title: Measurement of serum branched-chain amino acids to tyrosine ratio level is useful in a prediction of a change of serum albumin level in chronic liver disease.
abstract: OBJECTIVE
  In patients with hepatitis C virus (HCV)-associated chronic liver diseases, especially in those with liver cirrhosis, accurate evaluation of their protein nutrition status is very important to improve their quality of life. Whereas the serum albumin level is commonly used to evaluate patients' protein nutrition status, in the present study, the serum amino acid levels were measured, as they also provide valuable information.
  
  
  METHODS
  Serum albumin levels and branched-chain amino acids (BCAA) to tyrosine ratio (BTR) were determined in 447 patients with HCV-associated chronic liver diseases (313 with chronic hepatitis and 134 with liver cirrhosis).
  
  
  RESULTS
  Chronic hepatitis progressed to liver cirrhosis, serum albumin and serum BTR levels decreased significantlyas chronic hepatitis progressed to liver cirrhosis. Hypoalbuminemia was significantly more common in patients with liver cirrhosis than in those with chronic hepatitis; however, the incidence of an amino acid imbalance was significantly higher than that of hypoalbuminemia in patients with liver cirrhosis. The presence of an amino acid imbalance was associated with a reduction in the serum albumin level 1 year later.
  
  
  CONCLUSIONS
  It is important to evaluate serum albumin levels and the BTR in patients with HCV-associated chronic liver diseases.
authors.affiliation: Department of Gastroenterology and Hepatology, Koshigaya Hospital, Dokkyo Medical University, Koshigaya, Saitama, Japan.
authors.forename: Kazutomo
authors.initials: K
authors.lastname: Suzuki
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Suzuki
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Koizumi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ichimura
authors.forename: Shigeki
authors.initials: S
authors.lastname: Oka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takada
authors.forename: Hajime
authors.initials: H
authors.lastname: Kuwayama