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Efficacy of branched-chain amino acid supplementation and walking exercise for preventing sarcopenia in patients with liver cirrhosis.

Abstract

BACKGROUND/AIM

Sarcopenia is recognized as a condition related to quality of life and prognosis in patients with chronic liver disease, although no useful strategy for improving muscle volume and strength has been established. Here, we evaluated the efficacy of supplementation with branched-chain amino acid (BCAA) administration and walking exercise.

PATIENTS AND METHODS

From December 2015 to July 2016, 33 Japanese outpatients with liver cirrhosis were enrolled (median: 67 years, HCV : HBV : alcohol : others=26 : 2 : 2 : 3, male : female=13 : 20, Child-Pugh A : B=30 : 3). None had a history of BCAA supplementation. After calculating the average number of daily steps using a pedometer for a 2-3-week period, BCAA supplementation (protein 13.5 g, 210 kcal/day) as a late evening snack and walking exercise (additional 2000 steps/day prescribed) were started. Body composition including muscle volume was analyzed using a bioelectrical impedance analysis method, and serological data and muscle strength (leg, handgrip) were evaluated at enrollment, and then 1, 2, and 3 months after starting the protocol.

RESULTS

The median average number of daily steps was 3791 (interquartile range: 2238-5484). The average period of BCAA supplementation was 2.7±0.7 months. During the period from enrollment to 3 months after starting the protocol, HbA1c and NH3 were not significantly changed, whereas the BCAA/tyrosine ratio improved (4.3±1.35 to 5.24±2.04, P=0.001). In addition, the ratios for average daily steps (1.595, P=0.02) as well as muscle volume, leg strength, and handgrip strength (1.013, 1.110, and 1.056, respectively; all P<0.01) were increased at 3 months.

CONCLUSION

BCAA supplementation and walking exercise were found to be effective and easily implemented for improving muscle volume and strength in liver cirrhosis patients.

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  • Authors+Show Affiliations

    ,

    aGastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama bDepartment of Rehabilitation, Ehime Prefectural Central Hospital cDepartment of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan.

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    Source

    MeSH

    Aged
    Amino Acids, Branched-Chain
    Ammonia
    Body Composition
    Dietary Supplements
    Exercise Test
    Exercise Therapy
    Female
    Glycated Hemoglobin A
    Hand Strength
    Humans
    Liver Cirrhosis
    Lower Extremity
    Male
    Middle Aged
    Muscle, Skeletal
    Organ Size
    Sarcopenia
    Tyrosine
    Walking

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    29016470

    Citation

    Hiraoka, Atsushi, et al. "Efficacy of Branched-chain Amino Acid Supplementation and Walking Exercise for Preventing Sarcopenia in Patients With Liver Cirrhosis." European Journal of Gastroenterology & Hepatology, vol. 29, no. 12, 2017, pp. 1416-1423.
    Hiraoka A, Michitaka K, Kiguchi D, et al. Efficacy of branched-chain amino acid supplementation and walking exercise for preventing sarcopenia in patients with liver cirrhosis. Eur J Gastroenterol Hepatol. 2017;29(12):1416-1423.
    Hiraoka, A., Michitaka, K., Kiguchi, D., Izumoto, H., Ueki, H., Kaneto, M., ... Hiasa, Y. (2017). Efficacy of branched-chain amino acid supplementation and walking exercise for preventing sarcopenia in patients with liver cirrhosis. European Journal of Gastroenterology & Hepatology, 29(12), pp. 1416-1423. doi:10.1097/MEG.0000000000000986.
    Hiraoka A, et al. Efficacy of Branched-chain Amino Acid Supplementation and Walking Exercise for Preventing Sarcopenia in Patients With Liver Cirrhosis. Eur J Gastroenterol Hepatol. 2017;29(12):1416-1423. PubMed PMID: 29016470.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Efficacy of branched-chain amino acid supplementation and walking exercise for preventing sarcopenia in patients with liver cirrhosis. AU - Hiraoka,Atsushi, AU - Michitaka,Kojiro, AU - Kiguchi,Daisuke, AU - Izumoto,Hirofumi, AU - Ueki,Hidetaro, AU - Kaneto,Miho, AU - Kitahata,Shogo, AU - Aibiki,Toshihiko, AU - Okudaira,Tomonari, AU - Tomida,Hideomi, AU - Miyamoto,Yuji, AU - Yamago,Hiroka, AU - Suga,Yoshifumi, AU - Iwasaki,Ryuichiro, AU - Mori,Kenichiro, AU - Miyata,Hideki, AU - Tsubouchi,Eiji, AU - Kishida,Masato, AU - Ninomiya,Tomoyuki, AU - Kohgami,Shigeru, AU - Hirooka,Masashi, AU - Tokumoto,Yoshio, AU - Abe,Masanori, AU - Matsuura,Bunzo, AU - Hiasa,Yoichi, PY - 2017/10/11/pubmed PY - 2018/7/7/medline PY - 2017/10/11/entrez SP - 1416 EP - 1423 JF - European journal of gastroenterology & hepatology JO - Eur J Gastroenterol Hepatol VL - 29 IS - 12 N2 - BACKGROUND/AIM: Sarcopenia is recognized as a condition related to quality of life and prognosis in patients with chronic liver disease, although no useful strategy for improving muscle volume and strength has been established. Here, we evaluated the efficacy of supplementation with branched-chain amino acid (BCAA) administration and walking exercise. PATIENTS AND METHODS: From December 2015 to July 2016, 33 Japanese outpatients with liver cirrhosis were enrolled (median: 67 years, HCV : HBV : alcohol : others=26 : 2 : 2 : 3, male : female=13 : 20, Child-Pugh A : B=30 : 3). None had a history of BCAA supplementation. After calculating the average number of daily steps using a pedometer for a 2-3-week period, BCAA supplementation (protein 13.5 g, 210 kcal/day) as a late evening snack and walking exercise (additional 2000 steps/day prescribed) were started. Body composition including muscle volume was analyzed using a bioelectrical impedance analysis method, and serological data and muscle strength (leg, handgrip) were evaluated at enrollment, and then 1, 2, and 3 months after starting the protocol. RESULTS: The median average number of daily steps was 3791 (interquartile range: 2238-5484). The average period of BCAA supplementation was 2.7±0.7 months. During the period from enrollment to 3 months after starting the protocol, HbA1c and NH3 were not significantly changed, whereas the BCAA/tyrosine ratio improved (4.3±1.35 to 5.24±2.04, P=0.001). In addition, the ratios for average daily steps (1.595, P=0.02) as well as muscle volume, leg strength, and handgrip strength (1.013, 1.110, and 1.056, respectively; all P<0.01) were increased at 3 months. CONCLUSION: BCAA supplementation and walking exercise were found to be effective and easily implemented for improving muscle volume and strength in liver cirrhosis patients. SN - 1473-5687 UR - https://www.unboundmedicine.com/medline/citation/29016470/Efficacy_of_branched_chain_amino_acid_supplementation_and_walking_exercise_for_preventing_sarcopenia_in_patients_with_liver_cirrhosis_ L2 - http://Insights.ovid.com/pubmed?pmid=29016470 DB - PRIME DP - Unbound Medicine ER -