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Efficacy and safety of oral branched-chain amino acid supplementation in patients undergoing interventions for hepatocellular carcinoma: a meta-analysis.

Chen L, Chen Y, Wang X, Li H, Zhang H, Gong J, Shen S, Yin W, Hu H - Nutr J (2015)

Bottom Line: BCAA supplementation seemed to be effective in improving mortality, especially in Child-Pugh class B patients, but the efficacy was not confirmed.Apparent effects were not found in improving HCC recurrence, total bilirubin, ALT, or AST.BCAA supplementation was relatively safe without serious adverse events.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Nutrition, the Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road,Central District, Chongqing, 400010, PR China. chulingcclc@163.com.

ABSTRACT
Most hepatocellular carcinoma (HCC) patients have complications, including cirrhosis and malnutrition. The efficacy of dietary supplementation with oral branched-chain amino acids (BCAAs) in HCC patients undergoing interventions has not been confirmed. Relevant publications on the efficacy and safety of oral BCAA supplementation for HCC patients undergoing anti-HCC interventions through September, 2014 were searched for identification in the PubMed, Embase, Web of Science, and the Cochrane Library databases. The pooled risk ratio (RR) and standardized mean difference (SMD) were used to assess the supplementation effects. A total of 11 eligible studies (974 patients in total) were evaluated and included in our analysis. Oral BCAA supplementation helped to maintain liver reserve with higher serum albumin (SMD = 0.234, 95% CI: 0.033-0.435, P = 0.022), and lower rates of ascites (RR = 0.545, 95% CI: 0.316-0.938, P = 0.029) and edema (RR = 0.494, 95% CI: 0.257-0.952, P = 0.035) than in the control group. BCAA supplementation seemed to be effective in improving mortality, especially in Child-Pugh class B patients, but the efficacy was not confirmed. Apparent effects were not found in improving HCC recurrence, total bilirubin, ALT, or AST. BCAA supplementation was relatively safe without serious adverse events. BCAA supplementation may be clinically applied in improving liver functional reserve for HCC patients and further improving the quality of life.

No MeSH data available.


Related in: MedlinePlus

Flow diagram of literature selection process
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Related In: Results  -  Collection

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Fig1: Flow diagram of literature selection process

Mentions: As the search strategy shows (Fig. 1), 624 records in total were identified, and 311 records were removed as duplicate documents retrieved from two or more databases. The remaining studies received further screening by scanning the title or abstract, which resulted in the exclusion of a further 290 studies. As a result, 23 full-text articles were subjected to detailed evaluation, of which two were excluded because they analyzed the same patient groups, and a further ten were excluded due to lack of available data. Eventually, 11 eligible articles relating to a total of 974 subjects (450 in BCAA groups and 524 in control groups) were chosen for this meta-analysis. Of the 11 eligible studies, six were RCTs [19–24] and five were cohorts (of which three were retrospective and two prospective designs) [25–28, 32]. Out of the six RCTs, four received a Jadad score of 4 or 5 and were considered high-quality, while the other two were deemed low quality because of scores lower than 4 (Additional file 1: Table. S1). All five cohort studies received a NOS score of 7 or 8 (Additional file 2: Table S2). No publication bias was found among these included studies (Additional file 3: Figure S1). The detailed characteristics of the included studies are summarized in Table 1. All pooled results are summarized in Additional file 4: Table S3 and the results of each study reviewed are summarized in Additional file 5: Table S4.Fig. 1


Efficacy and safety of oral branched-chain amino acid supplementation in patients undergoing interventions for hepatocellular carcinoma: a meta-analysis.

Chen L, Chen Y, Wang X, Li H, Zhang H, Gong J, Shen S, Yin W, Hu H - Nutr J (2015)

Flow diagram of literature selection process
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4496824&req=5

Fig1: Flow diagram of literature selection process
Mentions: As the search strategy shows (Fig. 1), 624 records in total were identified, and 311 records were removed as duplicate documents retrieved from two or more databases. The remaining studies received further screening by scanning the title or abstract, which resulted in the exclusion of a further 290 studies. As a result, 23 full-text articles were subjected to detailed evaluation, of which two were excluded because they analyzed the same patient groups, and a further ten were excluded due to lack of available data. Eventually, 11 eligible articles relating to a total of 974 subjects (450 in BCAA groups and 524 in control groups) were chosen for this meta-analysis. Of the 11 eligible studies, six were RCTs [19–24] and five were cohorts (of which three were retrospective and two prospective designs) [25–28, 32]. Out of the six RCTs, four received a Jadad score of 4 or 5 and were considered high-quality, while the other two were deemed low quality because of scores lower than 4 (Additional file 1: Table. S1). All five cohort studies received a NOS score of 7 or 8 (Additional file 2: Table S2). No publication bias was found among these included studies (Additional file 3: Figure S1). The detailed characteristics of the included studies are summarized in Table 1. All pooled results are summarized in Additional file 4: Table S3 and the results of each study reviewed are summarized in Additional file 5: Table S4.Fig. 1

Bottom Line: BCAA supplementation seemed to be effective in improving mortality, especially in Child-Pugh class B patients, but the efficacy was not confirmed.Apparent effects were not found in improving HCC recurrence, total bilirubin, ALT, or AST.BCAA supplementation was relatively safe without serious adverse events.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Nutrition, the Second Affiliated Hospital of Chongqing Medical University, 74 Linjiang Road,Central District, Chongqing, 400010, PR China. chulingcclc@163.com.

ABSTRACT
Most hepatocellular carcinoma (HCC) patients have complications, including cirrhosis and malnutrition. The efficacy of dietary supplementation with oral branched-chain amino acids (BCAAs) in HCC patients undergoing interventions has not been confirmed. Relevant publications on the efficacy and safety of oral BCAA supplementation for HCC patients undergoing anti-HCC interventions through September, 2014 were searched for identification in the PubMed, Embase, Web of Science, and the Cochrane Library databases. The pooled risk ratio (RR) and standardized mean difference (SMD) were used to assess the supplementation effects. A total of 11 eligible studies (974 patients in total) were evaluated and included in our analysis. Oral BCAA supplementation helped to maintain liver reserve with higher serum albumin (SMD = 0.234, 95% CI: 0.033-0.435, P = 0.022), and lower rates of ascites (RR = 0.545, 95% CI: 0.316-0.938, P = 0.029) and edema (RR = 0.494, 95% CI: 0.257-0.952, P = 0.035) than in the control group. BCAA supplementation seemed to be effective in improving mortality, especially in Child-Pugh class B patients, but the efficacy was not confirmed. Apparent effects were not found in improving HCC recurrence, total bilirubin, ALT, or AST. BCAA supplementation was relatively safe without serious adverse events. BCAA supplementation may be clinically applied in improving liver functional reserve for HCC patients and further improving the quality of life.

No MeSH data available.


Related in: MedlinePlus