Effect of amino acid-balanced diet-based nutritional-psychological intervention on muscle wasting and quality of life in cirrhosis patients

Table 1 Comparison of general data of two groups of patients, mean ± SD

Group	Examples	Gender (male/female)	Age (years)	Child-Pugh grading (A; B; C)	Cause (hepatitis B; hepatitis C; alcohol-related; other)
Control group	65	35/30	52.3 ± 8.5	20; 30; 15	35; 10; 15; 5
Observation group	65	33/32	51.8 ± 9.2	22; 28; 15	33; 12; 14; 6
t		0.135	0.335	0.246	0.374
P value		0.713	0.738	0.884	0.945

Table 2 The scores of each dimension of the quality-of-life assessment questionnaire for the two groups of patients before and after the intervention (points), mean ± SD

Group	n	Time	Fatigue	Emotional function	Abdominal symptoms	Systemic symptoms	Activity	Worry	Total score	P value (between-group)
Observation group	65	Before intervention	3.84 ± 0.91	3.72 ± 0.89	3.52 ± 0.85	3.78 ± 0.90	3.61 ± 0.87	3.91 ± 0.93	22.38 ± 2.185	> 0.05
		Intervention for 3 months	4.78 ± 1.02	4.56 ± 0.97	4.36 ± 0.95	4.75 ± 1.02	4.56 ± 0.98	4.85 ± 1.02	27.86 ± 2.4351	< 0.001
		Intervention 6 months	5.28 ± 1.05	5.12 ± 1.02	4.85 ± 1.02	5.25 ± 1.05	5.02 ± 1.02	5.35 ± 1.05	30.87 ± 2.5352	< 0.001
		Overall within-group	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001
Control group	65	Before intervention	3.88 ± 0.93	3.76 ± 0.91	3.56 ± 0.87	3.82 ± 0.92	3.65 ± 0.89	3.95 ± 0.95	22.63 ± 2.234	> 0.05
		Intervention for 3 months	4.18 ± 0.95	4.05 ± 0.93	3.85 ± 0.90	4.12 ± 0.95	3.95 ± 0.92	4.25 ± 0.97	24.40 ± 2.2951	< 0.001
		Intervention 6 months	4.48 ± 0.97	4.35 ± 0.95	4.12 ± 0.92	4.42 ± 0.97	4.25 ± 0.95	4.55 ± 0.98	26.17 ± 2.3442	< 0.001
		Overall within-group	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

¹Significant difference compared with the same group before intervention.

²Significant difference compared with the same group 3 months after intervention and compared with the same group before intervention.

Intergroup comparisons were performed using independent samples t-tests; intra-group comparisons were performed using repeated measures analysis of variance, with post hoc tests using Bonferroni correction.

Table 3 Assessment of anxiety and depression in two groups of patients before and after intervention (points), mean ± SD

Group (n)	SAS			SDS
	Before intervention	3 months after intervention	6 months after intervention	Before intervention	3 months after intervention	6 months after intervention
Observation group (65)	54.3 ± 3.2	46.7 ± 2.5	42.5 ± 2.0	56.1 ± 2.8	48.3 ± 2.2	44.1 ± 1.8
Control group (65)	53.9 ± 3.5	52.1 ± 3.0	51.3 ± 2.8	55.8 ± 3.1	54.5 ± 2.6	53.7 ± 2.4
t	0.376	13.599	16.374	0.582	10.755	11.134
P value	0.769	< 0.001	< 0.001	0.741	< 0.001	< 0.001

SAS: Self-Rating Anxiety Scale; SDS: Self-Rating Depression Scale.

Table 4 The changes of muscle strength indexes such as grip strength before and after intervention in two groups of patients, mean ± SD

Group	Examples	Time	The power of gripping (kg)	Knee extension strength (Newton)
Control group	65	Before intervention	22.35 ± 4.12	125.36 ± 20.15
		Intervention lasted for 3 months	22.68 ± 4.20	128.56 ± 21.08
		Intervention 6 months	22.95 ± 4.25	130.25 ± 21.50
Observation group	65	Before intervention	22.18 ± 4.05	124.89 ± 19.87
		Intervention for 3 months	23.45 ± 4.35	135.68 ± 22.36
		Intervention for 6 months	24.20 ± 4.45	142.36 ± 23.50

Table 5 The repeated measurement variance analysis of grip strength and knee extension strength in two groups of patients at different time points

Metric	Time	Group F value	P value	Group F value	P value	Time × inter-group F value	P value
The power of gripping	Before intervention, 3 months and 6 months	16.325	< 0.001	12.568	< 0.001	14.874	< 0.001
Knee extension strength	Before intervention, 3 months and 6 months	17.256	< 0.001	13.654	< 0.001	15.987	< 0.001

Table 6 Dynamic changes in liver function indicators, mean ± SD

Indicator	Group	Baseline	3 months	6 months	P value (time × group)2
ALT (U/L)	Control group	68.3 ± 12.1	65.7 ± 11.8	67.2 ± 10.9	0.032
	Observation group	67.9 ± 13.5	58.2 ± 9.71	52.4 ± 8.31
AST (U/L)	Control group	75.6 ± 14.2	73.8 ± 13.6	74.1 ± 12.7	0.021
	Observation group	76.1 ± 15.0	66.3 ± 10.81	60.5 ± 9.41
Albumin (g/L)	Control group	31.2 ± 2.8	32.0 ± 3.1	31.7 ± 2.9	0.019
	Observation group	30.8 ± 3.0	34.5 ± 2.71	36.8 ± 2.51
Prealbumin (mg/L)	Control group	120.5 ± 15.7	125.3 ± 16.2	123.1 ± 14.9	0.008
	Observation group	118.7 ± 16.3	142.6 ± 18.11	158.3 ± 17.51
Total bilirubin (μmol/L)	Control group	42.5 ± 6.8	40.1 ± 6.2	41.3 ± 5.9	0.045
	Observation group	43.2 ± 7.1	36.7 ± 5.81	32.4 ± 4.71

¹Significant difference compared to before intervention within the same group and compared to control group at the same time point.

²Interaction effect by repeated-measures ANOVA, control group showed no significant changes from baseline at any time point (all P > 0.05); observation group showed significant improvements in all indicators at 3/6 months vs baseline and 3/6 months vs control group.