Efficacy and safety of oral branched-chain amino acid supplementation in patients undergoing interventions for hepatocellular carcinoma: a meta-analysis

Chen, Ling; Chen, Yaqin; Wang, Xiwei; Li, Hong; Zhang, Hongmin; Gong, Jiaojiao; Shen, Shasha; Yin, Wenwei; Hu, Huaidong

doi:10.1186/s12937-015-0056-6

Cited by 40 publications

(34 citation statements)

References 44 publications

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“…The administration of branched-chain amino acid effectively maintains the Child-Pugh score during chemotherapy of patients with advanced HCC [20,21]. In contrast, the present study did not detect a significant effect of consumption of branched-chain amino acids on maintaining Child-Pugh scores.…”

Section: Discussioncontrasting

confidence: 53%

Beneficial Effect of Maintaining Hepatic Reserve during Chemotherapy on the Outcomes of Patients with Hepatocellular Carcinoma

et al. 2017

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Hepatocellular carcinoma (HCC) usually develops in chronically damaged liver. We investigated hepatic reserves during chemotherapy of patients with advanced HCC and compensated liver function to evaluate the effect on patients' outcomes of maintaining hepatic reserve after chemotherapy. We retrospectively reviewed the medical records of 190 patients with Child-Pugh A with advanced HCC who were treated with sorafenib or hepatic arterial infusion chemotherapy (HAIC). We investigated the Child-Pugh score and albumin-bilirubin grade for hepatic reserve, and evaluated the effect of the change in Child-Pugh scores on patients' outcomes. Subjects were treated with sorafenib (n = 59) or HAIC (n = 131). Of patients with Child-Pugh data, 66.7% maintained or improved their Child-Pugh score after 4 weeks. Treatment with HAIC was the only factor that significantly contributed to maintaining Child-Pugh scores after 4 weeks. The overall survival of patients with a higher Child-Pugh score after 4 weeks was shorter than that of patients whose Child-Pugh classification was unchanged. Multivariate analysis demonstrated that an increased Child-Pugh score after 4 weeks was one of the independent unfavorable prognostic factors. The change of hepatic reserve as a function of albumin-bilirubin grade did not significantly correlate with patients' outcomes. Maintaining the Child-Pugh score during chemotherapy benefits the outcomes of patients with advanced HCC, even those with sufficient hepatic reserve.

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Section: Discussioncontrasting

confidence: 53%

Beneficial Effect of Maintaining Hepatic Reserve during Chemotherapy on the Outcomes of Patients with Hepatocellular Carcinoma

et al. 2017

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“…This is because patients with LC exhibited ascites due to low albumin levels, which can be improved through the supplementation of BCAAs. Our results is inconsistent with the meta‐analysis results reported by Chen et al . The only indicator for liver function that did not show significant differences was Bil‐T.…”

Section: Discussioncontrasting

confidence: 99%

Significant effects of late evening snack on liver functions in patients with liver cirrhosis: A meta‐analysis of randomized controlled trials

Chen

Wang

Kuo

et al. 2019

J of Gastro and Hepatol

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Background and Aim Reducing post‐absorptive (fasting) phase by eating late evening snacks (LESs) is a potential intervention to improve substrate utilization and reverse sarcopenia. This study analyzed the results of published randomized controlled trials and controlled clinical trials to evaluate the effects of LES on liver function of patients with cirrhosis. Methods A meta‐analysis was conducted. The search strategy included electronic database searches, and 300 articles were searched. Eight of these articles provided qualified data for pooling and analysis. Outcomes assessments included serum albumin, total bilirubin, alanine aminotransferase, prothrombin time, and aspartate aminotransferase, complications of cirrhosis, severity of liver disease, and blood glucose levels. Results Our analysis included eight studies comprising 341 patients (167 in LES groups and 174 in control groups). The results showed that LES intervention helped to maintain liver reserves. These eight studies demonstrated that LES intervention had significant effects for liver biochemical parameters on albumin, ammonia, and prothrombin time, with respective effect sizes of 0.233, −0.425, and −0.589; liver enzymes include aspartate aminotransferase and alanine aminotransferase, with respective effect sizes of −0.320 and −0.284. Studies on clinical signs of liver dysfunction showed lower occurrence rates of ascites and hepatic encephalopathy than in the control group. LES had no significant effect on Child–Pugh score. Conclusions The overall results of the meta‐analysis indicated that having LES can improve liver function reserve for patients with liver cirrhosis, with or without hepatocellular carcinoma. LES is a promising intervention for reversing anabolic resistance and the sarcopenia of cirrhosis, resulting in an improved quality of life for patients with cirrhosis.

