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Received Oct 20, 2017; Revised Feb 11, 2018; Accepted Mar 6, 2018
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
1. Introduction
Liver cirrhosis has been a serious health problem with high morbidity and mortality in the world [1]. Cirrhotic patients exhibit abnormal metabolism, including increased fat oxidation, decreased glucose oxidation, and protein-energy malnutrition (PEM), which were the main reasons leading to poor prognosis [2].
Cirrhotic patients having last eaten at 7 pm the day before will be experiencing starvation at the same level as a healthy person who has fasted for 3 days in the morning and will be experiencing reduction of nonprotein respiratory quotient (npRQ) because of an increased fat-burning rate [3, 4]. A late evening snack (LES) was recommended for patients with liver cirrhosis to improve the morning starving state [5].
Recent progressive studies showed that LES had various physiological effects, such as antihypertension, antiobesity, and antiamnesia properties and that it is helpful in maintaining a greater health-related quality of life (QOL) for patients with cirrhosis [6]. Nevertheless, the quantitative analysis of LES in cirrhotic patients is not clear, except a systematic review of trials about LES in cirrhosis patients published up to December 2011 [7]. It reported that LES was considered beneficial to decrease lipid oxidation and improve nitrogen balance. However, the results were summarized only by table form, lacking a systematic data analysis.
Recently, several new studies of potentially higher quality have been published. Being able to establish an average difference of pre-LES and post-LES in serum biochemical parameters and fuel metabolism indexes would be helpful for cirrhotic patients and clinical therapy. The quantitative analysis may provide more sufficient and more powerful evidence in the context of the current medical literature. Therefore, the objective of our study was to statistically combine these studies to make a quantitative analysis and evaluate the efficacy of LES treatment in patients with liver cirrhosis.
2. Methods
2.1. Searching Strategies
Systematic search was performed on PubMed, Embase, Web of Science, Elsevier, China National Knowledge Infrastructure, and Wanfang Database for articles published up to July 2017. The following keywords were used during the search: “late...