Effects of branched-chain-enriched amino acid solution on insulin and glucagon secretion and blood glucose level in liver cirrhosis

Scand J Gastroenterol. 1998 Aug;33(8):853-9. doi: 10.1080/00365529850171521.


Background: The aim of this study was to determine whether therapeutically used branched-chain amino acids (BCAAs) solution influences glucose metabolism in liver cirrhosis (LC).

Methods: BCAAs solution (200 ml) was infused in LC patients at different stages, and plasma concentrations of glucose and pancreatic hormones were determined.

Results: In patients with mild LC, BCAAs caused a significant increase in glucose level (maximal increment, 12.5+/-2.5 mg/dl) with a great increase in insulin (maximal increment, 39.5+/-8.3 microU/ml) and a small increase in glucagon secretion (maximal increment, 101.0+/-16.0 pg/ml). In patients with advanced LC, BCAAs caused a great increase in glucagon secretion (220.5+/-19.4 pg/ml) with only a slight increase in glucose levels (5.8+/-2.2 mg/dl).

Conclusion: BCAAs solution causes hyperglycemia in mild LC due to insulin resistance, whereas it causes only a slight increase in severe LC due to hepatic glucagon resistance. Thus, there is a possibility that BCAAs solution may lead to hypoglycemia in advanced LC with hepatic glycogen depletion.

MeSH terms

  • Adult
  • Aged
  • Amino Acids, Branched-Chain / administration & dosage
  • Amino Acids, Branched-Chain / pharmacology*
  • Blood Glucose / metabolism*
  • Case-Control Studies
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / complications
  • Dose-Response Relationship, Drug
  • Female
  • Glucagon / metabolism*
  • Humans
  • Infusions, Intravenous
  • Insulin / metabolism*
  • Insulin Secretion
  • Liver Cirrhosis / blood*
  • Liver Cirrhosis / complications
  • Male
  • Middle Aged
  • Treatment Outcome


  • Amino Acids, Branched-Chain
  • Blood Glucose
  • Insulin
  • Glucagon