title: The effect of supplementation with branched-chain amino acids in patients with liver cirrhosis.
abstract: OBJECTIVE
  We investigated the effect of supplementation with branched-chain amino acids (BCAA) in patients with liver cirrhosis on the change of energy metabolism as well as glucose tolerance.
  
  
  METHODS
  Thirty liver cirrhosis patients underwent nutrient supervision by a dietician for one week. They were then prescribed oral supplementation with three packs of a BCAA nutrient (Livact 4.15 g/pack; Ajinomoto Pharma, Tokyo, Japan), taken three times a day: after breakfast, dinner and before sleep. The change in energy metabolism and glucose tolerance was examined using an indirect calorimeter and 75 g oral glucose tolerance test (75 g OGTT).
  
  
  RESULTS
  Non-protein respiratory quotient (npRQ) as well as branched-chain amino acid/tyrosine ratio (BTR) showed significant improvement, especially in patients with a creatinine height index (CHI) greater than 80. There was also a significant correlation between npRQ after one week of BCAA supplementation and the CHI. The patients with CHI greater than 80 and those with borderline pattern assessed by 75 g OGTT showed significant improvement in impaired glucose tolerance.
  
  
  CONCLUSIONS
  Liver cirrhosis patients with CHI greater than 80 are the first candidates for BCAA supplementation. These patients showed improvement not only in energy metabolism and BTR, but also glucose tolerance.
authors.affiliation: Department of Gastroenterology and Hepatology, Yamaguchi University, Graduate School of Medicine, Yamaguchi Prefecture, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Urata
authors.forename: Kosuke
authors.initials: K
authors.lastname: Okita
authors.forename: Keiko
authors.initials: K
authors.lastname: Korenaga
authors.forename: Koichi
authors.initials: K
authors.lastname: Uchida
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamasaki
authors.forename: Isao
authors.initials: I
authors.lastname: Sakaida