Published online May 21, 2023. doi: 10.3748/wjg.v29.i19.2905
Peer-review started: December 28, 2022
First decision: January 10, 2023
Revised: January 24, 2023
Accepted: April 20, 2023
Article in press: April 20, 2023
Published online: May 21, 2023
Processing time: 138 Days and 10 Hours
Liver cirrhosis is commonly associated with nutritional alterations, reported in 20% of patients with compensated disease and over 60% of patients with decompensated cirrhosis. Nutritional disturbances are associated with a worse prognosis and increased risk of complication. Serum levels of branched-chain amino acids (BCAAs) are decreased in patients with liver cirrhosis. The imbalance of amino acids levels has been suggested to be associated with the development of complications, such as hepatic encephalopathy and sarcopenia, and to affect the clinical presentation and prognosis of these patients. Several studies investigated the efficacy of BCAAs supplementation as a therapeutic option in liver cirrhosis, but uncertainties remain about the real efficacy, the best route of administration, and dosage.
Core Tip: Nutritional perturbance is frequent in liver cirrhosis and has been correlated with the development of complications such as hepatic encephalopathy and sarcopenia. Branched-chain amino acids (BCAAs) have been implicated in the pathophysiology of these two complications and supplementation has been proposed as a therapeutic measure. In this review, we will examine the scientific evidence supporting the clinical use of BCAAs in cirrhotic subjects.