Effect of oral supplementation with branched-chain amino acid granules in the early stage of cirrhosis.
Background/aims: We focus on branched-chain amino acid (BCAA) for patients with early stage of cirrhosis. We designed a randomized trial to examine whether increase or preservation of serum albumin levels was attained with administration BCAA granules for compensated cirrhosis, compared with decompensated cirrhosis. Patients and method: Sixty-five patients with HCV-related cirrhosis with serum albumin level less than 4.0g/dl were enrolled in this study. Half of the patients were randomly assigned to receive 14.22 g/day of BCAA granules orally, and half were assigned to a control group. Patients were evaluated at entry and at 1-year intervals for at least 2 years. We divided the parameters into three categories. Class 1 was decompensated cirrhosis with serum albumin level less than 3.5mg/dl. Class 2 was compensated cirrhosis with serum albumin level over 3.6 mg/dl and molar ratio of BCAA to tyrosine (BTR) less than 4. Class 3 was compensated cirrhosis with serum albumin level over 3.6 mg/dl and BTR over 4. Results: In class 1 and class 2, the BCAA group exhibited significantly higher rates of maintaining serum albumin level than the control group for 2 years. In contrast, there was no significant difference between the BCAA group and control group in rate of maintaining serum albumin levels in class 3. Conclusions: Those results suggested that if cirrhotic patients were in the compensated stage at the entry but with lower BTR, as for decompensated cirrhosis, oral BCAA supplementation might be effective in maintaining serum albumin. Stating appropriate nutritional interventions, such as supplementation of BCAA, in the early stage of cirrhosis may improve prognosis and maintain QOL.
Nishiguchi
Shuhei
S
Departments of Hepatology, Graduate School of Medicine, Osaka City University, Medical School, 1-5-7 Asahimachi, Abeno-ku, Osaka 545-8586, Japan.
Habu
Daiki
D