Branched chain amino acid-to-tyrosine ratio: not only an indicator of the amino acid imbalance
Year: 2022
Type: article
Abstract: Chronic liver diseases induce various metabolic disorders. Amino acid imbalance is known to be associated with the symptoms of hepatic encephalopathy, especially in decompensated cirrhosis. The branched-chain amino acid (BCAA)-to-tyrosine ratio (BTR) was proposed as an easily measurable and inexpensive indicator of the amino acid imbalance. The BTR well correlates with Fischer’s ratio and is commonly used in Japan to assess the amino acid imbalance. However, the BTR also reflects various pathophysiological disorders of chronic liver diseases. The BTR decreases in line with the progression of liver fibrosis, and a low BTR is considered as a risk factor for the presence of sarcopenia (decreased skeletal muscle volume), high-risk varices, hypoalbuminemia, and insulin resistance in patients with chronic liver diseases. A low BTR was proposed as a possible predictive marker for undesired cirrhosis-related events and a poor prognosis. Furthermore, the BTR was suggested to be associated with the treatment efficacy and prognosis of patients with hepatocellular carcinoma. It is suggested that long-term BCAA administration can suppress the risk of all fatal events, such as the development of liver cancer, bleeding of esophagogastric varices, and progression of liver failure (encephalopathy, icterus and ascites). Patients with an amino acid imbalance and a decreased BTR are expected to effectively obtain clinical benefits from BCAA treatment, so the BTR may be useful for determining the indication of BCAA treatment.
Source: Digestive Medicine Research
DOI: 10.21037/dmr-22-29
Institution: Hyogo Medical University
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4293412928