We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Effects of Branched-Chain Amino Acids Supplementation in Patients With Cirrhosis and a Previous Episode of Hepatic Encephalopathy: A Randomized Study.
- Authors
Les, Iñigo; Doval, Eduardo; García-Martínez, Rita; Planas, Mercè; Cárdenas, Guillermo; Gómez, Pilar; Flavià, Montse; Jacas, Carlos; Mínguez, Beatriz; Vergara, Mercedes; Soriano, Germán; Vila, Carmen; Esteban, Rafael; Córdoba, Juan
- Abstract
OBJECTIVES:Protein intake impacts on nutritional status and may determine the recurrence of hepatic encephalopathy (HE). A low-protein diet has been considered the standard treatment after an episode of HE, while branched-chain amino acids (BCAA) have been shown to improve minimal HE. We performed a study to investigate the long-term effects of supplementing a protein-controlled diet with BCAA.METHODS:A randomized, double-blind, multicenter study that included 116 patients with cirrhosis and a previous episode of HE was conducted in four tertiary care hospitals. All patients received a standard diet of 35 kcal/kg per day and 0.7 g of proteins/kg per day and a supplement of 30 g of BCAA (BCAA group) or maltodextrin (MDX group) during 56 weeks.RESULTS:The actuarial risk of remaining free of HE did not differ between groups (BCAA=47%, MDX=34%, P=0.274), but patients in the BCAA group exhibited a better outcome on two neuropsychological tests and an increase in the mid-arm muscle circumference. Recurrence was associated with low plasma albumin at baseline and a decrease in sodium and an increase in creatinine during follow-up. Patients with recurrence of HE exhibited a lack of improvement in global cognitive function.CONCLUSIONS:Diet supplementation with BCAA after an episode of HE does not decrease recurrence of HE. However, supplementation with BCAA improves minimal HE and muscle mass. Identification of risk factors for recurrence of HE may allow the development of new preventive therapies that could decrease the neuropsychological sequelae of repeated episodes of HE.
- Subjects
AMINO acids; CIRRHOSIS of the liver; HEPATIC encephalopathy; NEUROPSYCHOLOGICAL tests; NEUROPSYCHOLOGY; DISEASE complications; ALBUMINS
- Publication
American Journal of Gastroenterology (Springer Nature), 2011, Vol 106, Issue 6, p1081
- ISSN
0002-9270
- Publication type
Article
- DOI
10.1038/ajg.2011.9