Hepatic amino acid metabolism during hyperinsulinemia and hyperaminoacidemia in conscious rabbit during late pregnancy

Associations between sarcopenia and circulating branched-chain amino acids: a cross-sectional study over 100,000 participants

BACKGROUND

Emerging evidence suggests that alterations in BCAA metabolism may contribute to the pathogenesis of sarcopenia. However, the relationship between branched-chain amino acids (BCAAs) and sarcopenia is incompletely understood, and existing literature presents conflicting results. In this study, we conducted a community-based study involving > 100,000 United Kingdom adults to comprehensively explore the association between BCAAs and sarcopenia, and assess the potential role of muscle mass in mediating the relationship between BCAAs and muscle strength.

METHODS

Multivariable linear regression analysis examined the relationship between circulating BCAAs and muscle mass/strength. Logistic regression analysis assessed the impact of circulating BCAAs and quartiles of BCAAs on sarcopenia risk. Subgroup analyses explored the variations in associations across age, and gender. Mediation analysis investigated the potential mediating effect of muscle mass on the BCAA-muscle strength relationship.

RESULTS

Among 108,017 participants (mean age: 56.40 ± 8.09 years; 46.23% men), positive associations were observed between total BCAA, isoleucine, leucine, valine, and muscle mass (beta, 0.56-2.53; p < 0.05) and between total BCAA, leucine, valine, and muscle strength (beta, 0.91-3.44; p < 0.05). Logistic regression analysis revealed that increased circulating valine was associated with a 47% reduced sarcopenia risk (odds ratio = 0.53; 95% confidence interval = 0.3-0.94; p = 0.029). Subgroup analyses demonstrated strong associations between circulating BCAAs and muscle mass/strength in men and individuals aged ≥ 60 years. Mediation analysis suggested that muscle mass completely mediated the relationship between total BCAA, and valine levels and muscle strength, partially mediated the relationship between leucine levels and muscle strength, obscuring the true effect of isoleucine on muscle strength.

CONCLUSION

This study suggested the potential benefits of BCAAs in preserving muscle mass/strength and highlighted muscle mass might be mediator of BCAA-muscle strength association. Our findings contribute new evidence for the clinical prevention and treatment of sarcopenia and related conditions involving muscle mass/strength loss.

Randomised clinical trial: effect of adding branched chain amino acids to exercise and standard-of-care on muscle mass in cirrhotic patients with sarcopenia

BACKGROUND

The role of branched-chain amino acids (BCAA) in improving muscle mass in cirrhosis is presently debatable.

AIMS

To evaluate the role of BCAA in improving muscle mass in a double-blind randomized placebo-controlled trial in patients with cirrhosis having sarcopenia.

METHODS

Consecutive patients with cirrhosis with Child-Pugh score < 10 and sarcopenia were randomized to receive either 12 g/day of BCAA orally or a placebo (1:1) for 6 months in addition to a home-based exercise program (30 min/day), dietary counselling and standard medical therapy. Sarcopenia was defined according to gender-specific axial skeletal muscle index (SMI) cut-offs. The primary endpoint was a change in muscle mass based on CT scan (SMI) after 6 months of supplementation.

RESULTS

Sixty patients [mean age 41.6 ± 9.9 years; males (66.6%) of predominantly viral (40%) and alcohol-related (31.7%) cirrhosis] were randomized. Baseline clinical and demographic characters were similar except MELD score (10.2 ± 2.8 vs. 12.2 ± 3.5, p = 0.02) and calorie intake (1838.1 kcal ± 631.5 vs. 2217.5 kcal ± 707.3, p = 0.03), both being higher in the placebo arm. After adjusting for both baseline confounders, baseline SMI and protein intake, the change in SMI at 6 months was similar in both groups [mean adjusted difference (MAD) + 0.84, CI - 2.9; + 1.2, p = 0.42] by intention-to-treat analysis. The secondary outcomes including change in handgrip strength (p = 0.65), 6-m gait speed (p = 0.20), 6-min walk distance (p = 0.39) were similar in both arms. Four patients had minor adverse events in each arm.

CONCLUSION

Addition of BCAA to exercise, dietary counselling and standard medical therapy did not improve muscle mass in patients with cirrhosis having sarcopenia. (CTRI/2019/05/019269).

TRIAL REGISTRATION NUMBER

CTRI/2019/05/019269 (Clinical Trials Registry of India).

Study of the energy and protein balance of pregnant rabbit does using two comparative methods

The total body composition of 4 x 10 female, 5-month-old New Zealand White rabbits was determined, using direct chemical analysis and computerised tomography (CT). Ten non-pregnant rabbits (control) and 3 x 10 pregnant rabbits at days 14, 21 and 28 of gestation, respectively, were included in the study. With the advancement of pregnancy, the body weight (BW) of does significantly (P < 0.05) increased (control: 3255 g, day 28: 3938 g), while the dry matter, DM (control: 43.02%, day 28: 40.94%), ether extract, EE (control: 20.15%, day 28: 18.13%), crude protein, CP (control: 20.15%, day 28: 18.13%), and energy concentration decreased (control: 12.41 MJ/kg BW, day 28: 11.81 MJ/kg BW). During pregnancy the protein content of uteri (control: 12.24%, day 28: 49.45% of DM) and the retained energy in the form of uterus with fetuses (day 14: 0.824 MJ, day 28: 2.189 MJ) increased, while the dry matter (control: 82.39%, day 28: 28.96%) and ether extract content (control: 86.05%, day 28: 45.92% of DM) of uteri decreased. With the advancement of pregnancy the dry matter (day 14: 39.70%, day 28: 18.65%) and crude protein (day 14: 75.74%; day 28: 63.63% of DM) content and the number of fetuses (day 14: 8.8; day 28: 6.4) decreased, while their fat concentration (day 14: 10.13%, day 28: 24.34% of DM) increased. According to the equations created from the CT pictures, body fat (R2 = 0.871) and energy (R2 = 0.926) content can be predicted with high accuracy. The accuracy of predicting body protein content is much lower (R2 = 0.356), which can be improved by introducing the body weight as a new dependent variable (R2 = 0.797). It can also be concluded that, in contrast to other animal species, rabbit fetuses show considerable development not only in the last trimester of gestation but already from the second half of pregnancy.

The role of insulin in the regulation of milk protein synthesis in dairy cows

We examined the role of insulin in milk protein synthesis using the hyperinsulinemic-euglycemic clamp approach in combination with abomasal infusion of casein. The two experimental periods consisted of abomasal infusion of water or 0.5 kg/d of casein. An insulin clamp was conducted over the last 4 d of each period. During the insulin clamp, circulating insulin was elevated fourfold, and euglycemia was maintained by the infusion of exogenous glucose. Casein infusion increased milk yield so that milk protein yield was 10% greater than baseline values. Use of the insulin clamp combined with casein infusion increased milk protein yield by 230 g/d (28% greater than baseline values). Milk protein composition was not altered, but content was increased from 3.13% during the baseline period to 3.44% by d 4 of the clamp; calcium concentration in milk increased about 10% to 1.2 g/kg. During the clamp, circulating concentrations of essential amino acids were dramatically reduced. The most pronounced effects were noted for branched-chain amino acids (64% reduction from baseline values). The insulin clamp resulted in alterations in circulating insulin-like growth factor (IGF)-I concentrations (increase) as well as IGF-II and IGF-binding protein-2 concentrations (decreases). Overall, results indicated that the ability of the mammary gland to synthesize milk protein does not function at maximum capacity, and there is a previously unrecognized potential to enhance milk protein percentage and yield.