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Branched chain amino acids supplemented with L-acetylcarnitine versus BCAA treatment in hepatic coma: a randomized and controlled double blind study.
Eur J Gastroenterol Hepatol. 2009 Jul; 21(7):762-70.EJ

Abstract

OBJECTIVE

Our earlier study has demonstrated that the administration of L-acetylcarnitine (LAC) improves neurological symptoms and serum parameters in hepatic coma. The aim of this work has been to evaluate the efficacy of the LAC and branched chain amino acids (BCAA) versus BCAA, administered in intravenous infusion, in patients with cirrhotic hepatic coma.

METHODS

Forty-eight highly selected patients were enrolled in the study and, after randomization, received blindly LAC+BCAA (n=24) versus BCAA (n=24). The two groups were similar in age, sex, pathogenesis of cirrhosis, and severity of liver disease. The comparison between values before and after LAC planned treatment showed statistical significant differences in neurological findings, evaluated by the Glasgow Scale, ammonia serum levels, blood urea nitrogen, and EEG.

RESULTS

After 60 min of the study period, the LAC+BCAA treated patients compared with BCCA treated showed a significant decrease of ammonia serum levels: 41.20 versus 10.40 mumol P<0.05. After 1 day of the study period, the LAC+BCAA treated patients compared with BCCA treated patients showed a significant increase of Glasgow's score: 3.60 versus 1.50 score P<0.05; a significant decrease of ammonia serum levels: 63.30 versus 27.00 mumol P<0.01; a significant improvement of EEG cps/s: 2.70 versus 0.6 P<0.001. No side-effects were observed in our study series.

CONCLUSION

Our study demonstrated that the administration of BCAA supplemented with LAC might improve neurological symptoms and serum ammonium levels in selected cirrhotic patients with hepatic coma.

Authors+Show Affiliations

Department of Senescence, Urological and Neurological Sciences, University of Catania, Italy. malaguar@unict.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

19357525

Citation

Malaguarnera, Mariano, et al. "Branched Chain Amino Acids Supplemented With L-acetylcarnitine Versus BCAA Treatment in Hepatic Coma: a Randomized and Controlled Double Blind Study." European Journal of Gastroenterology & Hepatology, vol. 21, no. 7, 2009, pp. 762-70.
Malaguarnera M, Risino C, Cammalleri L, et al. Branched chain amino acids supplemented with L-acetylcarnitine versus BCAA treatment in hepatic coma: a randomized and controlled double blind study. Eur J Gastroenterol Hepatol. 2009;21(7):762-70.
Malaguarnera, M., Risino, C., Cammalleri, L., Malaguarnera, L., Astuto, M., Vecchio, I., & Rampello, L. (2009). Branched chain amino acids supplemented with L-acetylcarnitine versus BCAA treatment in hepatic coma: a randomized and controlled double blind study. European Journal of Gastroenterology & Hepatology, 21(7), 762-70. https://doi.org/10.1097/MEG.0b013e328309c791
Malaguarnera M, et al. Branched Chain Amino Acids Supplemented With L-acetylcarnitine Versus BCAA Treatment in Hepatic Coma: a Randomized and Controlled Double Blind Study. Eur J Gastroenterol Hepatol. 2009;21(7):762-70. PubMed PMID: 19357525.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Branched chain amino acids supplemented with L-acetylcarnitine versus BCAA treatment in hepatic coma: a randomized and controlled double blind study. AU - Malaguarnera,Mariano, AU - Risino,Corrado, AU - Cammalleri,Lisa, AU - Malaguarnera,Lucia, AU - Astuto,Marinella, AU - Vecchio,Ignazio, AU - Rampello,Liborio, PY - 2009/4/10/entrez PY - 2009/4/10/pubmed PY - 2010/7/16/medline SP - 762 EP - 70 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 21 IS - 7 N2 - OBJECTIVE: Our earlier study has demonstrated that the administration of L-acetylcarnitine (LAC) improves neurological symptoms and serum parameters in hepatic coma. The aim of this work has been to evaluate the efficacy of the LAC and branched chain amino acids (BCAA) versus BCAA, administered in intravenous infusion, in patients with cirrhotic hepatic coma. METHODS: Forty-eight highly selected patients were enrolled in the study and, after randomization, received blindly LAC+BCAA (n=24) versus BCAA (n=24). The two groups were similar in age, sex, pathogenesis of cirrhosis, and severity of liver disease. The comparison between values before and after LAC planned treatment showed statistical significant differences in neurological findings, evaluated by the Glasgow Scale, ammonia serum levels, blood urea nitrogen, and EEG. RESULTS: After 60 min of the study period, the LAC+BCAA treated patients compared with BCCA treated showed a significant decrease of ammonia serum levels: 41.20 versus 10.40 mumol P<0.05. After 1 day of the study period, the LAC+BCAA treated patients compared with BCCA treated patients showed a significant increase of Glasgow's score: 3.60 versus 1.50 score P<0.05; a significant decrease of ammonia serum levels: 63.30 versus 27.00 mumol P<0.01; a significant improvement of EEG cps/s: 2.70 versus 0.6 P<0.001. No side-effects were observed in our study series. CONCLUSION: Our study demonstrated that the administration of BCAA supplemented with LAC might improve neurological symptoms and serum ammonium levels in selected cirrhotic patients with hepatic coma. SN - 1473-5687 UR - https://www.unboundmedicine.com/medline/citation/19357525/Branched_chain_amino_acids_supplemented_with_L_acetylcarnitine_versus_BCAA_treatment_in_hepatic_coma:_a_randomized_and_controlled_double_blind_study_ L2 - http://dx.doi.org/10.1097/MEG.0b013e328309c791 DB - PRIME DP - Unbound Medicine ER -