Effects of branched-chain amino acids supplementation in patients with cirrhosis and a previous episode of hepatic encephalopathy : A randomized study
Les, Iñigo (Hospital Universitari Vall d'Hebron)
Doval Dieguez, Eduardo (Universitat Autònoma de Barcelona. Departament de Psicobiologia i de Metodologia de les Ciències de la Salut)
García-Martínez, Rita (Hospital Universitari Vall d'Hebron)
Planas, Mercè (Hospital Universitari Vall d'Hebron)
Cárdenas, Guillermo (Hospital Universitari Vall d'Hebron)
Gómez, Pilar (Hospital Universitari Vall d'Hebron)
Flavià, Montse (Hospital Universitari Vall d'Hebron)
Jacas, Carlos (Hospital Universitari Vall d'Hebron)
Mínguez Rosique, Beatriz (Hospital Universitari Vall d'Hebron)
Vergara, Mercedes (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Soriano, German (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Vila, Carmen (Hospital del Mar (Barcelona, Catalunya))
Esteban, Rafael (Universitat Autònoma de Barcelona. Departament de Medicina)
Córdoba Cardona, Juan (Universitat Autònoma de Barcelona. Departament de Medicina)

Data:	2011
Resum:	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 (BCAA47%, MDX34%, P0. 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.
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Llengua:	Anglès
Document:	Article ; recerca ; Versió acceptada per publicar
Matèria:	Hepatic encephalopathy ; Proteins of the diet ; Branched-chain amino acids ; Liver cirrhosis ; Nutritional status
Publicat a:	The American journal of gastroenterology, Vol. 106, Núm. 6 (june 2011) , p. 1081-1088, ISSN 1572-0241

DOI: 10.1038/ajg.2011.9

Postprint 35 p, 1.0 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d’Investigació i Innovació Parc Taulí (I3PT)
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