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TOPLINE:

Short-term supplementation with a selective essential amino acid (EAA) formulation may reduce liver fat and aspartate aminotransferase (AST) and plasma triglyceride concentrations in adolescent girls with polycystic ovary syndrome (PCOS) and obesity.

METHODOLOGY:

• Women with PCOS are at an increased risk for insulin resistance, nonalcoholic fatty liver disease, and dyslipidemia; earlier research showed EAA supplementation reduces lipid fat and circulating triglycerides in the elderly and those with alcohol use disorder.
• To evaluate the effect of EAA on hepatic steatosis (HS) in adolescents with PCOS, researchers conducted a crossover randomized controlled trial that included 21 girls with PCOS, obesity, HS, and a sedentary lifestyle (age, 12-21 years; mean body mass index, 37.3).
• The participants were randomly allocated to receive daily supplementation with 15 g of either selective EAA or placebo (isocaloric maltodextrin) over two phases, with each lasting for 4 weeks.
• The proprietary selective EAA formulation contained 10% histidine, 11% isoleucine, 32% leucine, 16% lysine, 10% phenylalanine, 10% threonine, and 11% valine.
• Parameters such as liver fat, very low-density lipoprotein (VLDL) lipogenesis, and triacylglycerol metabolism were evaluated on the past 2 days of each intervention phase.

TAKEAWAY:

• Liver fat was lower following EAA supplementation compared with placebo (7.3% vs 8%; P = .020).
• EAA supplementation was well tolerated and reduced the concentration of fasting plasma triglycerides by 13 mg/dL (P = .015), VLDL-triacylglycerol by 21% (P = .031), and serum AST, a liver inflammatory marker by 8% (P = .004).
• The peak absolute quantity of VLDL-triacylglycerol obtained after the oral sugar tolerance test stimulus was reduced by 21% with EAA supplementation (P = .005).
• The concentration of gamma ATP, a common hepatic outcome measure, increased after EAA supplementation compared with placebo, representing a greater hepatic energy metabolism (P = .044).

IN PRACTICE:

"This supplement may be an option to ameliorate and prevent worsening of fatty liver and hypertriglyceridemia in women with high susceptibility due to polycystic ovary syndrome," wrote the authors, who also noted that EAA supplements are low-risk and relatively affordable.

SOURCE:

This study, led by Talyia M. Fordham, Department of Nutrition and Exercise Physiology, University of Missouri School of Medicine, Columbia, Missouri, was published online in Obesity.

LIMITATIONS:

The overnight protocol used for heavy water labeling may have underestimated lipogenesis levels, as the labeling period was relatively short. Participant compliance was measured by the return of EAA/placebo packaging, which may not accurately reflect actual supplement intake.

DISCLOSURE:

This study was supported by the Children's Hospital of Colorado, Boettcher Webb-Waring Foundation, Doris Duke Charitable Foundation, and the National Institutes of Health. Several other authors declared consulting and financial relationships with Pollie Incorporated, Zydus Incorporated, and Amino Corporation. The other authors declared no conflicts of interest.