Open AccessGlycine increases fat‐free mass in malnourished haemodialysis patients: a randomized double‐blind crossover trial
Author(s) -
Genton Laurence,
Teta Daniel,
Pruijm Menno,
Stoermann Catherine,
Marangon Nicola,
Mareschal Julie,
Bassi Isabelle,
WurznerGhajarzadeh Arelene,
Lazarevic Vladimir,
Cynober Luc,
Cani Patrice D.,
Herrmann François R.,
Schrenzel Jacques
Publication year - 2021
Publication title -
journal of cachexia, sarcopenia and muscle
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.803
H-Index - 66
eISSN - 2190-6009
pISSN - 2190-5991
DOI - 10.1002/jcsm.12780
Subject(s) - bioelectrical impedance analysis , crossover study , lean body mass , body mass index , medicine , wasting , randomized controlled trial , endocrinology , cachexia , body weight , placebo , alternative medicine , pathology , cancer
Background Protein energy wasting is associated with negative outcome in patients under chronic haemodialysis (HD). Branched‐chain amino acids (BCAAs) may increase the muscle mass. This post hoc analysis of a controlled double‐blind randomized crossover study assessed the impact of BCAAs on nutritional status, physical function, and quality of life. Methods We included 36 chronic HD patient features of protein energy wasting as plasma albumin <38 g/L, and dietary intakes <30 kcal/kg/day and <1 g protein/kg/day. Patients received either oral BCAA (2 × 7 g/day) or glycine (2 × 7 g/day) for 4 months (Period 1), followed by a washout period of 1 month, and then received the opposite supplement (Period 2). The outcomes were lean body mass measured by dual‐energy X‐ray absorptiometry, fat‐free mass index measured by bioelectrical impedance, resting energy expenditure, dietary intake and appetite rating, physical activity and function, quality of life, and blood parameters. Analyses were performed by multiple mixed linear regressions including type of supplementation, months, period, sex, and age as fixed effects and subjects as random intercepts. Results Twenty‐seven patients (61.2 ± 13.7 years, 41% women) were compliant to the supplementations (consumption >80% of packs) and completed the study. BCAA did not affect lean body mass index and body weight, but significantly decreased fat‐free mass index, as compared with glycine (coeff −0.27, 95% confidence interval −0.43 to −0.10, P = 0.002, respectively). BCAA and glycine intake had no effect on the other clinical parameters, blood chemistry tests, or plasma amino acids. Conclusions Branched‐chain amino acid did not improve lean body mass as compared with glycine. Unexpectedly, glycine improved fat‐free mass index in HD patients, as compared with BCAA. Whether long‐term supplementation with glycine improves the clinical outcome remains to be demonstrated.