간경변 환자의 영양상태에 있어서 경구용 분지형 아미노산 제제의 효과에 대한 전향적 연구

Abstract

Background / Aims : A prospective comparative study was conducted to investigate the efficacy of orally administered branched-chain amino acids(BCAA) in cirrhotic patients. Methods : Forty-seven patients with liver cirrhosis of viral etiologies, whose hypoalbunemia could not be corrected with adequate protein intake, were randomly assigned to either the BCAA group(n=31) or the control group(n=16). The selection criteria were ages between 16 and 70 years, patients whose Child-Pugh scores were less than 13 points and who were willing to participate in the study. Most patients(87.1%) belonged to Child -Pugh class B. Patients in the BCAA group received oral supplementation with branced-chain amino acid granules(12g/day, each packet containing total 4g of BCAA , i.e.leucine, 1904 mg ; valine, 1144mg; isoleucine, 952mg) for 12 weeks. Patients had complete blood counts and chemistry at entry and once every month. Serum ferritin and amino acid concentrations in plasma were determined. Anthropometric parameters including body weight, body fat contents and body mass index were assessed at the beginning and at the end of the 3-month period. Results : In the BCAA group, there was a significant increment in plasma levels of isoleucine, valine(p<0.001) whereas levels of aromatic amino acids did not show substantial change. Total BCAA concentration and BCAA/AAA(aromatic amino acid) molar ratio(Fischer`s ratio) also increased significantly after administration of oral BCAA (p<0.02). In contrast, patients in the control group showed no significant change in assessed parameters. Conclusion : Oral supplementation of BCAA to or other serious adverse effects.