Effects of branched-chain amino acids and zinc-enriched nutrients on prognosticators in HCV-infected patients: A multicenter randomized controlled trial

Kawaguchi, Takumi; Nagao, Yumiko; Abe, Kazumichi; Imazeki, Fumio; Honda, Koichi; Yamasaki, Kazumi; Miyanishi, Koji; Taniguchi, Eitaro; Kakuma, Tatsuyuki; Kato, Junji; Seike, Masataka; Yokosuka, Osamu; Ohira, Hiromasa; Sata, Michio

doi:10.3892/mmr.2014.2943

Cited by 14 publications

(9 citation statements)

References 27 publications

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“…Chronic liver injury results in the impaired Zn homeostasis and eventually Zn deficiency, and most CLD patients have Zn deficiency [3,4,5,10,13,14,32]. Zn deficiency can present numerous symptoms, which can be associated with decreased QOL and worse clinical outcomes [3,5,33]. However, as mentioned earlier, there is little data currently available regarding relationship between serum Zn concentration and sarcopenia in CLDs.…”

Section: Discussionmentioning

confidence: 99%

Serum Zinc Concentration and Sarcopenia: A Close Linkage in Chronic Liver Diseases

Nishikawa

Enomoto

Iwata

et al. 2019

JCM

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We sought to investigate the influence of serum zinc (Zn) concentration on sarcopenia in chronic liver diseases (CLDs, n = 372, median age = 65 years, 147 liver cirrhosis (LC) cases (39.5%)). Sarcopenia was defined by low grip strength and low skeletal muscle mass. Study subjects were divided into the following three groups (High-, Intermediate-, and Low-Zn groups) based on the baseline serum Zn level. The impacts of serum Zn concentration on sarcopenia were examined. The median (interquartile range) serum Zn concentration for all cases was 72.85 (63.7, 81.45) μg/dL. The proportions of sarcopenia in the High-Zn, Intermediate-Zn, and Low-Zn groups were 10.75% (10/93), 11.23% (21/187), and 27.17% (25/92), respectively (P = 0.9046 (High vs. Intermediate), P = 0.0007 (Intermediate vs. Low), P = 0.0044 (High vs. Low), overall P value = 0.0009). The median serum Zn concentrations in patients with sarcopenia, pre-sarcopenia, and control were 66.35, 73.1 and 73.8 μg/dL, respectively (P = 0.0234 (sarcopenia vs. pre-sarcopenia), P = 0.2116 (pre-sarcopenia vs. control), P = 0.0002 (sarcopenia vs. control), overall P value = 0.0016). In the multivariate analyses of factors linked to the presence of sarcopenia, Low-Zn was an independent predictor for all cases (P = 0.0236) and LC cases (P = 0.0082). In conclusion, Zn deficiency can be an independent predictor for sarcopenia in patients with CLDs.

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Section: Discussionmentioning

confidence: 99%

Serum Zinc Concentration and Sarcopenia: A Close Linkage in Chronic Liver Diseases

Nishikawa

Enomoto

Iwata

et al. 2019

JCM

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“…Given the effects of BCAA catabolism on insulin sensitivity [ 81 ], what role might BCAAs play in reversing insulin resistance? Several clinical investigators have administered BCAAs to HCV infected patients in attempts to improve prognosis [ 84 ]. This area is controversial, with some commentators suggesting that BCAAs can activate mTORC1 and cause insulin resistance [ 85 ], despite the observed beneficial effects to HCV infected patients of BCAA supplements or a BCAA-rich diet [ 84 , 86 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several clinical investigators have administered BCAAs to HCV infected patients in attempts to improve prognosis [ 84 ]. This area is controversial, with some commentators suggesting that BCAAs can activate mTORC1 and cause insulin resistance [ 85 ], despite the observed beneficial effects to HCV infected patients of BCAA supplements or a BCAA-rich diet [ 84 , 86 ]. These relationships between BCAAs, gluconeogenesis, and hyperglycemia in HCV patients are implicit in our metabolomic model, described herein.…”

