[Meta-analysis of branched chain amino acid-enriched nutrition to improve hepatic function in patients undergoing hepatic operation].
OBJECTIVE
To perform a meta-analysis of randomized controlled trials (RCTs) assessing the benefit of providing branched chain amino acid (BCAA)-enriched nutrition to improve hepatic function in patients undergoing hepatic operation.


METHODS
The electronic databases of PubMed, Springerlink, the Chinese Biomedical Database (CBM), the Cochrane Library, and the China National Knowledge Infrastructure (CNKI) were searched for relevant RCTs using the following search terms: nutritional support, enteral nutrition, parenteral nutrition, hepatic/liver surgery, liver cirrhosis, cancer, hepatectomy, and liver transplantation. The quality of the retrieved RCTs was assessed according to the scale developed by the Cochrane Collaboration. The meta-analysis was conducted using RevMan software, version 5.2.


RESULTS
A total of 11 relevant RCTs, representing 510 patients, were included in the meta-analysis. Compared to patients in the control (normal nutrition) group, the patients in the BCAA group experienced an effective improvement in hepatic function, as evidenced by significant decreases in total bilirubin (by 0.07 mumol/L; 95% confidence interval (CI): -0.18 to 0.05, P more than 0.05]. In addition, the BCAA group showed improvements in plasma levels of albumin (weighted mean difference (WMD) = 0.07; 95% CI: 0.06, 0.24, P less than 0.05) and alanine aminotransferase (WMD = +5.61; 95% CI: -8.63 to 19.86, P more than 0.05] but neither of the changes reached the threshold of a statistically significant improvement. The BCAA group did however show significantly lower complication rate after operation (65%, 95% CI: 0.48, 0.87, P less than 0.01] and mean duration of hospital stay (4.61 days; 95% CI: -6.61, -2.61, P less than 0.01].


CONCLUSIONS
BCAA-enriched nutrition improves hepatic function in patients undergoing hepatic operation, thereby helping to reduce the complication risk, duration of hospital stay, and financial burden. BCAA-enriched nutrition is a safe and effective therapy and further clinical application may be beneficial.
Department of Nutruition, East Hospital, Affiliated to Tongji University, Shanghai 200120, China.
Xiaoliang
X
Shu
Kai
K
Kang
Jingxia
J
Zhong
Shurong
S
Ji
Yongsheng
Y
Zhang
Huaidong
H
Hu
Dazhi
D
Zhang
D000597:Amino Acids, Branched-Chain / Q000627:therapeutic use*; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D007432:Intraoperative Period; D008099:Liver / Q000502:physiology* / Q000601:surgery; D016031:Liver Transplantation / Q000379:methods; D018529:Nutritional Support / Q000379:methods*; D016032:Randomized Controlled Trials as Topic
D000597:Amino Acids, Branched-Chain