title: Oral branched-chain amino acid supplementation improves the oxidized/reduced albumin ratio in patients with liver cirrhosis.
abstract: OBJECTIVE
  Branched-chain amino acid (BCAA) supplementation improves hypoalbuminemia in decompensated cirrhotics. Recently, it was clarified that the ratio of oxidized albumin within total albumin rises with progression of liver cirrhosis. We conducted a feasibility study to investigate whether BCAA supplementation might improve this ratio.
  
  
  METHODS
  Seven cirrhotic patients (age: 70 +/-> 6 years; M/F = 4/3; etiology: hepatitis C in six and non-B/non-C hepatitis virus in one; Child-Pugh classification: A in six and B in one) were enrolled consecutively in this study in October 2004 to March 2005. Patients were given 4 g BCAA after each meal for 8 weeks. Serum total, oxidized and reduced albumin, plasma amino acids, glutathione, zinc, selenium, and lipid peroxide concentrations were measured every 2 weeks.
  
  
  RESULTS
  Low total albumin, high oxidized albumin, and low reduced albumin levels were observed at entry. After 8 weeksBCAA supplementation, the ratio of oxidized albumin within total albumin decreased significantly and that of reduced albumin increased significantly (P < 0.05, respectively). Total albumin tended to rise and lipid peroxide concentrations tended to fall, but not significantly.
  
  
  CONCLUSIONS
  BCAA supplementation improved the oxidized/reduced state of serum albumin. This intervention is effective to maintain the quality of serum albumin in cirrhotic patients.
authors.affiliation: Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Fukushima
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Miwa
authors.forename: Makoto
authors.initials: M
authors.lastname: Shiraki
authors.forename: Ikuko
authors.initials: I
authors.lastname: Gomi
authors.forename: Katsuhisa
authors.initials: K
authors.lastname: Toda
authors.forename: Shoko
authors.initials: S
authors.lastname: Kuriyama
authors.forename: Hironori
authors.initials: H
authors.lastname: Nakamura
authors.forename: Toshitatsu
authors.initials: T
authors.lastname: Wakahara
authors.forename: Seiichi
authors.initials: S
authors.lastname: Era
authors.forename: Hisataka
authors.initials: H
authors.lastname: Moriwaki