{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T15:06:25Z","timestamp":1761663985327,"version":"build-2065373602"},"reference-count":24,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2019,9,7]],"date-time":"2019-09-07T00:00:00Z","timestamp":1567814400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Cirrhosis patients often have abnormal glucose metabolism. We investigated the effects of a late-evening snack (LES) with branched-chain amino acid-enriched nutrients (BCAA-EN) on glucose metabolism in cirrhosis patients. LES with BCAA-EN was administered for 1 week in 13 patients with cirrhosis and hypoalbuminemia. Blood glucose (BG) levels were measured every 15 min. The patients were divided into two groups based on BG levels: group 1 (G1, n = 11): nocturnal BG levels &lt;200 mg\/dL and group 2 (G2, n = 2): nocturnal BG levels \u2265200 mg\/dL. G1 had nocturnal BG levels &lt;200 mg\/dL, whereas G2 had nocturnal BG levels \u2265200 mg\/dL. The average BG levels did not significantly change after BCAA-EN administration in G1 (before 91.9 \u00b1 29.0 mg\/dL; after 89.0 \u00b1 24.3 mg\/dl). However, the average BG levels significantly increased after BCAA-EN administration in G2 (before 153.6 \u00b1 43.3 mg\/dL; after 200.9 \u00b1 59.7 mg\/dL) (p &lt; 0.01). The glycated albumin level (16.6 \u00b1 0.9% vs. 16.2 \u00b1 2.1%), fasting immunoreactive insulin (F-IRI) level (53.9 \u00b1 34.0 \u03bcU\/mL vs. 16.5 \u00b1 11.0 \u03bcU\/mL), and homeostasis model assessment of insulin resistance (HOMA-IR) score (17.85 \u00b1 10.58 vs. 4.02 \u00b1 2.59) were significantly higher in G2 than in G1 (p &lt; 0.05, p &lt; 0.05, and p &lt; 0.01, respectively). The quantitative insulin sensitivity check indices (0.32 \u00b1 0.03 vs. 0.27 \u00b1 0.02) were significantly higher in G1 than in G2 (p &lt; 0.01). One patient in G2 was obese and had type 2 diabetes. The other patient was obese and had a high HOMA-IR score and F-IRI level. A LES with BCAA-EN does not inhibit overt diabetes in most cirrhosis patients. However, close attention should be paid to fluctuations in BG levels in cirrhosis patients who present with obesity and severe insulin resistance.<\/jats:p>","DOI":"10.3390\/nu11092140","type":"journal-article","created":{"date-parts":[[2019,9,9]],"date-time":"2019-09-09T04:12:40Z","timestamp":1568002360000},"page":"2140","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Late-Evening Snack with Branched-Chain Amino Acid-Enriched Nutrients Does Not Always Inhibit Overt Diabetes in Patients with Cirrhosis: A Pilot Study"],"prefix":"10.3390","volume":"11","author":[{"given":"Keisuke","family":"Nakanishi","sequence":"first","affiliation":[{"name":"Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadashi","family":"Namisaki","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsuyoshi","family":"Mashitani","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kosuke","family":"Kaji","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuniaki","family":"Ozaki","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soichiro","family":"Saikawa","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinya","family":"Sato","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Inoue","sequence":"additional","affiliation":[{"name":"Institute for Clinical and Translational Science, Nara Medical University Hospital, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhiko","family":"Sawada","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kou","family":"Kitagawa","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Takaya","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naotaka","family":"Shimozato","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideto","family":"Kawaratani","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kei","family":"Moriya","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6675-0475","authenticated-orcid":false,"given":"Takemi","family":"Akahane","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Mitoro","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitoshi","family":"Yoshiji","sequence":"additional","affiliation":[{"name":"Third Department of Internal Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,9,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Kakazu, E., Sano, A., Morosawa, T., Inoue, J., Ninomiya, M., Iwata, T., Nakamura, T., Takai, S., Sawada, S., and Katagiri, H. 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