Effects of Branched-Chain Amino Acid (BCAA) Supplementation on the Progression of Advanced Liver Disease: A Korean Nationwide, Multicenter, Prospective, Observational, Cohort Study.

Won Kee Lee ,Soo Young Park ,Jeong Ill Suh ,Won Young Tak ,Myung Jin Oh ,Hyun Young Woo ,Jae Young Jang ,In Hee Kim ,Seok Hyun Kim ,Heon Ju Lee ,Woo Jin Chung ,Jeong Heo ,Young Oh Kweon ,Do Young Kim ,June Sung Lee ,Se Young Jang ,Ki Tae Suk ,Jung Gil Park ,Byoung Kuk Jang ,Min Kyu Kang ,Si Hyun Bae ,Yu Rim Lee

doi:10.3390/nu12051429

Abstract

Background and Aims: Clinical evidence for the benefits of branched-chain amino acids (BCAAs) is lacking in advanced liver disease. We evaluated the potential benefits of long-term oral BCAA supplementation in patients with advanced liver disease. Methods: Liver cirrhosis patients with Child–Pugh (CP) scores from 8 to 10 were prospectively recruited from 13 medical centers. Patients supplemented with 12.45 g of daily BCAA granules over 6 months, and patients consuming a regular diet were assigned to the BCAA and control groups, respectively. The effects of BCAA supplementation were evaluated using the model for end-stage liver disease (MELD) score, CP score, serum albumin, serum bilirubin, incidence of cirrhosis-related events, and event-free survival for 24 months. Results: A total of 124 patients was analyzed: 63 in the BCAA group and 61 in the control group. The MELD score (p = 0.009) and CP score (p = 0.011) significantly improved in the BCAA group compared to the control group over time. However, the levels of serum albumin and bilirubin in the BCAA group did not improve during the study period. The cumulative event-free survival was significantly improved in the BCAA group compared to the control group (HR = 0.389, 95% CI = 0.221–0.684, p < 0.001). Conclusion: Long-term supplementation with oral BCAAs can potentially improve liver function and reduce major complications of cirrhosis in patients with advanced liver disease.

Highlights

Protein-calorie malnutrition is a progressing condition caused by underlying chronic liver disease and poor nutritional support [1,2]
This study evaluated the beneficial effects of branched-chain amino acids (BCAAs) in cirrhotic patients with CP scores from 8 to 10 who were in the decompensated stage rather than the terminal stage
The patients supplemented with BCAAs for more than 6 months exhibited improved model for end-stage liver disease (MELD) and CP scores

Summary

Introduction

Protein-calorie malnutrition is a progressing condition caused by underlying chronic liver disease and poor nutritional support [1,2]. As chronic liver disease progresses to decompensated cirrhosis, more than 60% of patients suffer from malnutrition, which worsens their quality of life and increases their mortality rate [1,3]. Most of the conditions underlying chronic liver disease, including chronic hepatitis B (CHB) and chronic hepatitis C, have been relatively well controlled by recent advances in antiviral treatments, malnutrition is frequently underevaluated in clinical practice [4]. Clinical evidence for the benefits of branched-chain amino acids (BCAAs) is lacking in advanced liver disease. Conclusion: Long-term supplementation with oral BCAAs can potentially improve liver function and reduce major complications of cirrhosis in patients with advanced liver disease

Methods

Results

Conclusion