Effects of Branched-Chain Amino Acids on Patients Undergoing Hepatic Intervention: A Meta-Analysis of Randomized Controlled Trials

Abstract

BACKGROUND: The benefits of branched-chain amino acid (BCAA) administration after hepatic intervention in patients with liver diseases remains unclear. We conducted a systematic review and meta-analysis to evaluate the effects of BCAA on patients undergoing hepatectomy, trans-arterial embolization, radiofrequency ablation. METHODS: Relevant randomized controlled trials (RCTs) were obtained from PubMed, EMBASE, and Cochrane Library databases. A meta-analysis was performed to calculate the pooled effect size by using random-effects models. The primary outcomes were survival, hospital stay, nutrition status, and biochemistry profile. The secondary outcomes were the complication rate of liver treatment and adverse effect of BCAA supplementation. RESULTS: In total, 11 RCTs involving 750 patients were included. Our meta-analysis showed no significant difference in the rates of tumorrecurrence and overall survival between the BCAA and control groups. However, the pooled estimate showed that BCAA supplementation in patients undergoing hepatic intervention significantly increased serum albumin (mean difference [MD]: 0.11 g/dL, 95% confidence interval [CI]: 0.02–0.20) at 6 months and cholinesterase level (MD: 50.00 U/L, 95% CI: 21.08–78.92) at 12 months, increased body weight (MD: 3.29 kg, 95% CI: 1.07–5.50) at 12 months, and reduced ascites incidence (risk ratio: 0.39, 95% CI: 0.21–0.71) compared with the control group. Additionally, BCAA administration shortened the hospital stay length (MD: −2.36 days, 95% CI: −4.78 to 0.07) compared with the control group. CONCLUSION: BCAA supplementation significantly reduced postintervention complication and hospitalization duration and increased body weight. Thus, BCAA supplementation may benefit patients undergoing liver intervention.

Effects of Parenteral Nutrition with Amino Acid Alone and Amino Acid-Intralipid Combination on Vital Signs and Rate of Diuresis in ICU Patients

“…As for the liver enzymes, the findings of this study revealed that the administration of PN with amino acid-intralipid decreased the ALT, AST, and Bil, which was in line with the report of Liu et al The combination itself could further reduce ALT and AST (29). In addition, Navaratnarajah et al found that the children using SMOFlipid-intralipid had lower BL levels at the end of the study (30); however, Hsu et al established that amino acid administration had no effect on liver tests (31). The reason for the difference in results could be attributed to the types of diseases affecting the patients, as some studies were conducted on cases with liver diseases, preterm infants, or in animal laboratory environments.…”