Effects of home‐based exercise and branched‐chain amino acid supplementation on aerobic capacity and glycemic control in patients with cirrhosis

Aim The aim of the current study is to examine whether home‐based step exercise at anaerobic threshold (AT) and branched‐chain amino acid (BCAA) supplementation improve aerobic capacity, ectopic fat in liver and muscle, and glycemic control in patients with liver cirrhosis. Methods Six female patients with compensated liver cirrhosis received oral BCAA and were instructed to undertake bench step exercises at an intensity that corresponded to AT, with a goal of performing 140 min of exercise per week at home for 12 months. Fat deposition in liver (liver to spleen ratio) and intramuscular adipose tissue content were assessed at baseline and after 6 and 12 months by computed tomography. Glycemic control indices (homeostasis model assessment of insulin resistance, hemoglobin A1c [HbA1c], glycated albumin [GA] and chronic liver disease [CLD]‐HbA1c [average of HbA1c and GA/3]) were also measured. Results Twelve months of moderate training significantly increased AT, which is an index of aerobic capacity, but no changes were observed in body weight, liver to spleen ratio, or intramuscular adipose tissue content. Glycated albumin significantly decreased (P