Recent studies have shown that protein-energy malnutrition has a great impact on both quality of life and survival in a cirrhotic patient. Yoshitaka Fukuzawa, MD, PhD, professor, Division of Gastroenterology, School of Medicine, Aichi Medical University, Nagoya, led a prospective study on the effects in outpatients with cirrhosis caused by hepatitis C. The subjects were 70% male, and the average age was 60 years old.

Subjects with poor nutrition (90%) were identified and grouped using the Maastricht Index, and were then prescribed a late-evening snack product with 6.1 g BCAAs and 13.7 g of protein (Aminoleban® EN (Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan). The product was given in divided doses, 1 hour before bedtime for 3 months. The researchers conducted a statistical comparison of classic dietetic, immunological and biochemical parameters, as well as Short Form 36 quality of life questionnaire (SF-36) scales before and after treatment.

Patients who took the late-evening snacks had a significant increase in each parameter, which resulted in a significant decrease in Maastricht Index score (P <.001) 3 months after treatment compared to the pre-treatment baseline. In addition, arm circumference and arm-muscle circumference increased significantly (P <.001) in these patients, while the triceps skin-fold thickness decreased significantly (P <.001). For the non-poor-nutrition group, changes in the various parameters were not significant during the treatment period.

Virtually no adverse reactions were noted in the treated group. Muscle cramps were reported by 20% of patients before treatment and by 10% at the 3-month mark. Three parameters improved significantly (P <.05) in the quality-of-life assessment based on SF-36 -- role functioning (physical), vitality, and mental health.

The researchers found the nutritional assessment based on the Maastricht Index to be convenient and useful for screening patients with poor nutrition, allowing them to conduct appropriate nutritional assessments at an early stage of cirrhosis.

Aminoleban® EN is marketed by Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan.


[Study title: "Nutrition Assessment and Management in Outpatients With Liver Cirrhosis Caused by HCV (LC-C) – Usefulness of a Branched Chain Amino Acid (BCAA)-Rich Product As Late-Evening Snacks (LES)." Abstract 798]

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