Comparison of the Effects of Hepatic-Aid and a Casein Modular Diet on Enceph-alopathy, Plasma Amino Acids, and Nitrogen Balance in Cirrhotic Patients

Publisher Website
Google Scholar
Abstract
Hepatic-Aid is purported to ameliorate encephalopathy and promote positive N balance in protein-intolerant, cirrhotic patients by correcting their imbalanced amino acid profile. Hepatic-Aid was evaluated by comparing a 50 g casein diet with an identical diet with 20 g casein/30 g Hepatic-Aid per day in a cross-over study. Four patients with biopsy-proven stable cirrhosis, encephalopathy and undernutrition were studied. Each study period included 3 days of equilibrium and 8 days of metabolic balance, with the following measured at baseline and on balance days 5 and 8: routine biochemistry, fasting ammonia, psychometric tests, EEG and plasma amino acid profiles. There was no significant change in clinical status, routine biochemistry, fasting ammonia, psychometrics or EEG between the 2 study periods. Mean (.+-. SD) N balance on the casein diet at 1.5 .+-. 1.5 g/day was not significantly different from that on the Hepatic-Aid diet at 1.5 .+-. 1.2 g/day. Plasma amino acid profiles showed a significant fall (P < 0.05) in fasting and intraprandial tyrosine (Tyr) and phenylalanine (Phe) on Hepatic-Aid, but only intraprandial leucine (Leu), isoleucine (Ile) and valine (Val) were significantly increased (P < 0.05) on Hepatic-Aid. The ratio Leu + Ile + Val to Tyr + Phe was significantly increased (P < 0.05) on Hepatic-Aid. Hepatic-Aid, as given in this study, maintains N balance similar to casein, alters the amino acid profile towards normal, but does not ameliorate encephalopathy.