This study, published in the journal Obesity, investigated the potential benefits of essential amino acid (EAA) supplementation in adolescents with polycystic ovary syndrome (PCOS) and obesity. Adolescents with PCOS and obesity often have fatty liver disease. This study tested if taking a daily essential amino acid (EAA) supplement could help. The study found that EAA reduced liver fat content by 7.5% compared to a placebo. Additionally, markers of liver health and blood fat levels improved with EAA. This suggests that EAA supplements might be a safe and affordable approach to managing fatty liver disease in teenagers with PCOS. However, more research is needed to understand how EAA works and if the benefits last over time.

Key Findings

Background:

• PCOS is a hormonal disorder affecting women, characterized by hyperandrogenism (excess male hormones), insulin resistance, and fatty liver disease (hepatic steatosis).

• Prior research suggested that EAA supplements might reduce liver fat in various populations.

Objective:

• To determine if EAA supplementation can decrease liver fat in adolescents with PCOS.

Methods:

• A randomized, double-blind, placebo-controlled trial was conducted.

• Participants: 21 adolescents with PCOS (average age 15.6 years, BMI 37.3).

• Intervention: Participants received either a placebo or a daily dose of a 15-gram EAA supplement for 28 days, followed by a switch to the other option in a crossover design.

• Measurements: Liver fat content, markers of liver health (AST), blood triglycerides and fat components (VLDL-TG), and insulin sensitivity were assessed before and after each phase.

Results:

• Liver fat: EAA supplementation led to a significant decrease in liver fat content compared to placebo (7.5% relative reduction).

• Liver health: Aspartate aminotransferase (AST), an indicator of liver damage, also improved with EAA.

• Blood lipids: EAA decreased both total triglycerides and triglycerides specifically associated with very low-density lipoprotein (VLDL).

• Other observations:

  • Body weight remained unchanged.

  • Surprisingly, participants consumed fewer carbohydrates and total sugars during the EAA phase.

  • Insulin sensitivity was not significantly affected by the supplement.

Conclusions:

• Similar to findings in adults, short-term EAA supplementation in adolescents with PCOS effectively reduced liver fat, improved liver health markers, and lowered blood fat levels.

Significance:

• Confirms previous findings: This study supports the potential of EAA supplements in reducing liver fat.

• New insights in a younger population: This is the first study to demonstrate these benefits in adolescents with PCOS.

• Potential treatment option: EAA supplementation appears to be a safe and affordable approach for managing fatty liver disease in adolescents with PCOS.

Future implications:

• Mechanism of action: Further research is needed to understand how EAA supplementation exerts these positive effects.

• Long-term effects: Longitudinal studies are crucial to investigating the sustained benefits of EAA over time.

• Clinical application: These findings suggest EAA supplementation as a potential therapeutic strategy for improving liver health and blood lipid profiles in women with PCOS, especially those at high risk of fatty liver disease.

Polycystic ovary syndrome (PCOS) stands out as the most prevalent reproductive endocrine disorder, impacting a substantial percentage of women worldwide. Particularly in adolescent populations, PCOS manifests with irregular menstrual cycles and heightened levels of androgens, often presenting as hirsutism and acne. Studies have linked PCOS to increased peripheral insulin resistance (IR), a condition not solely attributed to adiposity.

The Link Between PCOS, Obesity, and Metabolic Disorders

Research indicates a significant association between elevated testosterone concentrations, adipose, and hepatic insulin resistance in adolescents with PCOS. The risk further extends to the development of metabolic disorders such as cardiovascular diseases, type 2 diabetes, and metabolic dysfunction steatotic liver disease (MASLD). MASLD, comprising hepatic steatosis (HS) progressing to nonalcoholic steatohepatitis and potentially cirrhosis, poses a substantial health burden. It's noteworthy that women with PCOS and obesity exhibit higher rates of HS compared to similarly obese counterparts without PCOS.

Investigating Treatment Options: EAA Supplementation

Exploring potential interventions for MASLD, recent studies have examined the efficacy of essential amino acid (EAA) supplementation. EAA, comprising histidine, isoleucine, leucine, lysine, phenylalanine, threonine, and valine, has shown promise in reducing liver fat and improving metabolic parameters.

