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Article

Effects of Branched-Chain Amino Acid (BCAA) Supplementation on the Progression of Advanced Liver Disease: A Korean Nationwide, Multicenter, Prospective, Observational, Cohort Study

1
Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu 42415, Korea
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Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu 41944, Korea
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Department of Internal Medicine, School of Medicine, Keimyung University, Daegu 42601, Korea
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Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
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Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul 04401, Korea
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Department of Internal Medicine, College of Medicine, Hallym University, Chuncheon 24252, Korea
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Department of Internal Medicine, CHA Gumi Medical Center, CHA University School of Medicine, Gumi 39295, Korea
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Department of Internal Medicine, School of Medicine, Pusan National University, Pusan 49241, Korea
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Department of Internal Medicine, Ilsan Paik Hospital, College of Medicine, Inje University College of Medicine, Goyang 10380, Korea
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Department of Internal Medicine, College of Medicine, Yonsei University, Seoul 03722, Korea
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Department of Internal Medicine, School of Medicine, Choungnam National University, Daejeon 61469, Korea
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Department of Internal Medicine, College of Medicine, Dongguk University, Gyeongju 39067, Korea
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Department of Internal Medicine, School of Medicine, Chonbuk National University, Chungju 54907, Korea
14
Medical Research Collabration Center in KNUH and School of Medicine, Kyungpook National University, Daegu 41944, Korea
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(5), 1429; https://doi.org/10.3390/nu12051429
Received: 28 March 2020 / Revised: 9 May 2020 / Accepted: 13 May 2020 / Published: 15 May 2020
(This article belongs to the Special Issue Nutrition and Body Composition Assessment in Cirrhosis)
Background and Aims: 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. Methods: 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. Results: A total of 124 patients was analyzed: 63 in the BCAA group and 61 in the control group. The MELD score (p = 0.009) and CP score (p = 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, p < 0.001). Conclusion: Long-term supplementation with oral BCAAs can potentially improve liver function and reduce major complications of cirrhosis in patients with advanced liver disease. View Full-Text
Keywords: amino acids; branched-chain; liver cirrhosis; prognosis; ascites; hepatic encephalopathy amino acids; branched-chain; liver cirrhosis; prognosis; ascites; hepatic encephalopathy
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MDPI and ACS Style

Park, J.G.; Tak, W.Y.; Park, S.Y.; Kweon, Y.O.; Chung, W.J.; Jang, B.K.; Bae, S.H.; Lee, H.J.; Jang, J.Y.; Suk, K.T.; Oh, M.J.; Heo, J.; Woo, H.Y.; Jang, S.Y.; Lee, Y.R.; Lee, J.S.; Kim, D.Y.; Kim, S.H.; Suh, J.I.; Kim, I.H.; Kang, M.K.; Lee, W.K. Effects of Branched-Chain Amino Acid (BCAA) Supplementation on the Progression of Advanced Liver Disease: A Korean Nationwide, Multicenter, Prospective, Observational, Cohort Study. Nutrients 2020, 12, 1429. https://doi.org/10.3390/nu12051429

AMA Style

Park JG, Tak WY, Park SY, Kweon YO, Chung WJ, Jang BK, Bae SH, Lee HJ, Jang JY, Suk KT, Oh MJ, Heo J, Woo HY, Jang SY, Lee YR, Lee JS, Kim DY, Kim SH, Suh JI, Kim IH, Kang MK, Lee WK. Effects of Branched-Chain Amino Acid (BCAA) Supplementation on the Progression of Advanced Liver Disease: A Korean Nationwide, Multicenter, Prospective, Observational, Cohort Study. Nutrients. 2020; 12(5):1429. https://doi.org/10.3390/nu12051429

Chicago/Turabian Style

Park, Jung G., Won Y. Tak, Soo Y. Park, Young O. Kweon, Woo J. Chung, Byoung K. Jang, Si H. Bae, Heon J. Lee, Jae Y. Jang, Ki T. Suk, Myung J. Oh, Jeong Heo, Hyun Y. Woo, Se Y. Jang, Yu R. Lee, June S. Lee, Do Y. Kim, Seok H. Kim, Jeong I. Suh, In H. Kim, Min K. Kang, and Won K. Lee 2020. "Effects of Branched-Chain Amino Acid (BCAA) Supplementation on the Progression of Advanced Liver Disease: A Korean Nationwide, Multicenter, Prospective, Observational, Cohort Study" Nutrients 12, no. 5: 1429. https://doi.org/10.3390/nu12051429

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