Abstract: Objective The aim of this study was to evaluate the efficacy and safety of late evening snack (LES) in patients with liver cirrhosis (LC). Methods The systematic search was carried out in PubMed, EMbase, The Cochrane Library, China knowledge Network, Wanfang database and VIP database, and the articles published from January 2000 to August 2020 were retrieved systematically. RevMan5.3 was applied to conduct a statistical analysis. Results Fourteen trials involving 492 cases were included in this study; thirteen studies evaluated the changes of serum albumin levels after administration of LES, and the results showed that the high-quality proteins and amino acids-rich LES could increase serum albumin levels (MD =5.68,95％CI:1.78-9.59,P=0.004); eight clinical trials including 398 participants reported serum pre-albumin level was higher than the baseline (SMD=3.87,95％CI:2.14-5.61,P<0.0001); eight trials including a total of 366 participants reported that after a period of LES, serum CHE level was found to be higher than the baseline (SMD=0.95,95％CI:0.04-1.87,P=0.4); after LES intervention, HGB increased compared with baseline level (MD=4.41,95％CI:0.001-8.82,P=0.05) in 4 trials, and in 10 papers showed total serum bilirubin level decreased after LES intervention (MD=-22.62,95％CI:40.63--4.62,P=0.01); six studies reported an increase in RQ (MD=0.17,95％CI:-0.02-0.36,P=0.08) after taking LES for 1 to 12 weeks; there were 5 studies on fat, protein and carbohydrate oxidation rate, showed a downward trend in protein oxidation rate (MD=-4.07,95％CI:-7.22--0.91,P=0.01) , the utilization of carbohydrates increased significantly (MD=8.47,95％CI:7.51-9.43,P<0.00001), and fat oxidation decreased significantly (MD=-4.88,95%Cl:-7.73--2.02,P=0.0008) after LES. Conclusion LES could improve the malnutrition status of patients with LC.

Key words: Liver cirrhosis, Nocturnal snack, Meta-analysis