title: Supplementation of branched-chain amino acids maintains the serum albumin level in the course of hepatocellular carcinoma recurrence.
abstract: Hepatocellular carcinoma (HCC) is the third leading cause of cancer deaths worldwide. Serum albumin (Alb) is an important prognostic factor for patients with HCC. Moreover, plasma levels of branched-chain amino acids (BCAA), L-valine, L-leucine, and L-isoleucine, are commonly decreased in patients with cirrhosis. Accordingly, formulations of BCAA has been used to maintain the Alb level and prevent ascites in patients with cirrhosis. The aim of this study is to investigate differences in the changes in Alb between a group that received a BCAA formulation (n = 29) and a group given a standard diet (n = 60) in the course of HCC recurrences. All patients experienced more than one hospitalization (mean: 2.6; range: 2-10) owing to recurrence. The plasma BCAA concentration and BCAA-to-tyrosine ratio (BTR), which is a good indicator of the severity of hepatic parenchymal injury in patients with cirrhosis, were significantly correlated with Alb. We defined the changes in BCAA and Alb between recurrences as ΔBCAA and ΔAlb, respectively, and stratified the patients in both groups based on number of recurrences (3 < early, 3-5 middle, or 5 > later). There was also a positive correlation between ΔBCAA and ΔAlb. Interestingly, in the group with BCAA, ΔAlb and ΔBCAA were significantly smaller, especially in the middle period (3-5 recurrences), than in the group without BCAA. These results indicate that the BCAA supplementation could maintain the BCAA and Alb levels in the middle period (3-5 recurrences). BCAA formulation is useful for hypoalbuminemia in the course of HCC recurrence.
authors.affiliation: Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kakazu
authors.forename: Yasuteru
authors.initials: Y
authors.lastname: Kondo
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kogure
authors.forename: Masashi
authors.initials: M
authors.lastname: Ninomiya
authors.forename: Osamu
authors.initials: O
authors.lastname: Kimura
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Iwata
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Morosawa
authors.forename: Takao
authors.initials: T
authors.lastname: Iwasaki
authors.forename: Tooru
authors.initials: T
authors.lastname: Shimosegawa
mesh_terms: D000368:Aged; D000597:Amino Acids, Branched-Chain / Q000008:administration & dosage* / Q000097:blood / Q000494:pharmacology*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis / Q000178:diet therapy* / Q000453:epidemiology; D016022:Case-Control Studies; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis / Q000178:diet therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis / Q000378:metabolism*
chemical_list: D000597:Amino Acids, Branched-Chain; D012709:Serum Albumin