Branched Chain Amino Acids Are Associated with Physical Performance in Patients with End-Stage Liver Disease

• Published in: Biomolecules (Basel, Switzerland) Vol. 13; no. 5; p. 824
• Main Authors: Trillos-Almanza, Maria Camila, Wessel, Hanna, Martínez-Aguilar, Magnolia, van den Berg, Eline H, Douwes, Rianne M, Moshage, Han, Connelly, Margery A, Bakker, Stephan J L, de Meijer, Vincent E, Dullaart, Robin P F, Blokzijl, Hans
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 12-05-2023; MDPI
• Subjects: Amino acids; Amino Acids, Branched-Chain; Ascites; Biobanks; Blood pressure; Branched chain amino acids; Cell cycle; chronic liver disease; Complications and side effects; Creatinine; Diuretics; End Stage Liver Disease; essential amino acids; Female; Glucose; Hand Strength; Health aspects; hepatic cirrhosis; Hepatic encephalopathy; Humans; Laboratories; Liver cirrhosis; Liver Diseases; Liver failure; Liver transplantation; Liver transplants; Magnetic resonance spectroscopy; Male; Measurement; Medical prognosis; Mortality; NMR; Nuclear magnetic resonance; Patients; Physical Functional Performance; Postural Balance; Prognosis; Proteins; Risk factors; Sarcopenia; Spectrum analysis; Time and Motion Studies; Netherlands; United States > US; functional performance; hepatic cirrhosis; frailty; essential amino acids; hepatic encephalopathy; chronic liver disease; magnetic resonance spectroscopy; muscle development; liver transplantation; sarcopenia
• ISSN: 2218-273X; 2218-273X
• DOI: 10.3390/biom13050824

Decreased circulating branched chain amino acids (BCAA) represent a prominent change in amino acid profiles in patients with end-stage liver disease (ESLD). These alterations are considered to contribute to sarcopenia and hepatic encephalopathy and may relate to poor prognosis. Here, we cross-sectionally analyzed the association between plasma BCAA levels and the severity of ESLD and muscle function in participants of the liver transplant subgroup of TransplantLines, enrolled between January 2017 and January 2020. Plasma BCAA levels were measured by nuclear magnetic resonance spectroscopy. Physical performance was analyzed with a hand grip strength test, 4 m walking test, sit-to-stand test, timed up and go test, standing balance test and clinical frailty scale. We included 92 patients (65% men). The Child Pugh Turcotte classification was significantly higher in the lowest sex-stratified BCAA tertile compared to the highest tertile (
= 0.015). The times for the sit-to-stand (r = -0.352,
< 0.05) and timed up and go tests (r = -0.472,
< 0.01) were inversely correlated with total BCAA levels. In conclusion, lower circulating BCAA are associated with the severity of liver disease and impaired muscle function. This suggests that BCAA may represent a useful prognostic marker in the staging of liver disease severity.