Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
Hepatol Res. 2006 Jul;35(3):204-14. doi: 10.1016/j.hepres.2006.04.007. Epub 2006 Jun 5.
We conducted a multicenter, randomized, controlled trial to investigate the effect of long-term oral supplementation with branched-chain amino acids (BCAA) on the event-free survival in 622 patients with decompensated cirrhosis. In the present study, the development of liver cancer was analyzed as an endpoint in particular. Subjects received either treatment with BCAA at 12g/day or dietary therapy containing the matched daily energy and protein intake. A Cox regression analysis was carried out to estimate the hazard ratios for different background factors stratified by treatment group. Liver cancer was noted in 89 patients. The risk for liver cancer was significantly higher for males, patients with concurrent diabetes mellitus, patients with an alpha-fetoprotein (AFP) level of 20ng/mL or higher, patients with higher body mass index (BMI), and patients with lower serum albumin levels. When the BCAA group and the diet group were compared for factors that interacted with the treatment arms, the risk for liver cancer was significantly reduced in the BCAA group with a BMI of 25 or higher and with an AFP level of 20ng/mL or higher. Oral supplemental treatment with BCAA may reduce the risk of liver cancer in cirrhotic patients with these specific factors.
我们进行了一项多中心、随机、对照试验，以研究长期口服补充支链氨基酸（BCAA）对 622 例失代偿期肝硬化患者无事件生存的影响。在本研究中，我们特别分析了肝癌的发展作为一个终点。受试者接受每天 12 克 BCAA 治疗或含有匹配的每日能量和蛋白质摄入的饮食治疗。通过 Cox 回归分析，按治疗组分层，估计不同背景因素的风险比。89 例患者发生肝癌。男性、合并糖尿病、甲胎蛋白（AFP）水平≥20ng/ml、体重指数（BMI）较高和血清白蛋白水平较低的患者肝癌发生风险显著较高。当比较与治疗组相互作用的因素时，BCAA 组的肝癌风险在 BMI≥25 和 AFP≥20ng/ml 的患者中显著降低。口服补充 BCAA 可能降低具有这些特定因素的肝硬化患者肝癌的风险。