Section: Discussionmentioning

confidence: 99%

Robust Regression Analysis of GCMS Data Reveals Differential Rewiring of Metabolic Networks in Hepatitis B and C Patients

et al. 2017

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About one in 15 of the world’s population is chronically infected with either hepatitis virus B (HBV) or C (HCV), with enormous public health consequences. The metabolic alterations caused by these infections have never been directly compared and contrasted. We investigated groups of HBV-positive, HCV-positive, and uninfected healthy controls using gas chromatography-mass spectrometry analyses of their plasma and urine. A robust regression analysis of the metabolite data was conducted to reveal correlations between metabolite pairs. Ten metabolite correlations appeared for HBV plasma and urine, with 18 for HCV plasma and urine, none of which were present in the controls. Metabolic perturbation networks were constructed, which permitted a differential view of the HBV- and HCV-infected liver. HBV hepatitis was consistent with enhanced glucose uptake, glycolysis, and pentose phosphate pathway metabolism, the latter using xylitol and producing threonic acid, which may also be imported by glucose transporters. HCV hepatitis was consistent with impaired glucose uptake, glycolysis, and pentose phosphate pathway metabolism, with the tricarboxylic acid pathway fueled by branched-chain amino acids feeding gluconeogenesis and the hepatocellular loss of glucose, which most probably contributed to hyperglycemia. It is concluded that robust regression analyses can uncover metabolic rewiring in disease states.

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“…Serum zinc levels decrease in patients with hepatitis C as the disease progresses to chronic hepatitis, compensated cirrhosis and decompensated cirrhosis (1). Zinc supplementation therapy in patients with hepatitis C improves the longterm prognosis by improving the hepatic function and inhibiting hepatocarcinogenesis (2)(3)(4)(5). Reports have shown that serum zinc has a decreasing trend during interferon treat-ment in hepatitis C patients (6) and that zinc supplementation during treatment increases the viral clearance rate (7).…”

Section: Introductionmentioning

confidence: 99%

Hypozincemia in Chronic Hepatitis C Is Improved with Viral Clearance by Direct-acting Antiviral Agents

2021

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Objective Hypozincemia is a decrease in the serum zinc level of patients with hepatitis C and often requires zinc supplementation to improve the hepatic function. Our previous study showed the efficacy of direct-acting antiviral agent (DAA) treatment on serum zinc levels in patients with hepatitis C without zinc supplementation. In this study, we aimed to prospectively examine factors related to the improvement of serum zinc levels of patents with hepatitis C with DAA treatment. Methods Fifty-three patients with hepatitis C treated with DAAs between March 2018 and February 2019 at a university medical center were divided into two groups based on their initial serum level: the zinc deficiency group (n=43, <80 μg/dL) and the normal zinc group (n=10, ! 80 μg/dL). Their serum zinc levels and clinical parameters were measured before DAA treatment, at the end of treatment and 12 weeks posttreatment. Results All 53 patients achieved a sustained viral response to DAAs at the end of treatment and at followup. There was a significant increase in the serum zinc level from baseline to follow-up in the zinc deficiency group but not in the normal zinc group. The change in serum albumin was the only factor contributing to the observed increase in serum zinc levels by a multiple regression analysis. Conclusion DAA treatment in patients with hepatitis C improved hypozincemia due to the restored function of serum albumin, which binds to about 60% of serum zinc, upon the amelioration of the hepatitis C infection.

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Effects of branched-chain amino acids and zinc-enriched nutrients on prognosticators in HCV-infected patients: A multicenter randomized controlled trial

Cited by 14 publications

References 27 publications

Serum Zinc Concentration and Sarcopenia: A Close Linkage in Chronic Liver Diseases

Serum Zinc Concentration and Sarcopenia: A Close Linkage in Chronic Liver Diseases

Robust Regression Analysis of GCMS Data Reveals Differential Rewiring of Metabolic Networks in Hepatitis B and C Patients

Hypozincemia in Chronic Hepatitis C Is Improved with Viral Clearance by Direct-acting Antiviral Agents

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