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Background <p>Leucine, a branched-chain amino acid (BCAA), is an effective nutritional strategy to enhance skeletal muscle mass in aging populations. This study aimed to evaluate the effects of oral leucine-enriched BCAA supplementation on muscle mass, muscle synthesis biomarkers, and physical performance in elderly patients with chronic kidney disease (CKD).</p> Methods <p>A randomized controlled trial was conducted among CKD patients aged over 65&#xa0;years. The participants were randomly assigned to receive either oral mixed BCAA supplementation (60% leucine, 4.5&#xa0;g/day; 20% valine, 1.5&#xa0;g/day; 20% isoleucine, 1.5&#xa0;g/day) (<i>N</i> = 29) or a placebo (<i>N</i> = 26) for 12&#xa0;weeks. Muscle mass, serum insulin-like growth factor 1 (IGF-1), and myostatin levels were measured at baseline and after 12&#xa0;weeks. A 3-day food record was reviewed by a dietitian, and functional capacity was assessed using handgrip and 6-min walk tests.</p> Results <p>Fifty-five patients (mean age 75.4 ± 5.2&#xa0;years) were enrolled. Daily protein and calorie intake were comparable between groups. At study conclusion, lean muscle mass significantly increased in the leucine group compared to placebo (0.4&#xa0;kg [95% CI 0.1–0.7] vs. − 0.2&#xa0;kg [95% CI − 0.6–0.2], <i>P</i> = 0.010). A significant difference in the percentage change in muscle mass was also observed (1.0 ± 1.8% vs. − 0.5 ± 2.6%, <i>P</i> = 0.014). No significant differences were found in muscle strength, serum myostatin, IGF-1, or adverse events.</p> Conclusions <p>Leucine-enriched BCAA supplementation for 12&#xa0;weeks significantly increased muscle mass but did not impact biomarkers of muscle activity or functional capacity in elderly CKD patients.</p> Clinical trial registration <p>TCTR20200314003</p>

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Anti-sarcopenic effect of leucine-enriched branched-chain amino acid supplementation among elderly chronic kidney disease patients: a double-blinded randomized controlled trial

  • 期刊论文

  • 发表日期：

    2025年5月17日

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  • Neti Sunsandee,
  • Paramat Thimachai,
  • Bancha Satirapoj,
  • Ouppatham Supasyndh

摘要

Background

Leucine, a branched-chain amino acid (BCAA), is an effective nutritional strategy to enhance skeletal muscle mass in aging populations. This study aimed to evaluate the effects of oral leucine-enriched BCAA supplementation on muscle mass, muscle synthesis biomarkers, and physical performance in elderly patients with chronic kidney disease (CKD).

Methods

A randomized controlled trial was conducted among CKD patients aged over 65 years. The participants were randomly assigned to receive either oral mixed BCAA supplementation (60% leucine, 4.5 g/day; 20% valine, 1.5 g/day; 20% isoleucine, 1.5 g/day) (N = 29) or a placebo (N = 26) for 12 weeks. Muscle mass, serum insulin-like growth factor 1 (IGF-1), and myostatin levels were measured at baseline and after 12 weeks. A 3-day food record was reviewed by a dietitian, and functional capacity was assessed using handgrip and 6-min walk tests.

Results

Fifty-five patients (mean age 75.4 ± 5.2 years) were enrolled. Daily protein and calorie intake were comparable between groups. At study conclusion, lean muscle mass significantly increased in the leucine group compared to placebo (0.4 kg [95% CI 0.1–0.7] vs. − 0.2 kg [95% CI − 0.6–0.2], P = 0.010). A significant difference in the percentage change in muscle mass was also observed (1.0 ± 1.8% vs. − 0.5 ± 2.6%, P = 0.014). No significant differences were found in muscle strength, serum myostatin, IGF-1, or adverse events.

Conclusions

Leucine-enriched BCAA supplementation for 12 weeks significantly increased muscle mass but did not impact biomarkers of muscle activity or functional capacity in elderly CKD patients.

Clinical trial registration

TCTR20200314003