Randomized Pilot Study: Effects of an Exercise Programme and Leucine Supplementation in Patients with Cirrhosis

• Published in: Digestive diseases and sciences Vol. 59; no. 8; pp. 1966 - 1975
• Main Authors: Román, Eva, Torrades, Mª Teresa, Nadal, Mª Josep, Cárdenas, Guillem, Nieto, Juan Camilo, Vidal, Sílvia, Bascuñana, Helena, Juárez, Cándido, Guarner, Carlos, Córdoba, Juan, Soriano, Germán
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.08.2014; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Amino acids; Analysis; Biochemistry; Body Composition; Care and treatment; Complications and side effects; Dietary Supplements; Exercise; Exercise Test; Exercise Therapy; Exercise Tolerance; Female; Gastroenterology; Hepatology; Humans; Leucine - therapeutic use; Liver; Liver cirrhosis; Liver Cirrhosis - drug therapy; Liver Cirrhosis - therapy; Male; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Middle Aged; Oncology; Original Article; Pilot Projects; Prospective Studies; Quality of Life; Transplant Surgery; Effort tolerance; Cirrhosis; Branched-chain amino acids; Muscle mass
• ISSN: 0163-2116; 1573-2568; 1573-2568
• DOI: 10.1007/s10620-014-3086-6

Background Physical exercise could improve functional limitations, muscle mass, and health-related quality of life (HRQoL) in patients with cirrhosis. Aim The purpose of this study was to evaluate the efficacy and safety of an exercise programme and leucine supplementation to increase exercise capacity, muscle mass, and HRQoL in patients with cirrhosis. Patients and Methods Seventeen outpatients with cirrhosis were randomized to an exercise group ( n  = 8) or a control group ( n  = 9) in a pilot study. The programme of moderate exercise was performed for 12 weeks under supervision of a physiotherapist. All patients received oral leucine (10 g/day) during the study. At baseline and at the end of the study, we determined exercise capacity (6-min walk and 2-min step tests), anthropometric measurements, and HRQoL by Short Form-36 (SF-36) questionnaire. We also analyzed safety regarding complications of cirrhosis, liver and renal function, inflammatory response and oxidative stress. Results In the exercise group, exercise capacity improved, as shown by the increase in the 6-min walk test from 365 (160–420) to 445 m (250–500) ( p  = 0.01), and in the 2-min step test ( p  = 0.02). Lower thigh circumference also increased, from 41 (34–53) to 46 cm (36–56) ( p  = 0.02), and the domains of SF-36 general health ( p  = 0.03), vitality ( p  = 0.01) and social function ( p  = 0.04) improved significantly. In the control group, no statistically significant changes were observed in any of the parameters. We did not observe complications of cirrhosis in either group during the study. Conclusions A programme of moderate physical exercise together with leucine supplements in patients with cirrhosis is safe and improves exercise capacity, leg muscle mass and HRQoL.