title: Oral branched-chain amino acid granules reduce the incidence of hepatocellular carcinoma and improve event-free survival in patients with liver cirrhosis.
abstract: BACKGROUND
  It has been reported that branched-chain amino acid (BCAA) supplementation can improve nutritional status and prevent liver-related complications in patients with decompensated cirrhosis. We investigated the effects of oral BCAA supplementation on the incidence of hepatocellular carcinoma (HCC) and liver-related events in patients with compensated and decompensated cirrhosis.
  
  
  METHODS
  We enrolled 211 patients with cirrhosis including 152 patients with Child-Pugh A cirrhosis, but no history of HCC. Of these, 56 received oral administration of 12 g/day BCAA for ≥6 months (BCAA group), and 155 were followed-up without BCAA treatment (control group). The HCC occurrence and event-free survival rates were compared between the two groups. We used a propensity score analysis to overcome selection bias of this retrospective analysis.
  
  
  RESULTS
  The HCC occurrence rate was significantly lower and event-free survival rate was significantly higher in the BCAA group than in the control group. Multivariate analyses showed BCAA supplementation was significantly associated with reduced incidence of HCC (hazard ratio (HR) 0.416, 95% confidence interval (CI) 0.216-0.800, p = 0.0085). BCAA supplementation also reduced the incidence of liver-related events in patients with Child-Pugh A cirrhosis, although the difference did not reach statistical significance (HR 0.585, 95% CI 0.336-1.017, p = 0.0575).
  
  
  CONCLUSIONS
  Oral BCAA supplementation is associated with reduced incidence of HCC in patients with cirrhosis and seems to prevent liver-related events in patients with Child-Pugh A cirrhosis.
authors.affiliation: Department of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Sakai Hospital, Osaka, Japan.
authors.forename: Sosuke
authors.initials: S
authors.lastname: Hayaishi
authors.forename: Hobyung
authors.initials: H
authors.lastname: Chung
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
authors.forename: Emi
authors.initials: E
authors.lastname: Ishikawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Takita
authors.forename: Taisuke
authors.initials: T
authors.lastname: Ueda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kitai
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Inoue
authors.forename: Norihisa
authors.initials: N
authors.lastname: Yada
authors.forename: Satoru
authors.initials: S
authors.lastname: Hagiwara
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Minami
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Ueshima
mesh_terms: D000284:Administration, Oral; D000597:Amino Acids, Branched-Chain / Q000008:administration & dosage* / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D018572:Disease-Free Survival; D005260:Female; D016174:Hepacivirus / Q000502:physiology; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000150:complications* / Q000188:drug therapy / Q000821:virology; D008113:Liver Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis
chemical_list: D000597:Amino Acids, Branched-Chain