(OR26-04-24) Impact of Low GI Oral Nutritional Supplement on QOL, Strength and Nutritional Status of Chronic Liver Disease (CLD) Patients – A Multicenter Longitudinal Prospective Study

Objectives: To evaluate the impact of low GI whey and soy based high protein, BCAA enriched oral nutritional supplement (ONS) on the nutritional status, strength, QOL and liver parameters in patients with CLD.

Methods: A multi-centric, single arm, prospective intervention study was conducted at Gleneagles Global and Aditya Hospitals, India (approved by ethics committees and CTRI/2023/03/050644). Informed consent form was obtained from the CLD patients aged 18-65 years (N=76, 4 dropouts). They were prescribed1-3 servings of ONS/day, for 3-months, along with daily diet as per ESPEN guidelines. The nutritional status (24-hour dietary recall), handgrip strength, quality of life (QOL CLDQ questionnaire) and liver parameters were evaluated. The pre-post data was analyzed using paired t– test at 5% level of significance.

Results: A significant improvement in nutritional status was evidenced by improvement in protein (24.46 ± 24.9 g, p< 0.005) and calorie intake (188 ± 389 kcal, p< 0.005) and Serum albumin (0.2 ± 0.639, p< 0.05). Liver function tests improved significantly, particularly a decline in Transaminases (ALT) (-3.5 ± 11.56, p< 0.01), AST (-6.64 ± 17.39, p< 0.005), and Total Bilirubin (-0.96 ± 2.56, p< 0.005) along with a decline in GGT (-18.12 ± 80.83, p >0.05) and Alkaline Phosphatase (-6.8 ± 29.21, p >0.05) was seen. As a result of improved nutritional status, a significant improvement was seen in Overall CLDQ score (0.27 ± 1.039, p< 0.05). Although improvements were seen in all domains, but significant changes were observed in following domains- fatigue (0.34 ± 0.896, p< 0.005), emotional function (0.37 ± 1.106, p< 0.005), Worry (0.39 ± 1.438, p< 0.05). A significant improvement was seen in health biomarker hand grip strength associated with improved nutritional status, overall mortality and quality of life (0.87 ± 3.23, p< 0.05). A positive association was seen between improved protein and BCAA intake on nutritional status, strength, liver function tests and QOL in patients with CLD.

Conclusions: Improving protein and BCAA intake is crucial to tackle malnutrition in patients with Chronic Liver Disease. ONS can be used as an adjunct to diet to meet the gap in protein and amino acid requirements and may help improve nutritional status, liver function and quality of life in Indian patients with chronic liver disease.

Funding Sources: Dr Reddys Laboratories Ltd.