Effect of Oral Supplementation with Branched-chain Amino Acid Granules on Serum Albumin Level in the Early Stage of Cirrhosis: a Randomized Pilot Trial

We designed a randomized pilot trial to examine whether increase or preservation of serum albumin levels was attained with earlier administration of branched-chain amino acid (BCAA) granules for cirrhosis in grade A according to Child-Pugh classification using branched-chain tyrosine ratio (BTR) as an indicator. Forty patients with HCV-related cirrhosis in grade A with serum albumin level between 3.5 and 3.9 g/dl were enrolled in this study. Half of the patients were randomly assigned to receive 14.3 g/day of BCAA granules orally, and half were assigned to a control. Patients were evaluated at entry and at 1-year interval for at least 2 years. For patients whose BTR was less than 4.0, mean change in serum albumin in the BCAA group was significantly higher than that in the control group after 1 and 2 years of treatment. However, for patients whose BTR was more than 4.0, mean change in serum albumin in the BCAA group was not significantly higher than that in the control group after 1 and 2 years of treatment. In conclusion, early oral supplementation of BCAA for HCV-related cirrhosis with serum albumin level between 3.5 and 3.9 g/dl and BTR less than 4.0, improves serum albumin levels and thus might improve prognosis.