Prospective Study on Efficacy of Oral Supplement of Branched-Chain Amino Acid Granules on the Nutritional Status of the Cirrhotics / 대한간학회지

ABSTRACT

BACKGROUND/AIMS: A prospective comparative study was conducted to investigate the efficacy of orally administered branched-chain amino acids (BCAA) in cirrhotic patients. METHODS: Forty-seven patients with liver cirrhosis of viral etiologies, whose hypoalbuminemia could not be corrected with adequate protein intake, were randomly assigned to either the BCAA group (n=31) or the control group (n=16). The selection criteria were ages between 16 and 70 years, patients whose Child-Pugh scores were less than 13 points and who were willing to participate in the study. Most patients (87.1%) belonged to Child-Pugh class B. Patients in the BCAA group received oral supplementation with branched-chain amino acid granules (12 g/day, each packet containing total 4 g of BCAA, i.e. leucine, 1904 mg; valine, 1144 mg; isoleucine, 952 mg) for 12 weeks. Patients had complete blood counts and chemistry at entry and once every month. Serum ferritin and amino acid concentrations in plasma were determined. Anthropometric parameters including body weight, body fat contents and body mass index were assessed at the beginning and at the end of the 3-month period. RESULTS: In the BCAA group, there was a significant increment in plasma levels of isoleucine, valine (p < 0.001) whereas levels of aromatic amino acids did not show substantial change. Total BCAA concentration and BCAA/AAA (aromatic amino acid) molar ratio (Fischer's ratio) also increased significantly after the administration of oral BCAA (p < 0.001). In contrast, patients in the control group showed no significant change in assessed parameters. CONCLUSION: Oral supplementation of BCAA to cirrhotic patients improved several parameters reflecting nutritional status without causing encephalopathy or other serious adverse effects.