Quality of life indicators in hepatic encephalopathy following supplementation with branched chain amino acids and/or synbiotics: a post-hoc analysis

Varan Perananthan*, Edwin Shores, Avik Majundar, Simone I. Strasser, David G. Bowen, Geoffrey W. McCaughan, Ken Liu, Nicholas A. Shackel, Helen Vidot

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background and Aims
Individuals with hepatic encephalopathy (HE) report impaired quality of life. We aimed to identify changes in health-related quality of life (HRQOL) in patients with HE who were randomised to receive oral supplementation with branched chain amino acids (BCAA) and/or synbiotics.

Methods
Subjects with HE from a previously published study were randomised to receive placebo, BCAA, synbiotics or a combination of BCAA and synbiotics. A post-hoc analysis of responses to the Short Form-Liver Disease Quality of Life (SF-LDQOL) questionnaires completed by participants at baseline, 1 month and 2 months during this study was performed. Depression, Anxiety and Stress Scales (DASS-21) were also analysed.

Results
In all, 43 participants were included in the analysis. There was a self-reported improvement in the domain of concentration and memory in the BCAA group (P = 0.003) and combined BCAA group (BCAA + BCAA/synbiotics) (P = 0.038) at 2 months compared to baseline. Further analysis comparing combined BCAA groups to non-BCAA groups demonstrated that DASS-Anxiety improved following intervention (P = 0.023) and was inversely correlated with DASS-Anxiety (r = −0.579, P = 0.012). No significant changes were observed in other domains including symptoms of liver disease, effects of liver disease, health distress, sleep, loneliness, hopelessness, stigma of liver disease and sexual functioning.

Conclusion
Nutritional supplementation with BCAA (alone or with synbiotics) resulted in improvements in participants’ self-reported concentration and memory but not overall HRQOL. Concentration and memory scores were found to be inversely correlated with DASS-Anxiety scores in BCAA groups. A larger study with longer duration to investigate overall patient reported HRQOL is needed.
Original languageEnglish
Pages (from-to)50-57
Number of pages8
JournalGastroHep.com: an international journal of gastroenterology and hepatology
Volume3
Issue number1
Early online date22 Dec 2020
DOIs
Publication statusPublished - Jan 2021

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