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“…Previous studies have proposed the use of BCAA supplementation for the treatment of hepatic encephalopathy (36,44), and others have noted improved nutritional balance and a decreased frequency of cirrhosis-related complications with BCAA supplementation (45)(46)(47). In addition to the nutritional role of BCAAs, studies have also evaluated patient QoL based on SF-36 tests (46,47).…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the nutritional role of BCAAs, studies have also evaluated patient QoL based on SF-36 tests (46,47). However, the effect of BCAA supplementation on IR and its association with viral load is less understood (29,30).…”

Section: Discussionmentioning

confidence: 99%

Effect of branched‑chain amino acid supplementation on insulin resistance and quality of life in chronic hepatitis C patients

et al. 2017

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Abstract. The incidence rate of insulin resistance (IR) in patients with chronic hepatitis C (CHC) is high. Recently, branched-chain amino acids (BCAA) have been shown to attenuate IR in CHC patients; however, their effect on patient quality of life remains unclear. Therefore, the aim of the current prospective study was to determine the effects of BCAA supplement on IR and health-related quality of life (HR-QoL) in patients with CHC. In the study, 20 non-diabetic patients with CHC, who were non-responders to peginterferon-α and ribavirin, were recruited. Patients took a BCAA supplement once a day (30 g, after a minimum 10-h overnight fast) for 3 months. Serum levels of glucose, insulin, albumin, triglycerides and cholesterol were measured at 0 and 3 months. Additionally, IR was measured using the Homeostasis Model Assessment-IR, HR-QoL was assessed using the 36-item Short Form Health Survey and viral load was measured by reverse transcription polymerase chain reaction using Taqman probes. The Wilcoxon signed-rank test was used to determine statistical significance. The results indicated that 70% of the subjects were positive for IR, which decreased to 50% by the end of the study; furthermore, 85% of the subjects demonstrated some level of improvement. Overall, the BCAA treatment significantly decreased IR (P=0.006) and augmented serum albumin concentration (P=0.008) compared with basal values. Additionally, by the end of the treatment, viral load and triglycerides levels had decreased, though these results were not significant (P= 0.084 and P= 0.080, respectively). BCAA treatment also improved HR-QoL regarding role limitations due to physical health problems (P= 0.017), role limitations due to emotional problems (P= 0.026) and social function (P=0.008). In conclusion, BCAA supplementation reduced IR and improved HR-QoL in patients with CHC. These findings support the application of IR therapy as a possible therapeutic strategy for hepatitis C infection.

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Efficacy and safety of oral branched-chain amino acid supplementation in patients undergoing interventions for hepatocellular carcinoma: a meta-analysis

Cited by 40 publications

References 44 publications

Beneficial Effect of Maintaining Hepatic Reserve during Chemotherapy on the Outcomes of Patients with Hepatocellular Carcinoma

Beneficial Effect of Maintaining Hepatic Reserve during Chemotherapy on the Outcomes of Patients with Hepatocellular Carcinoma

Significant effects of late evening snack on liver functions in patients with liver cirrhosis: A meta‐analysis of randomized controlled trials

Effect of branched‑chain amino acid supplementation on insulin resistance and quality of life in chronic hepatitis C patients

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