Supplementation with essential amino acid improves liver health in teen girls with PCOS

Short-term supplementation with a selective essential amino acid (EAA)-containing product significantly improved liver-related outcomes among adolescent girls with polycystic ovarian syndrome (PCOS) in a recent study.

The finding suggests that this simple intervention could be a promising avenue for managing hepatic steatosis (HS), a common complication of PCOS.

Participants in the study had an average BMI of 37.3 kg/m² and an average age of 15.6  years. Over two 28-day phases, they were administered either a placebo or 15 g of an EAA powder supplement dissolved in liquid of any volume and taken twice daily. Researchers measured the participants’ liver fat, very low-density lipoprotein (VLDL) lipogenesis, and triacylglycerol (TG) metabolism. [Obesity (Silver Spring) 2024;32:678-690]

Compared with the placebo, the EAA supplement reduced HS (0.8 per cent absolute, 7.5 per cent relative; p=0.013), aspartate aminotransferase (AST) (8 per cent; p=0.004), plasma triglycerides (9 per cent; p=0.015), and VLDL triglycerides (VLDL-TG) (21 percent; p=0.031).

“VLDL-TG palmitate derived from lipogenesis did not differ between phases, suggesting that the observed changes may not be attributed to alterations in de novo lipogenesis,” said the researchers. “The improvements in HS, AST, total plasma, and lipoprotein TG suggest that changes in lipid handling occurred within the liver and plasma domain to lower lipid levels in young women at risk for metabolic associated fatty liver disease.”

Surprisingly, participants reported consuming fewer carbohydrates (p=0.038) and total sugars (p=0.046) during the EAA phase, indicating potential dietary modifications associated with the supplementation regimen.

PCOS a common endocrine disorder

PCOS is the most common endocrine disorder among women, affecting between 6 and 18 percent of adolescent girls, with variations between populations. [BMC Med 2020;18:72]

The disorder is characterized by hyperandrogenism, insulin resistance, and HS.  Addressing the liver-related complications of PCOS is crucial for managing the condition effectively. Adolescent girls with both PCOS and obesity have shown a higher rate of HS compared to BMI-matched controls without PCOS.

Amino acid supplementation in teen girls with PCOS

While essential amino acid supplements have previously shown promise in lowering liver fat and blood triglycerides in adults, their effectiveness in adolescent girls with PCOS remains uncertain. This randomized, double-blind, crossover, placebo-controlled trial was conducted in 21 adolescent girls with PCOS and obesity to determine whether supplementation would decrease HS.

“Our findings suggest that EAA supplements could serve as a low-risk, relatively affordable treatment option for adolescent girls with PCOS who are at risk of developing nonalcoholic fatty liver disease,” the researchers said. “Furthermore, this supplement may offer a preventive measure against the worsening of fatty liver and hypertriglyceridaemia in individuals with high susceptibility due to PCOS.”

They added that short-term EAA supplementation may help manage hepatic steatosis and improve lipid metabolism.

However, the researchers said larger clinical trials are needed to confirm these findings and explore the potential long-term benefits of this intervention.