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

Abstract

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.