title: Oral supplementation with branched-chain amino acid granules prevents hepatocarcinogenesis in patients with hepatitis C-related cirrhosis: A propensity score analysis.
abstract: OBJECTIVE
  It has been reported that branched-chain amino acids (BCAA) supplementation can improve nutritional status and reduce liver-related complications in patients with decompensated cirrhosis. BCAA supplementation reportedly reduces the incidence of hepatocellular carcinoma (HCC) in obese cirrhotic patients infected with hepatitis C virus (HCV). We investigated the effects of oral supplementation with BCAA granules on hepatocarcinogenesis in patients with HCV-related cirrhosis using propensity score matching.
  
  
  METHODS
  A total of 60 patients with HCV-related cirrhosis and without history of HCC who were selected by one-to-one matching of propensity scores: 30 patients receiving 12 g/day of BCAA granules for 3 months or more (BCAA group) and 30 being observed without BCAA supplementation (control group). The impact of BCAA supplementation was analyzed on the incidence of HCC.
  
  
  RESULTS
  The 3- and 5-year rates of HCC development were 13.7% and 13.7% in the BCAA group and 35.1% and 44.5% in the control group, respectively. The BCAA group had a significantly lower rate of HCC than the control group (P = 0.032). Multivariate analysis for factors that were associated with hepatocarcinogenesis indicated that BCAA supplementation was independently associated with a reduced incidence of HCC (hazard ratio 0.131; 95% confidence interval, 0.032-0.530; P = 0.004) along with sex and serum α-fetoprotein. Obesity (body mass index, ≥25 kg/m(2) ) was not significantly associated with an increased incidence of HCC.
  
  
  CONCLUSIONS
  Oral supplementation with BCAA granules is associated with a reduced incidence of HCC in patients with HCV-related cirrhosis regardless of the presence of obesity based on the propensity score analysis.
authors.affiliation: Department of Gastoroenterology and Hepatology, Ogaki Municipal Hospital, Gifu, Japan.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Tada
authors.forename: Takashi
authors.initials: T
authors.lastname: Kumada
authors.forename: Hidenori
authors.initials: H
authors.lastname: Toyoda
authors.forename: Seiki
authors.initials: S
authors.lastname: Kiriyama
authors.forename: Makoto
authors.initials: M
authors.lastname: Tanikawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hisanaga
authors.forename: Akira
authors.initials: A
authors.lastname: Kanamori
authors.forename: Shusuke
authors.initials: S
authors.lastname: Kitabatake
authors.forename: Takuro
authors.initials: T
authors.lastname: Niinomi
authors.forename: Takanori
authors.initials: T
authors.lastname: Ito
authors.forename: Ryohei
authors.initials: R
authors.lastname: Hasegawa
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ando
authors.forename: Kenta
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Tanaka
keywords: branched-chain amino acids; hepatitis C; hepatocarcinogenesis; hepatocellular carcinoma; propensity score