title: Late-evening snack with branched-chain amino acids improves liver function after radiofrequency ablation for hepatocellular carcinoma.
abstract: OBJECTIVE
  This prospective study was designed to examine whether consumption of a branched-chain amino acid (BCAA)-enriched nutrient mixture as a late-evening snack (LES) helps maintain and/or improve liver functioning in liver cirrhosis (LC) patients who have undergone radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC).
  
  
  METHODS
  An equal number (10) of 30 LC patients who had undergone RFA for HCC was randomly assigned to a standard diet group (control) group, a morning BCAA (M-BCAA) administration group, or a LES with BCAA (LES-BCAA) administration group. Liver function testing was performed and Child-Pugh scores (CPS) calculated for each group to assess the improvement at 1, 4 and 12 weeks post-RFA.
  
  
  RESULTS
  Compared to the control and M-BCAA groups, the LES-BCAA group experienced a rapid and significant improvement in albumin and total serum bilirubin levels and in CPS that began during the initial post-RFA period. These results indicate that LES with BCAA supplementation significantly improved the CPS of the LES-BCAA group at 4 and 12 weeks post-RFA. Although no patients experienced serious adverse effects, two patients who had been diagnosed with diabetes mellitus before undergoing RFA required blood sugar management to improve glycemic control and one subject withdrew due to supplement-induced vomiting.
  
  
  CONCLUSIONS
  LES with BCAA supplementation significantly and rapidly improves liver functioning and CPS in LC patients who have undergone RFA for HCC. Control of blood sugar levels is necessary when calorie-containing BCAA is administrated to LC patients with impaired glucose tolerance.
authors.affiliation: Department of Gastroenterology             Division of Advanced Clinical Research for Viral Hepatitis and Liver Cancer, Fukuoka University Faculty of Medicine             Department of Internal Medicine, Fukuseikai Hospital             Department of Gastroenterology, Fukuoka City Medical Association Hospital             Department of Medicine, Hakujyuji Hospital             Department of Hepatology, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Morihara
authors.forename: Kaoru
authors.initials: K
authors.lastname: Iwata
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hanano
authors.forename: Hideo
authors.initials: H
authors.lastname: Kunimoto
authors.forename: Shizuka
authors.initials: S
authors.lastname: Kuno
authors.forename: Atsushi
authors.initials: A
authors.lastname: Fukunaga
authors.forename: Kaoru
authors.initials: K
authors.lastname: Yotsumoto
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Takata
authors.forename: Takashi
authors.initials: T
authors.lastname: Tanaka
authors.forename: Kunitoshi
authors.initials: K
authors.lastname: Sakurai
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Iwashita
authors.forename: Shu-Ichi
authors.initials: S
authors.lastname: Ueda
authors.forename: Genryu
authors.initials: G
authors.lastname: Hirano
authors.forename: Keiji
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Nakane
authors.forename: Shinya
authors.initials: S
authors.lastname: Nishizawa
authors.forename: Makoto
authors.initials: M
authors.lastname: Yoshikane
authors.forename: Akira
authors.initials: A
authors.lastname: Anan
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Takeyama
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kakumitsu
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kitamura
authors.forename: Masaharu
authors.initials: M
authors.lastname: Sakamoto
authors.forename: Makoto
authors.initials: M
authors.lastname: Irie
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shakado
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Sohda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Watanabe
authors.forename: Shotaro
authors.initials: S
authors.lastname: Sakisaka