Measurement of serum branched‐chain amino acids to tyrosine ratio level is useful in a prediction of a change of serum albumin level in chronic liver disease

Suzuki, Kazutomo; Suzuki, Kazuyoshi; Koizumi, Kazuhito; Ichimura, Hiroki; Oka, Shigeki; Takada, Hiroshi; Kuwayama, Hajime

doi:10.1111/j.1872-034x.2007.00268.x

Cited by 45 publications

(35 citation statements)

References 11 publications

(10 reference statements)

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“…Six studies [117,[125][126][127][128][129] have reported an association between GERD and chronic liver disease (Table 7). First, Akatsu et al [125] demonstrated that 8 (27.6%) of 29 patients developed reflux esophagitis after living-donor liver transplantation, although only 1 patients had reflux esophagitis before transplantation.…”

Section: Chronic Liver Diseasementioning

confidence: 99%

“…The mechanisms of GERD development after living-donor liver transplantation are still unknown. The other five studies [117,[126][127][128][129] showed the prevalence of GERD in patients with chronic liver disease using specific questionnaires such as QUEST or FSSG. Two studies [126,128] showed a significantly higher prevalence of GERD (approximately 19%) in liver disease patients compared with controls, but the prevalence of GERD in controls was extremely low compared with that in the general adult population (see Tables 1, 2).…”

Section: Chronic Liver Diseasementioning

confidence: 99%

“…Two studies [126,128] showed a significantly higher prevalence of GERD (approximately 19%) in liver disease patients compared with controls, but the prevalence of GERD in controls was extremely low compared with that in the general adult population (see Tables 1, 2). Only one report, by Suzuki et al [129] using QUEST, showed that more than 30% of patients with chronic liver disease had GERD. Thus, we could not conclude that the prevalence of GERD in Japanese patients with chronic liver disease was high.…”

Section: Chronic Liver Diseasementioning

confidence: 99%

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Epidemiology and clinical characteristics of GERD in the Japanese population

2009

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We reviewed articles on the epidemiology and clinical characteristics of gastroesophageal reflux disease (GERD) in Japan to clarify these features of GERD in this country. Although the definition of GERD depends on the individual study, the prevalence of GERD has been increasing since the end of the 1990s. The reasons for the increase in the prevalence of GERD may be due to increases in gastric acid secretion, a decrease in the Helicobacter pylori infection rate, more attention being paid to GERD, and advances in the concept of GERD. More than half of GERD patients had non-erosive reflux disease, and the majority (87%) of erosive esophagitis was mild type, such as Los Angeles classification grade A and grade B. There were several identified risk factors, such as older age, obesity, and hiatal hernia. In particular, mild gastric atrophy and absence of H. pylori infection influence the characteristics of GERD in the Japanese population. We also discuss GERD in the elderly; asymptomatic GERD; the natural history of GERD; and associations between GERD and peptic ulcer disease and H. pylori eradication. We examined the prevalence of GERD in patients with specific diseases, and found a higher prevalence of GERD, compared with that in the general population, in patients with diabetes mellitus, those with obstructive sleep apnea syndrome, and those with bronchial asthma. We provide a comprehensive review of GERD in the Japanese population and raise several clinical issues.

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Section: Chronic Liver Diseasementioning

confidence: 99%

Section: Chronic Liver Diseasementioning

confidence: 99%

Section: Chronic Liver Diseasementioning

confidence: 99%

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Epidemiology and clinical characteristics of GERD in the Japanese population

2009

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“…The dose of BCAAs used in this study may have been insufficient to increase serum albumin levels over the period of 60 days. However, a lower serum BTR can predict decreases in serum albumin levels (19), suggesting that long-term administration of the supplement may maintain constant serum albumin levels. In addition, low serum BTRs have been recently reported to be a predictive factor in the development of HCC, intrahepatic distant recurrence of HCC and poor prognosis in patients with cirrhosis (2,3).…”

Section: Discussionmentioning

confidence: 99%

Effects of branched-chain amino acids and zinc-enriched nutrients on prognosticators in HCV-infected patients: A multicenter randomized controlled trial

