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Journal of Gastroenterology

, Volume 53, Issue 3, pp 427–437 | Cite as

Supplementation with branched-chain amino acids ameliorates hypoalbuminemia, prevents sarcopenia, and reduces fat accumulation in the skeletal muscles of patients with liver cirrhosis

  • Yoichiro Kitajima
  • Hirokazu Takahashi
  • Takumi Akiyama
  • Kenichiro Murayama
  • Shinji Iwane
  • Takuya Kuwashiro
  • Kenichi Tanaka
  • Seiji Kawazoe
  • Naofumi Ono
  • Takahisa Eguchi
  • Keizo Anzai
  • Yuichiro EguchiEmail author
Original Article—Liver, Pancreas, and Biliary Tract

Abstract

Background

Liver cirrhosis induces marked metabolic disorders, protein-energy malnutrition, and sarcopenia. The objective of the study reported here was to investigate the effects of dietary branched-chain amino acids (BCAAs) on systemic glucose metabolism, skeletal muscle, and prognosis of patients with liver cirrhosis.

Methods

Japanese patients with liver cirrhosis (n = 21) were enrolled into a longitudinal study in which their diets were supplemented with BCAAs. We evaluated glucose metabolism and analyzed the skeletal muscle area index (SAI) and intramuscular adipose tissue content (IMAC) using computed tomography.

Results

After 48 weeks of supplementation with BCAAs, there were no changes in glucose metabolism and skeletal muscle findings. In patients with ameliorated hypoalbuminemia, IMAC was significantly decreased and SAI was preserved concomitant with decreasing 90- and 120-min post-challenge plasma glucose levels (P < 0.01 each). In patients without increased albumin levels, IMAC was significantly increased and the SAI was significantly decreased (P < 0.01 each). Liver-related event-free survival rates for 72 months were 63.6% in patients with decreased IMAC and 20.0% in patients with increased IMAC.

Conclusions

Amelioration of hypoalbuminemia associated with BCAA supplementation correlated with decreased fat accumulation in skeletal muscle, maintenance of skeletal muscle mass, and improved glucose sensitivity, all factors which may contribute to improving the survival of patients with liver cirrhosis.

Keywords

Branched-chain amino acids Skeletal muscle steatosis Sarcopenia Liver cirrhosis 

Notes

Acknowledgements

We thank the medical staff at Eguchi Hospital and Professor Kyuichi Tanikawa (International Institute for Liver Research) for excellent advice. This work was supported by a Grant-in-Aid from the Ministry of Education, Culture, Sports, Science and Technology of Japan (2010) (#22590741 to Y.E.).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

535_2017_1370_MOESM1_ESM.pptx (243 kb)
Supplementary material 1 (PPTX 242 kb)
535_2017_1370_MOESM2_ESM.doc (104 kb)
Supplementary material 2 (DOC 104 kb)

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Copyright information

© Japanese Society of Gastroenterology 2017

Authors and Affiliations

  • Yoichiro Kitajima
    • 1
    • 3
  • Hirokazu Takahashi
    • 1
  • Takumi Akiyama
    • 1
  • Kenichiro Murayama
    • 1
  • Shinji Iwane
    • 1
  • Takuya Kuwashiro
    • 1
  • Kenichi Tanaka
    • 1
  • Seiji Kawazoe
    • 4
  • Naofumi Ono
    • 3
  • Takahisa Eguchi
    • 3
  • Keizo Anzai
    • 1
  • Yuichiro Eguchi
    • 2
    Email author
  1. 1.Division of Metabolism and Endocrinology, Faculty of MedicineSaga UniversitySagaJapan
  2. 2.Liver CenterSaga Medical SchoolSagaJapan
  3. 3.Department of Clinical GastroenterologyEguchi HospitalOgiJapan
  4. 4.Hepatobiliary and Pancreatology Division, Department of Internal MedicineSaga Prefectural Hospital Kosei-kanSagaJapan

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