Essential Amino Acid Supplement Lowers Intrahepatic Lipid despite Excess Alcohol Consumption.

Melynda S Coker,Robert H Coker,Bradley R Newcomer,Robert R Wolfe,Kaylee R Ladd,Carl J Murphy,Jimin Kim,Ryan Decort

doi:10.3390/nu12010254

Abstract

Excess alcohol consumption is a top risk factor for death and disability. Fatty liver will likely develop and the risk of liver disease increases. We have previously demonstrated that an essential amino acid supplement (EAAS) improved protein synthesis and reduced intrahepatic lipid in the elderly. The purpose of this exploratory pilot study was to initiate the evaluation of EAAS on intrahepatic lipid (IHL), body composition, and blood lipids in individuals with mild to moderate alcohol use disorder (AUD). Following consent, determination of eligibility, and medical screening, 25 participants (18 males at 38 ± 15 years/age and 7 females at 34 ± 18 years/age) were enrolled and randomly assigned to one of two dosages: a low dose (LD: 8 g of EAAS twice/day (BID)) or high dose (HD: 13 g of EAAS BID). Five of the twenty-five enrolled participants dropped out of the intervention. Both groups consumed the supplement BID for 4 weeks. Pre- and post-EAAS administration, IHL was determined using magnetic resonance imaging/spectroscopy, body composition was analyzed using dual-energy X-ray absorptiometry, and blood parameters were measured by LabCorp. T-tests were used for statistical analysis and considered significant at p < 0.05. While there was no significant change in IHL in the LD group, there was a significant 23% reduction in IHL in the HD group (p = 0.02). Fat mass, lean tissue mass, bone mineral content, and blood lipids were not altered. Post-EAAS phosphatidylethanol was elevated and remained unchanged in LD at 407 ± 141 ng/mL and HD at 429 ± 196 ng/mL, indicating chronic and excess alcohol consumption. The HD of the proprietary EAAS formulation consumed BID seemed to lower IHL in individuals with mild to moderate AUD. We suggest that further studies in a larger cohort be conducted to more completely address this important area of investigation.

Highlights

Alcohol use disorder (AUD) is a leading risk factor for death and disability and is responsible for 69 million disability-adjusted life years (DALYs) [1]
We have demonstrated that 13 g of essential amino acid supplement (EAAS) provided BID significantly reduced intrahepatic lipid (IHL) without manipulation of dietary intake, change in habitual alcohol consumption, or any form of behavioral modification
This work has focused on nonalcoholic hepatic steatosis, which describes an excessive accumulation of IHL similar to alcoholic hepatic steatosis [32]

Summary

Introduction

Alcohol use disorder (AUD) is a leading risk factor for death and disability and is responsible for 69 million disability-adjusted life years (DALYs) [1]. Ameliorating the metabolic consequences of AUD requires more than abstinence and good overall nutrition, as the majority of individuals with AUD continue to drink alcohol, increasing their risk for liver disease [3]. This clinical scenario is not dissimilar from other diseases involving lipotoxicity, in which unhealthy human behaviors require a combination of pharmaceutical, surgical, or nutritional approaches [4]. Many individuals with AUD are malnourished, and the degree of alcoholic liver disease severity correlates with the degree of malnutrition [5]. The dietary intake of protein and micronutrients often fails to meet recommended levels, even during professional, supervised recovery from AUD [6,7]

Methods

Discussion

Conclusion