Role of Branched Chain Amino Acids in Hepatic Encephalopathy

Abstract

Introduction: Hepatic encephalopathy (HE) or portosystemic encephalopathy is a state characterized by disordered central nervous system functions because of failure of liver to detoxify nitrogenous agents originating from gut because of dysfunction of hepatocytes and portosystemic shunting. Patients with HE often present alteration of mental status varying from minor psychological abnormalities to deep coma. Multiple studies conducted worldwide suggest that the branched-chain amino acids (BCAAs) leucine, isoleucine, and valine may be useful in improving survival and reducing morbidity in patients with HE. Objectives: To compare the efficacy of branched chain amino acids in reversal of hepatic encephalopathy in patients with cirrhosis of liver with placebo. Study Design: Randomized control trial Setting: Medical Unit V, DHQ Hospital  Faisalabad  Duration: Study was carried out over a period of 6 months from 1^st July 2016 to 30 December 2016 Results: A total of 60 patients (30 in each group) were enrolled, majority of the patients were between 41-50 years in both groups, 36.67% (n=11) in Study and 43.33% (n=13) control group, mean and standard deviation of age was calculated as 43.56+5.21 in study and 45.78+4.98 years in control group, 70% (n=21)patients were male in study group and 63.33% (n=19) in the control group, 30% (n=9)  patients in study group and 36.67% (n=11) in control group were females, comparison of efficacy of BCAAs in reversal of HE with placebo reveals 63.33% (n=19) patients in study group showed reversal of HE and 26.67% (n=8) patients in control group. Conclusion: The results of the study conclude that branched chain amino acids are significantly effective in reversal of hepatic encephalopathy when compared with placebo.