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Effects of branched-chain amino acids (BCAAs) on the progression of advanced liver disease: A Korean nationwide, multicenter, retrospective, observational, cohort study.

Abstract
Evidence of the potential benefits of long-term oral branched-chain amino acid (BCAA) supplementation in reducing the severity of liver disease is limited.Patients who were diagnosed with liver cirrhosis with a Child-Pugh (CP) score of 8-10 were included. The BCAA group consumed BCAAs daily for at least 6 months, and the control group consumed a diet without BCAA. We analyzed the improvements based on the model for end-stage liver disease (MELD) score, CP score, incidence of cirrhosis-related complications, and event-free survival over 2 years. Among the 867 recruited patients, 307 (166 in the BCAA group and 141 in the control group) were analyzed. The BCAA group was divided into 3 subgroups, whose patients consumed 4.15 g, 8.3 g, or 12.45 g of BCAAs daily for the analysis. There were significant differences in the CP score, albumin, and hepatic encephalopathy between the 2 groups at baseline. After matching the propensity scores, we analyzed patients in the BCAA-12.45 g group (12.45 g of BCAAs daily, n = 41) and matched control group (n = 41). The MELD score significantly improved in the BCCA-12.45 g group compared to the matched control group (P = .004). The changes in the serum bilirubin level (P = .014) and CP score (P = .033) over time also differed significantly between the 2 groups. The incidence rates of cirrhosis-related complications (P = .973) and development of hepatocellular carcinoma (2 cases each) did not differ significantly between the 2 groups.Long-term oral BCAA supplementation has beneficial effects in patients with advanced liver cirrhosis. A further large-scale prospective study is needed to delineate these beneficial effects.
AuthorsJung Gil Park, Won Young Tak, Soo Young Park, Young Oh Kweon, Se Young Jang, Yu Rim Lee, Si Hyun Bae, Jae Young Jang, Do Young Kim, June Sung Lee, Ki Tae Suk, In Hee Kim, Heon Ju Lee, Woo Jin Chung, Byoung Kuk Jang, Jeong Ill Suh, Jeong Heo, Won Kee Lee
JournalMedicine (Medicine (Baltimore)) Vol. 96 Issue 24 Pg. e6580 (Jun 2017) ISSN: 1536-5964 [Electronic] United States
PMID28614215 (Publication Type: Journal Article, Multicenter Study, Observational Study)
Chemical References
  • Amino Acids, Branched-Chain
  • Bilirubin
Topics
  • Administration, Oral
  • Amino Acids, Branched-Chain (administration & dosage)
  • Bilirubin (blood)
  • Carcinoma, Hepatocellular (blood, complications, epidemiology, prevention & control)
  • Dietary Supplements
  • Disease Progression
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Liver Cirrhosis (blood, complications, diet therapy, epidemiology)
  • Male
  • Middle Aged
  • Propensity Score
  • Republic of Korea
  • Retrospective Studies
  • Severity of Illness Index
  • Tertiary Care Centers

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