Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Korea.
Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, Korea.
Nutrients. 2020 May 15;12(5):1429. doi: 10.3390/nu12051429.
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.
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.
A total of 124 patients was analyzed: 63 in the BCAA group and 61 in the control group. The MELD score ( = 0.009) and CP score ( = 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, < 0.001).
Long-term supplementation with oral BCAAs can potentially improve liver function and reduce major complications of cirrhosis in patients with advanced liver disease.
在晚期肝病中，缺乏支链氨基酸（BCAA）有益作用的临床证据。我们评估了长期口服 BCAA 补充剂对晚期肝病患者的潜在益处。
从 13 个医疗中心前瞻性招募 Child-Pugh（CP）评分为 8 至 10 分的肝硬化患者。患者每天补充 12.45 克 BCAA 颗粒，持续 6 个月，而食用常规饮食的患者分别被分配到 BCAA 和对照组。使用终末期肝病模型（MELD）评分、CP 评分、血清白蛋白、血清胆红素、肝硬化相关事件发生率和 24 个月无事件生存率评估 BCAA 补充的效果。
共分析了 124 例患者：BCAA 组 63 例，对照组 61 例。与对照组相比，BCAA 组的 MELD 评分（=0.009）和 CP 评分（=0.011）随时间推移显著改善。然而，BCAA 组的血清白蛋白和胆红素水平在研究期间没有改善。与对照组相比，BCAA 组的累积无事件生存率显著提高（HR=0.389，95%CI=0.221-0.684，<0.001）。
长期口服补充 BCAA 可能改善晚期肝病患者的肝功能，减少肝硬化的主要并发症。
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