Dietary protein intake and mortality among survivors of liver cirrhosis: a prospective cohort study

BMC Gastroenterol. 2023 Jul 3;23(1):227. doi: 10.1186/s12876-023-02832-1.

Abstract

Background: Liver cirrhosis is a worldwide burden and is associated with poor clinical outcomes, including increased mortality. The beneficial effects of dietary modifications in reducing morbidity and mortality are inevitable.

Aim: The current study aimed to evaluate the potential association of dietary protein intake with the cirrhosis-related mortality.

Methods: In this cohort study, 121 ambulatory cirrhotic patients with at least 6 months of cirrhosis diagnosis were followed-up for 48 months. A 168-item validated food frequency questionnaire was used for dietary intake assessment. Total dietary protein was classified as dairy, vegetable and animal protein. We estimated crude and multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs), applying Cox proportional hazard analyses.

Results: After full adjustment for confounders, analyses showed that total (HR = 0.38, 95% CI = 0.2-1.1, p trend = 0.045) and dairy (HR = 0.38, 95% CI = 0.13-1.1, p trend = 0.046) protein intake was associated with a 62% lower risk of cirrhosis-related mortality. While a higher intake of animal protein was associated with a 3.8-fold increase in the risk of mortality in patients (HR = 3.8, 95% CI = 1.7-8.2, p trend = 0.035). Higher intake of vegetable protein was inversely but not significantly associated with mortality risk.

Conclusion: A comprehensive evaluation of the associations of dietary protein intake with cirrhosis-related mortality indicated that a higher intakes of total and dairy protein and a lower intakes of animal protein are associated with a reduced risk of mortality in cirrhotic patients.

Keywords: Cirrhosis; Cohort study; Dairy; Mortality; Protein.

MeSH terms

  • Animals
  • Cardiovascular Diseases*
  • Cohort Studies
  • Diet
  • Dietary Proteins*
  • Humans
  • Liver Cirrhosis
  • Prospective Studies
  • Risk Factors
  • Survivors

Substances

  • Dietary Proteins