| Background and objectivesBecause of inadequate intake of nutrients and liver cell metabolic defects, patientswith chronic liver disease, especially patients with liver cirrhosis often have varyingdegrees of malnutrition. Nutritional status is considered to be an independentpredictor of morbidity and mortality of serious complications in patients withadvanced liver disease. In patients with liver cirrhosis, assessment of nutritional statusand nutrition support has an important role to reduce the incidence and severity ofserious complications; It can also improve the short-term and long-term quality of lifeof patients.Previous studies have shown that application of nutrition based on bee pollen inrats model of liver injury can significantly improve liver function; Nutrition basedon bee pollen can be used as good materials for nutritional support in liver disease. Inrat model of liver fibrosis induced by carbon tetrachloride (CCl4), application ofnutritional therapy based on combination of nutrients (Noveliver) can improve thelevel of serum albumin. This may be related to liver regeneration promoted bynutritional intervention in rats of liver fibrosis. Liver cirrhosis is a state accompaniedby a decrease in IGF-1and progression of the disease. In liver cirrhosis IGF-1levelwould be decreased while growth hormone would be increased. Increase in growthhormone is due to loss of inhibitory effect of IGF-1on the hypothalamus or the hypophysis. The level of serum IGF-1was positively correlated with the severity ofliver cirrhosis.If nutritional support therapy can increase the level of serum IGF-1in patients withcirrhosis, it will provide a new theoretical basis for nutritional support treatment inliver cirrhosis. The impact of compound nutrients (Noveliver) on serum growthhormone (GH) and insulin-like growth factor-1(IGF-1) in patients with cirrhosis orliver cirrhosis animal model has not been reported. In our study, using nutritionalintervention based on compound nutrients (Noveliver) in rat model of liver fibrosisinduced by CCl4, we examined changes of the body weight, liver function, as well asthe levels of serum growth hormone (GH) and insulin like growth factor-1before andafter treatment. In addition, we observed hepatic histology changes. We analyze theimpact of nutritional intervention based on compound nutrients (Noveliver) onnutritional status and regeneration of liver in liver fibrosis rats, and explore thepossible mechanisms of nutritional support in the cirrhotic patients. To provide newideas for nutritional support in treatment of liver cirrhosis.Materials and Methods1Establishment of rat model of liver fibrosis induced by CCl450SD rats were divided into liver fibrosis model group (n=40) and normal controlgroup (n=10); The rats in liver fibrosis model group were injected intraperitoneallymixture of carbon tetrachloride (CCl4,40%) and olive oil (60%) by0.2ml per100gweight, twice a week for12weeks. Normal control group was injected same volumeof olive oil in the same time and route as the liver fibrosis model group. After12weeks, part rats of the two group were killed respectively. Through the changes ofliver tissue pathology, evaluate whether the animal model of liver fibrosis isestablished. And observe the changes of body weight, liver function, the levels ofserum growth hormone and serum insulin-like growth factor-1.2Nutritional intervention in liver fibrosis ratsSuccessfully prepared liver fibrosis rats randomly divided into2groups:(1)Noveliver intervention group (n=12): CCl4injection discontinued at the12th weekand fed with Noveliver twice a day, and killed in the2nd and4th week of nutritionaltreatment;(2)model control group (n=12): CCl4injection discontinued in the12th week and fed with same volume of distilled water as nutrient twice a day, and killedin the2nd and4th week of nutritional treatment. Observe and record daily food intake,mental condition, activity and weight change of rats in the two groups.3Collection and detection of samplesBefore the nutrition intervention (after12weeks of CCl4administration),2weeksand4weeks after nutritional intervention, the rats were killed in batches, then collectblood from the inferior vena cava. Serum were separated and harvested, usingautomatic biochemical analyzer to measure the alanine aminotransferase (ALT),aspartate aminotransferase (AST), albumin (ALB), total bilirubin (TBil). By enzymelinked immunosorbent assay (ELISA) for detection of serum growth hormone (GH),insulin like growth factor-1(IGF-1). HE staining and Masson staining was used forpathological examination of liver tissue, analysis collagen fiber content in liver tissueand evaluate the degree of liver fibrosis.Results1We successfully established rat model of liver fibrosis by using40%CCl4oliveoil mixed solution. Compared with normal control group, serum transaminases andtotal bilirubin of liver fibrosis model group increased, serum albumin decreased,serum growth hormone(GH) elevated and insulin-like growth factor-1(IGF-1)reduced.2After four weeks of nutrition intervention, the weight of Noveliver interventiongroup(452.1g±21.6g) was significantly higher than that of model control group(416.5g±20.1g). The difference was statistically significant(P<0.05).3After four weeks of nutrition intervention, the level of serum albumin inNoveliver intervention group (34.78g/L±1.87g/L) was higher than that in modelcontrol group(31.73g/L±2.00g/L), and the difference was statistically significant(P<0.05).4Analysis the degree of liver fibrosis of rats in both groups using semi-quantitativescoring system(SSS), the results show that, semi-quantitative scoring of liver fibrosisin Noveliver intervention group (6.17±1.17) was significantly lower than that inmodel control group (10.50±1.05)(P<0.05).5After four weeks of nutrition intervention, both the levels of serum growth hormone (GH) in Noveliver intervention group (0.79ng/ml±0.15ng/ml) and modelcontrol group (0.95ng/ml±0.13ng/ml) were lowered compared with the levels ofbefore nutrition intervention(1.28ng/ml±0.14ng/ml), and no statistically significantdifference between the two groups; But the level of serum insulin-like growthfactor-1(IGF-1) in Noveliver intervention group (1614ng/ml±147ng/ml) wassignificantly higher than that in model control group (1390ng/ml±142ng/ml)(P<0.05).ConclusionsCompound nutrients (Noveliver) can improve the nutritional status, increase serumalbumin level, reduce the degree of liver fibrosis in liver fibrosis rats; And the level ofserum insulin-like growth factor-1(IGF-1) increased significantly after nutritionalintervention; The function of compound nutrients (Noveliver) to promote theregeneration of liver cells may be significantly associated with elevated level ofserum IGF-1. |
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