title: The efficacy of nocturnal administration of branched-chain amino acid granules to improve quality of life in patients with cirrhosis.
abstract: BACKGROUND
  Nocturnal administration of branched-chain amino acid (BCAA) granules improves serum albumin levels in patients with cirrhosis. However, it is unclear whether or not this administration method can improve the patients' quality of life (QOL). In this study, we aimed to investigate the efficacy of BCAA granules, given nocturnally, in improving QOL in these patients.
  
  
  METHODS
  We performed a multicenter, randomized controlled trial examining the comparative effects of BCAA granules given orally for 3 months with daytime or nocturnal administration in patients with compensated cirrhosis. Health-related QOL was measured by a Japanese version of the questionnaire on subjective and objective symptoms, and the Short Form-8 (SF-8) questionnaire.
  
  
  RESULTS
  Twenty-one patients received BCAA granules three times a day (one sachet after each meal: the daytime group), and 16 patients received the granules twice a day (one sachet after breakfast, and two sachets before bedtime: the nocturnal group). Baseline characteristics did not differ between the groups (whole cohort: Child-Pugh grade A/B, 21/16; mean age, 68.2 years). There was no significant difference in any of the subjects revealed by the questionnaire regarding subjective or objective symptoms, or by the SF-8 between the daytime group and the nocturnal group after 3 months of treatment. The daytime group showed a significant effect on general health, vitality, social functioning, mental health, and role emotional as revealed on the SF-8. Conversely, the nocturnal group exhibited a significant decrease in the occurrence of muscle cramps in the legs (P = 0.014) and significantly improved Fisher's ratio after 3 months (P = 0.04).
  
  
  CONCLUSIONS
  Nocturnal administration of BCAA granules in patients with cirrhosis reduced the occurrence of muscle cramps in the leg but did not improve the patients' QOL.
authors: Department of Gastroenterology, Kitasato University School of Medicine, 2-1-1 Asamizodai, Minami, Sagamihara, Kanagawa, 252-0380, Japan. hisashi7@kitasato-u.ac.jp
authors: Hisashi
authors: H
authors: Hidaka
authors: Takahide
authors: T
authors: Nakazawa
authors: Shinji
authors: S
authors: Kutsukake
authors: Yoshiki
authors: Y
authors: Yamazaki
authors: Izumi
authors: I
authors: Aoki
authors: Shiro
authors: S
authors: Nakano
authors: Noriyuki
authors: N
authors: Asaba
authors: Tsutomu
authors: T
authors: Minamino
authors: Juichi
authors: J
authors: Takada
authors: Yoshiaki
authors: Y
authors: Tanaka
authors: Yusuke
authors: Y
authors: Okuwaki
authors: Masaaki
authors: M
authors: Watanabe
authors: Akitaka
authors: A
authors: Shibuya
authors: Wasaburo
authors: W
authors: Koizumi
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000597:Amino Acids, Branched-Chain / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000209:etiology; D004334:Drug Administration Schedule; D004932:Esophageal and Gastric Varices / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000534:rehabilitation; D008113:Liver Neoplasms / Q000209:etiology; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life; D016896:Treatment Outcome
chemical_list: D000597:Amino Acids, Branched-Chain; D015415:Biomarkers