The impact of branched‐chain amino acid supplementation on measures of glucose homeostasis in individuals with hepatic disorders: A systematic review of clinical studies

Background Branched chain amino acid (BCAA) supplementation may influence glucose metabolism in individuals with an impaired glyceamic profile. This systematic review investigated the effects of isolated BCAA supplementation on measures of glucose homeostasis in individuals with hepatic disorders. Methods We searched PubMed, Web of Science, Cochrane Library and Scopus for published clinical trials that investigated the effects of isolated BCAA supplementation on measures of glucose homeostasis, including serum glucose and insulin, glycated haemoglobin (HbA1c) levels and homeostatic model assessment for insulin resistance (HOMA‐IR) scores. Results Eleven trials met the inclusion criteria. Only one study revealed a decrease in serum glucose from BCAA supplementation compared to three studies that showed increases. Five studies demonstrated no significant changes in serum glucose, and two studies displayed no changes in HbA1c following BCAA supplementation. Serum levels of insulin were decreased in three studies, remained unchanged in one, and increased in the remaining three studies. BCAA supplementation reduced HOMA‐IR scores in two studies, increased HOMA‐IR scores in another two, or resulted in no changes in two other studies. Conclusions BCAA supplementation in isolation had no effect on overall glucose homeostasis in individuals with hepatic disorders, although some improvements on serum insulin levels and HOMA‐IR scores were observed. Overall, there is little evidence to support the utilisation of BCAA supplementation as a potential nutritional strategy for improving measures of glucose homeostasis in individuals with hepatic disorders. Key points Hepatic disorders such as liver cirrhosis, hepatic encephalopathy and hepatocellular carcinoma are characterised by an impaired circulating branched‐chain amino acid (BCAA) profile. Τhe aim of this systematic review was to explore the effects of isolated BCAA supplementation on markers of glucose metabolism in adults with hepatic disorders. Qualitative analysis revealed limited benefits of isolated BCAA supplementation on overall glucose homeostasis among individuals with hepatic disorders. BCAA supplementation as an independent strategy is not an effective tool in improving glucose homeostasis in this population group.