Late evening snacks with branched-chain amino acids improve the Fischer ratio with patients liver cirrhosis at fasting in the next morning.

Autor: Maki H; Department of Pharmacy, Kofu Municipal Hospital, Kofu, Yamanashi, Japan., Yamanaka-Okumura H; Department of Clinical Nutrition and Food Management, Institute of Biomedical Sciences, Tokushima University Graduate School, Kuramoto-cho, Tokushima, Japan. Electronic address: okumurah@tokushima-u.ac.jp., Katayama T; Department of Statistics and Computer Science, College of Nursing Art and Science, University of Hyogo, Hyogo, Japan., Ozawa Y; Department of Nutrition Management, Kofu Municipal Hospital, Kofu, Yamanashi, Japan., Hosoda A; Department of Pharmacy, Kofu Municipal Hospital, Kofu, Yamanashi, Japan., Kurata N; Department of Healthcare and Regulatory Sciences, Showa University School of Pharmacy, Tokyo, Japan., Amemiya F; Department of Internal Medicine, Kofu Municipal Hospital, Kofu, Yamanashi, Japan.
Jazyk: angličtina
Zdroj: Clinical nutrition ESPEN [Clin Nutr ESPEN] 2019 Apr; Vol. 30, pp. 138-144. Date of Electronic Publication: 2019 Jan 24.
DOI: 10.1016/j.clnesp.2019.01.003
Abstrakt: Background & Aims: A late evening snack (LES) is recommended as a nutritional therapy for liver cirrhosis to minimize early starvation. In patients with liver cirrhosis, the maintenance of the branched-chain amino acid (BCAA) levels is important during muscle synthesis at night. Therefore, we investigated the effects of a LES with BCAAs on the Fischer ratio in patients with liver cirrhosis.
Methods: This study included 10 outpatients with liver cirrhosis who did not consume a LES. Regarding the patient characteristics, the mean age was 73.1 ± 8.9 years, the male:female ratio was 5:5, and the mean body mass index was 23.3 ± 2.4 kg/m 2 . The etiology was hepatitis C virus in eight patients and alcoholism in two patients. Amino acid levels were measured in all 10 patients at four time points: before LES (control) and 1 month after the administration of each BCAA. The administration levels included 1) LES: BCAA-enriched enteral nutrition (BCAA-EN) containing BCAAs 6.1 g as a LES; 2) GP-no LES: BCAA-enriched granule product (BCAA-GP) containing 4 g BCAAs per pack, two packs per day, and BCAA-EN until dinner containing BCAAs in total 14.1 g per day; and 3) GP-LES: BCAA-GP, two packs per day, and BCAA-EN as a LES containing BCAAs in total 14.1 g per day. The Friedman nonparametric test with a post-hoc Dunn's multiple comparison was used for statistical analyses.
Results: There were no significant changes in body weight and serum albumin levels between the three types of BCAA administration. Valine significantly increased following LES and GP-LES, isoleucine significantly increased following GP-LES, and tyrosine significantly decreased following LES and GP-LES compared with those in the control. There was no significant difference in the leucine and phenylalanine levels among the groups. The Fischer ratio in the LES (2.2 ± 0.8) and GP-LES (2.3 ± 0.8) groups were significantly higher than that in the control (1.8 ± 0.6), but there was no significant difference compared with the Fischer ratio in the GP-no LES (1.8 ± 0.7) group. Furthermore, the Fischer ratio was significantly higher in the GP-LES group than in the GP-no LES group.
Conclusion: These results suggested that it is not only the amount of BCAAs, but also LES with BCAAs, which is needed to improve the Fischer ratio at fasting.
(Copyright © 2019. Published by Elsevier Ltd.)
Databáze: MEDLINE
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