减少(p<0.05),骨骼肌量无明显变化。握力和血清白蛋白水平无明显变化。治疗后6个月,TSF%和体脂量也恢复到治疗前的水平。在Peg-IFN-"-2b和利巴韦林治疗期间观察到的体重减轻是由于体脂肪量减少而不是骨骼肌量减少。治疗后6个月体重和体脂量均恢复到治疗前水平,体成分无变化。
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