Study Design and Findings

A double-blind, crossover, placebo-controlled study investigated the effects of EAA supplementation on adolescents with PCOS, obesity, and HS. Significant reductions in plasma triglycerides (TG), very low-density lipoprotein (VLDL-TG), and aspartate aminotransferase (AST), a marker of liver inflammation, were observed following EAA supplementation compared to placebo. Notably, liver fat content significantly decreased with EAA supplementation.

Mechanisms of Action

EAA supplementation impacts various mechanisms associated with HS reduction, including:

• Regulation of hepatic fatty acid synthesis and VLDL secretion

• Enhanced plasma TG clearance

• Stimulation of liver protein synthesis and fatty acid oxidation

• Inhibition of proinflammatory cytokines

Implications and Future Directions

These findings underscore the potential of EAA supplementation as a therapeutic strategy for mitigating MASLD in adolescents with PCOS and obesity. Further research is warranted to elucidate the precise mechanisms and optimize treatment protocols.

To Summarize

Key Findings:

• Liver Fat Reduction: EAA supplementation significantly reduced liver fat content by 7.3% compared to placebo (measured by MRI). This indicates a potential therapeutic effect for fatty liver disease in this population.

• Improved Liver Health: Serum aspartate aminotransferase (AST), a liver function marker, showed an 8% decrease with EAA, suggesting improved liver health.

• Reduced Blood Lipids: EAA significantly lowered fasting plasma triglycerides (TG) by 13 mg/dL and VLDL-TG (a specific type of blood fat) by 21%. This suggests a positive impact on blood lipid profiles.

• Dietary Shift: Interestingly, participants consumed fewer carbohydrates and sugars during the EAA phase, potentially due to altered appetite regulation or metabolic changes induced by the supplement.

• No Change in Insulin Sensitivity: EAA supplementation did not significantly affect insulin sensitivity, as measured by various tests.

• Potential Mechanism: Reduced VLDL-TG production, a key factor in fat metabolism, might be partially responsible for the observed decrease in blood fat levels with EAA.

Additional Observations:

• Anthropometric measurements (height, weight, and BMI) and other fat distribution measures remained unchanged.

• Fasting and peak rates of de novo lipogenesis (DNL, the process of synthesizing new fat molecules) were not significantly affected by EAA.

• Total testosterone levels showed a downward trend with EAA, although not statistically significant.

Limitations:

• Relatively small sample size (21 participants).

• Short-term intervention (28 days per phase).

• Lack of investigation into the exact mechanisms by which EAA exerts its effects.

Strengths:

• Randomized, double-blind, placebo-controlled design.

• Comprehensive assessment of liver fat content, blood lipids, metabolic function, and dietary intake.

Overall Implications:

This study provides initial evidence that EAA supplementation might be a promising strategy for managing fatty liver disease and improving blood lipid profiles in adolescents with PCOS and obesity.

Future Directions:

• Larger, long-term studies are needed to confirm these findings and assess the sustained effects of EAA.

• Elucidating the mechanisms underlying the observed benefits is crucial for understanding the therapeutic potential of EAA.

• Investigating the impact of EAA on other PCOS-related symptoms, such as hyperandrogenism and menstrual irregularities, warrants further research.

Conclusion

PCOS, often accompanied by obesity, presents a significant risk factor for MASLD. EAA supplementation emerges as a promising therapeutic avenue for mitigating liver fat accumulation and improving metabolic health in affected adolescents. Further investigation into the precise mechanisms underlying these effects is warranted to optimize treatment strategies and enhance patient outcomes.

Journal Reference

Fordham, T. M., Morelli, N. S., Garcia-Reyes, Y., Ware, M. A., Rahat, H., Sundararajan, D., Fuller, K. N. Z., Severn, C., Pyle, L., Malloy, C. R., Jin, E. S., Parks, E. J., Wolfe, R. R., & Cree, M. G. (2024). Metabolic effects of an essential amino acid supplement in adolescents with PCOS and obesity. Obesity (Silver Spring, Md.), 10.1002/oby.23988. Advance online publication. https://doi.org/10.1002/oby.23988

Related

https://healthnewstrend.com/the-protective-power-of-physical-activity-lowering-cardiovascular-event-risks

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