Kawaguchi

Nagao

Abe

et al. 2014

Molecular Medicine Reports

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Abstract. Branched-chain amino acids (BCAAs) and trace element deficiencies are associated with poor prognosis in hepatitis C virus (HCV)-infected patients. The aim of this study was to investigate the effects of BCAA and zinc-enriched supplementation on prognostic factors in HCV-infected patients. Fifty-three HCV-infected patients were enrolled in this multicenter randomized controlled trial. The patients were assigned to either the placebo (n=27) or supplement group (n=26; 6,400 mg/day BCAAs and 10 mg/day zinc) and were followed up for 60 days. Primary outcomes were prognostic factors for chronic liver disease, including the serum BCAA-to-tyrosine ratio (BTR), zinc levels and α-fetoprotein (AFP) levels. There were no significant differences in any of the prognostic factors between the placebo and supplement groups at baseline. In the supplement group, the BTR and zinc levels were significantly increased compared with the placebo group (BTR: 5.14±1.59 vs. 4.23±1.14, P= 0.0290; zinc: 76±11 vs. 68±11 µg/dl, P=0.0497). No significant differences were observed in AFP levels between the groups in the whole analysis. However, a stratification analysis showed a significant reduction in ΔAFP levels in the supplement group, with elevated AFP levels compared with the other groups (-2.72±3.45 ng/ml, P= 0.0079). It was demonstrated that BCAA and zinc-enriched supplementation increased the BTR and zinc levels in the HCV-infected patients. Furthermore, the supplementation reduced the serum AFP levels in patients who had elevated serum AFP levels at baseline. Thus, BCAA and zinc-enriched supplementation may prolong the survival of HCV-infected patients by improving amino acid imbalance and zinc deficiency, and by partly downregulating AFP.

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“…decreases in the ratio of Bcaas to aromatic amino acids (aaas) (Fisher's ratio) are associated with the severity of liver disease. Bcaarich supplements up-regulate albumin synthesis through an increase in Fisher's ratio (7). Thus, in patients with liver cirrhosis, Bcaa supplementation seems to be effective at reducing ascites and improving Qol.…”

Section: Introductionmentioning

confidence: 99%

Branched-chain amino acid supplements reduced ascites and increased the quality of life in a patient with liver cirrhosis: A case report

Itou

Kawaguchi²,

Taniguchi³

et al. 2009

Mol Med Rep

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Abstract. liver cirrhosis is frequently accompanied by malnutrition and hypoalbuminemia, which in turn commonly induces ascites in patients with liver cirrhosis. ascites leads to abdominal distention and appetite loss, resulting in a deteriorated quality of life (Qol). administration of branched-chain amino acid (Bcaa)-rich supplements reduces hepatic encephalopathy and malnutrition. in addition, Bcaas by themselves up-regulate albumin synthesis through an increase in Fisher's ratio. Thus, in patients with liver cirrhosis, Bcaa-rich supplements seem to be effective at reducing ascites and improving the Qol. Here, we report the case of a 58-year-old Japanese man with liver cirrhosis with severe ascites and peripheral edema. The hepatic function of the patient was classified as Child-Pugh grade C. To reduce protein-energy malnutrition, Bcaa-rich supplements were administered as a late evening snack as part of a regimen including 2000 kcal/day (32.5 kcal/kg/day) of total energy and 83.5 g/day (1.3 g/kg/day) of total protein intake. eight weeks after admission, ascites and edema had decreased. nutritional status also improved from the time of admission to discharge; the serum BCAA level increased from 365.4 to 450.2 µmol/l. Furthermore, the ratio of Bcaas to tyrosine (BTr) increased from 1.70 to 3.65. We also evaluated the effects of nutritional therapy on the patient's Qol using the Medical outcomes Study 36-item Short-Form Health Survey upon admission and at discharge. all subscores showed marked improvement and reached a level greater than the Japanese norm with nutritional treatment. in conclusion, Bcaa supplementation not only reduced ascites, but also improved the Qol in a patient with liver cirrhosis.

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Measurement of serum branched‐chain amino acids to tyrosine ratio level is useful in a prediction of a change of serum albumin level in chronic liver disease

Abstract: It is important to evaluate serum albumin levels and the BTR in patients with HCV-associated chronic liver diseases.

Cited by 45 publications

References 11 publications

Epidemiology and clinical characteristics of GERD in the Japanese population

Epidemiology and clinical characteristics of GERD in the Japanese population

Effects of branched-chain amino acids and zinc-enriched nutrients on prognosticators in HCV-infected patients: A multicenter randomized controlled trial

Branched-chain amino acid supplements reduced ascites and increased the quality of life in a patient with liver cirrhosis: A case report

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