AIM: To study and determine the resting energy ex- penditure (REE) and oxidation rates of glucose, fat and protein in severe chronic hepatitis B patients. METHODS: A total of 100 patients with liver diseases were categorized into three groups: 16 in the acute hepatitis group, 56 in the severe chronic hepatitis group, and 28 in the cirrhosis group. The REE and the oxidation rates of glucose, fat and protein were as- sessed by indirect heat measurement using the CCM-D nutritive metabolic investigation system. RESULTS: The REE of the severe chronic hepatitis group (20.7 ± 6.1 kcal/d per kg) was significantly lower than that of the acute hepatitis group (P = 0.014). The respiratory quotient (RQ) of the severe chronic hepatitis group (0.84 ± 0.06) was significantly lower than that of the acute hepatitis and cirrhosis groups (P = 0.001). The glucose oxidation rate of the severe hepatitis group (39.2%) was significantly lower than that of the acute hepatitis group and the cirrhosis group (P < 0.05),="" while="" the="" fat="" oxidation="" rate="" (39.8%)="" in="" the="" severe="" hepatitis="" group="" was="" markedly="" higher="" than="" that="" of="" the="" other="" two="" groups="" (p="">< 0.05).="" with="" improve-="" ment="" of="" liver="" function,="" the="" glucose="" oxidation="" rate="" in-="" creased="" from="" 41.7%="" to="" 60.1%,="" while="" the="" fat="" oxidation="" rate="" decreased="" from="" 26.3%="" to="" 7.6%.="" conclusion:="" the="" glucose="" oxidation="" rate="" is="" signifi-="" cantly="" decreased,="" and="" a="" high="" proportion="" of="" energy="" is="" provided="" by="" fat="" in="" severe="" chronic="" hepatitis.="" these="" re-="" sues="" warrant="" a="" large="" clinical="" trail="" to="" assess="" the="" optimal="" nutritive="" support="" therapy="" for="" patients="" with="" severe="" liver="" disease.="">