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Roux-en-Y gastric bypass surgery, but not calorie restriction, reduces plasma branched-chain amino acids in obese women independent of weight loss or the presence of type 2 diabetes.
Lips, MA, Van Klinken, JB, van Harmelen, V, Dharuri, HK, 't Hoen, PA, Laros, JF, van Ommen, GJ, Janssen, IM, Van Ramshorst, B, Van Wagensveld, BA, et al
Diabetes care. 2014;(12):3150-6
Abstract
OBJECTIVE Obesity and type 2 diabetes mellitus (T2DM) have been associated with increased levels of circulating branched-chain amino acids (BCAAs) that may be involved in the pathogenesis of insulin resistance. However, weight loss has not been consistently associated with the reduction of BCAA levels. RESEARCH DESIGN AND METHODS We included 30 obese normal glucose-tolerant (NGT) subjects, 32 obese subjects with T2DM, and 12 lean female subjects. Obese subjects underwent either a restrictive procedure (gastric banding [GB], a very low-calorie diet [VLCD]), or a restrictive/bypass procedure (Roux-en-Y gastric bypass [RYGB] surgery). Fasting blood samples were taken for the determination of amine group containing metabolites 4 weeks before, as well as 3 weeks and 3 months after the intervention. RESULTS BCAA levels were higher in T2DM subjects, but not in NGT subjects, compared with lean subjects. Principal component (PC) analysis revealed a concise PC consisting of all BCAAs, which showed a correlation with measures of insulin sensitivity and glucose tolerance. Only after the RYGB procedure, and at both 3 weeks and 3 months, were circulating BCAA levels reduced. CONCLUSIONS Our data confirm an association between deregulation of BCAA metabolism in plasma and insulin resistance and glucose intolerance. Three weeks after undergoing RYGB surgery, a significant decrease in BCAAs in both NGT as well as T2DM subjects was observed. After 3 months, despite inducing significant weight loss, neither GB nor VLCD induced a reduction in BCAA levels. Our results indicate that the bypass procedure of RYGB surgery, independent of weight loss or the presence of T2DM, reduces BCAA levels in obese subjects.
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Effects of branched-chain amino acid-enriched nutrient for patients with hepatocellular carcinoma following radiofrequency ablation: a one-year prospective trial.
Kuroda, H, Ushio, A, Miyamoto, Y, Sawara, K, Oikawa, K, Kasai, K, Endo, R, Takikawa, Y, Kato, A, Suzuki, K
Journal of gastroenterology and hepatology. 2010;(9):1550-5
Abstract
BACKGROUND AND AIM This prospective control study examined whether supplementation with branched-chain amino acid (BCAA)-enriched nutrients can help maintain and improve residual liver function and nutritional status in cirrhotic patients with hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA). METHODS Subjects were 49 patients with hepatitis C-related HCC who underwent RFA. Two groups were formed: BCAA group (BCAA-enriched nutrient, aminoleban EN) and controls (standard diet only). Event-free survival rate, liver function tests, and Short Form (SF)-8 scores were evaluated in both groups before and one year after RFA. Energy metabolism using indirect calorimetry was measured before and after 3 months. RESULTS Complete data were obtained from 35 patients (BCAA group, n = 20; controls, n = 15). Six events (death, recurrence of HCC, rupture of esophageal varices and liver failure) occurred during the observation period, but frequencies of these events did not differ between groups. Event-free survival rate tended to be higher in the BCA group than in controls. Among the parameters of liver function, serum albumin level was only significantly increased over 6 months, and remained at similar values for one year (P < 0.05). SF-8 scores for general health, physical functioning, and social functioning were significantly elevated in the BCAA group (P < 0.05). Non-protein respiratory quotient was significantly improved in the BCAA group (P < 0.01). CONCLUSION Supplementation with BCAA-enriched nutrients for one year in cirrhotic patients with HCC after RFA therapy can perform safety and improve both nutritional state and quality of life.
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Effects of branched-chain amino acids-enriched nutrient support for patients undergoing liver resection for hepatocellular carcinoma.
Okabayashi, T, Nishimori, I, Sugimoto, T, Maeda, H, Dabanaka, K, Onishi, S, Kobayashi, M, Hanazaki, K
Journal of gastroenterology and hepatology. 2008;(12):1869-73
Abstract
BACKGROUND AND AIMS Most patients with hepatocellular carcinoma (HCC) have underlying liver cirrhosis that is frequently associated with a state of protein energy malnutrition. The aim of this study was to evaluate the clinical benefit of perioperative supplementation of a branched-chain amino acid-enriched nutrient-mixture for patients undergoing liver resection for HCC. METHODS A total of 112 patients with HCC who underwent hepatic resection were enrolled in this study. These patients were divided into two groups: 40 patients received perioperative supplementation of branched-chain amino acid-enriched nutrient-mixture (AEN group) and 72 patients did not (control group). Laboratory data, postoperative complications, duration of hospitalization, and survival were assessed for each group and compared. RESULTS The overall incidence of postoperative complications was lower in the AEN group (17.5%) than in the control group (44.4%) (P = 0.01). Among the postoperative complications, surgical site infection and bile leakage was observed in 5% of patients in the AEN group and in 15.3% and 12.5% of patients in the control group, respectively. Ascites appeared after the surgery in 7.5% of patients in the AEN group and in 16.7% of patients in the control group. The duration of hospitalization was significantly shorter in the AEN group was than in the control group (P < 0.05). CONCLUSIONS This study strongly suggests that perioperative supplementation of a branched-chain amino acid-enriched nutrient-mixture is clinically beneficial in reducing the morbidity associated with postoperative complications and in shortening the duration of hospitalization of patients with chronic liver disease who undergo liver resection for HCC.
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Concentrations of branched amino acids: isoleucine, valine, leucine in serum of hemodialysis patients during one-year observation.
Bednarek-Skublewska, A, Swatowski, A, Wawrzycki, S, Baranowicz-Gaszczyk, I, Ksiazek, A
Annales Universitatis Mariae Curie-Sklodowska. Sectio D: Medicina. 2002;(2):322-9
Abstract
Malnutrition is commonly reported in haemodialysis patients (HD pts) and is multifactorial in origin. Previous studies indicated a possible relationship between plasma levels of branched-chain amino acids (BCAA): isoleucine, leucine, valine and nutritional status of HD pts. The BCAA have important influence on metabolism of energy in skeletal muscles, in addition the leucine makes easy the synthesis of protein. In the present investigation we evaluated some parameters of nutritional state and the concentration of branched-amino acids in haemodialysis patients during one-year observation. Sixty-seven patients undergoing haemodialysis were assessed in the first study (study I), after 12 months this assessment was repeated in 70 patients (study II). Blood was drawn before the midweek dialysis session. Morphology, plasma albumin concentration and urea for KT/V calculation were determined by routine methods. Branched amino acids were measured by chromatography method with amino acid analyser AAA 400, using a lithium-citric buffer system. The plasma amino acid pattern was measured in the study group and compared with 20 healthy persons. Mean amino acids concentration observed in both study groups was significantly lower than in the control group. Mean concentration of BCAA was also lower than in control group. There was a small negative correlation between albumin concentrations and the length of dialysis therapy. There were significant positive correlations between: total amino acids, branched amino acids as well as albumin, especially in study II.