Effect of oral supplementation with branched-chain amino acid granules on serum albumin level in the early stage of cirrhosis: a randomized pilot study.

Abstract

Summary. The present study was undertaken to examine changes in the levels of amino acids, particularly branched-chain amino acids (BCAAs), following exacerbation of liver cirrhosis and to determine the optimal timing of starting nutritional therapy using BCAA. In patients with well-compensated cirrhosis, both the aminoacid composition and the albumin level were normal. However, as the disease advanced, BCAA first began to decrease, causing amino-acid imbalance, and this change was later followed by a decrease in albumin. We reviewed the criteria for determining indications for treatment with a BCAA formula (Livact), which is currently used after a decrease in albumin level. In patients in whom the BCAA-to-tyrosine ratio (BTR) was less than 4.0 despite normal albumin levels, the use of the BCAA preparation prevented a decrease in albumin. In view of this result, it is advisable to administer the BCAA formula following a reduction in BTR rather than to begin its use following a decrease in albumin