Supplementation with branched-chain amino acids ameliorates hypoalbuminemia, prevents sarcopenia, and reduces fat accumulation in the skeletal muscles of patients with liver cirrhosis.

BACKGROUND: Liver cirrhosis induces marked metabolic disorders, protein-energy malnutrition, and sarcopenia. The objective of the study reported here was to investigate the effects of dietary branched-chain amino acids (BCAAs) on systemic glucose metabolism, skeletal muscle, and prognosis of patients with liver cirrhosis. METHODS: Japanese patients with liver cirrhosis (n = 21) were enrolled into a longitudinal study in which their diets were supplemented with BCAAs. We evaluated glucose metabolism and analyzed the skeletal muscle area index (SAI) and intramuscular adipose tissue content (IMAC) using computed tomography. RESULTS: After 48 weeks of supplementation with BCAAs, there were no changes in glucose metabolism and skeletal muscle findings. In patients with ameliorated hypoalbuminemia, IMAC was significantly decreased and SAI was preserved concomitant with decreasing 90- and 120-min post-challenge plasma glucose levels (P < 0.01 each). In patients without increased albumin levels, IMAC was significantly increased and the SAI was significantly decreased (P < 0.01 each). Liver-related event-free survival rates for 72 months were 63.6% in patients with decreased IMAC and 20.0% in patients with increased IMAC. CONCLUSIONS: Amelioration of hypoalbuminemia associated with BCAA supplementation correlated with decreased fat accumulation in skeletal muscle, maintenance of skeletal muscle mass, and improved glucose sensitivity, all factors which may contribute to improving the survival of patients with liver cirrhosis.

[Examination of original plant of mulberry bark extract, a natural food additive, based on composition of the constituents].

Mulberry bark extract, a natural food additive, is described as a "root bark extract from Morus bombycis" (Japanese name: Yamaguwa) in the Notice (1996) relating to existing food additives used in Japan. The results of analyses by LC/UV and LC/MS suggested that the Mulberry bark extract products that were tested were actually made from the root bark of Morus alba (Japanese name: Maguwa) or its hybrid species, because the compositions of the constituents in the products are more similar to those in the extracts of the dried root bark of M. alba and hybrid species that are cultivated in Japan than to those of M. bombycis. In addition, the constituents of the food additive products were different from those of the natural medicine Mori Cortex products ('Souhakuhi' in Japanese) made from the root bark of mulberry grown in China, and which is described as being derived from M. alba in the Japanese pharmacopoeia. These results were also corroborated by Principal Component Analysis using the peak areas of LC/MS analysis as explanatory variables. After this study, it was decided that Mulberry bark extract is one of the existing food additives that should be excluded from the list this year in Japan.

[Examination of original plant of Jamaica quassia extract, a natural bittering agent, based on composition of the constituents].

Jamaica quassia extract is a natural bittering agent used as a food additive in Japan. The main constituents of the extract have already been reported to be quassin and neoquassin. In this study, the differences in composition of the constituents among four Jamaican quassia extract products were analyzed by LC/MS. The results showed that the four products have similar compositions of their minor constituents, as well as their main constituents. We isolated four of the minor constituents that were commonly included in the four products, and identified them as 11-dihydro-12-norneoquassin, canthin-6-one, 4-methoxy-1-vinyl-beta-carboline and 4,9-dimethoxy-1-vinyl-beta-carboline. The List of Existing Food Additives in Japan mentions that Jamaica quassia (Picrasma excelsa) is the original plant from which Jamaica quassia extract is produced. However, we presume that Jamaica quassia extract may actually be made from appropriate plants other than Picrasma excelsa, since P. excelsa is listed as an endangered species by the International Union for Conservation of Nature and Natural Resources. We prepared hot water extracts from two other species of plants, Quassia amara (American quassia, Surinam quassia) and P. quassioides ('Nigaki' in Japanese), and investigated their constituents by LC/MS. The results showed that the compositions of the constituents in the Jamaica quassia extract products resembled those in the extract derived from Q. amara. These findings suggest that Jamaica quassia extract products are probably made from Q. amara.