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World J Gastroenterol. Sep 7, 2012; 18(33): 4486-4490
Published online Sep 7, 2012. doi: 10.3748/wjg.v18.i33.4486
Early administration of branched-chain amino acid granules
Toru Ishikawa
Toru Ishikawa, Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Niigata 950-1104, Japan
Author contributions: Ishikawa T contributed solely to this review.
Correspondence to: Toru Ishikawa, MD, PhD, Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, 280-7 Teraji, Niigata 950-1104, Japan.
Telephone: +81-25-2336161 Fax: +81-25-2338880
Received: March 11, 2012
Revised: May 21, 2012
Accepted: May 26, 2012
Published online: September 7, 2012

The effect of malnutrition on survival in patients with decompensated liver cirrhosis has not been well defined. Nutritional intervention with branched-chain amino acid (BCAA) can increase serum albumin concentration in patients with decompensated cirrhosis but its effects on survival are unclear. The BCAA to tyrosine ratio (BTR) is a surrogate marker (the normal range of BTR is between 4.41 and 10.05, and a Fischer’s ratio of 1.8 corresponds to a BTR of 3.5) in patients with decompensated liver cirrhosis, and BCAA inhibits hepatic carcinogenesis in patients with compensated cirrhosis. This review discusses data regarding the effect of early administration of BCAA granules based on the ratio of BCAA to BTR on prognosis in patients with cirrhosis.

Keywords: Branched-chain amino acid to tyrosine ratio, Branched-chain amino acid granules, Liver cirrhosis, Nutritional intervention, Malnutrition, Quality of life, Albumin, Cancer onset