JP2005350371A - Nutrient composition for hepatopathic patient - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To obtain a nutrient composition for a hepatopathic patient, enabling the hepatopathic patient to easily ingest a branched-chain amino acid, capable of preventing postcibal hyperglycemia caused by glucose tolerance abnormality, and suitable for protein trophotherapy. <P>SOLUTION: This nutrient composition for the hepatopathic patient contains the branched-chain amino acid and paratinose. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a nutritional composition for liver disorders useful for nutritional treatment.

  Persons with liver impairment, such as patients with cirrhosis, exhibit protein energy malnutrition from an early stage, and have low protein, hypoalbuminemia, plasma amino acid imbalance, hyperammonemia, protein intolerance, and negative nitrogen balance. These are phenomena that occur through quantitative and qualitative abnormalities in the biological amino acid pool, and are the most basic background factors as nutritional pathologies in cirrhotic patients. In patients with cirrhosis with undernutrition, liver pathology has progressed, QOL values are low, and life prognosis is often worse than patients with cirrhosis without it. Therefore, in order to improve the low protein nutritional state, active protein nutritional treatment is performed by supplementing and administering branched chain amino acids that are deficient in cirrhosis patients as a medicine. However, a therapeutic effect is obtained (Non-patent Document 1).

  Patent Document 1 describes a beverage composition containing a branched chain amino acid. Patent Document 2 describes a granule preparation for pharmaceutical use in which only a specific branched chain amino acid is the main drug. Patent Document 3 describes an amino acid preparation for patients with hepatic encephalopathy containing a specific amino acid containing a branched-chain amino acid in a specific ratio, and in its application, intravenous injection, infusion, etc. are usually performed in the form of a sterile aqueous solution. In addition, it is described that solid preparations such as powders, granules, fine granules and the like may be applied to patients who can be administered orally.

  Patent Document 4 describes a pharmaceutical suspension containing a branched chain amino acid and a specific suspending agent. Patent Document 5 describes a chewable agent containing a branched chain amino acid and a magnesium compound as an active ingredient. Patent Document 6 describes a pharmaceutical jelly agent containing only a branched chain amino acid as an active ingredient, and containing a suspending agent and a gelling agent. Patent Document 7 describes a solution containing a branched chain amino acid dissolved in water under specific conditions and containing a branched chain amino acid in a specific ratio. Patent Document 8 describes a pharmaceutical suspension containing a branched chain amino acid as an active ingredient and at least one specific organic acid as a sour agent. Patent Document 9 discloses a pharmaceutical suspension containing only a specific branched chain amino acid as an active ingredient, the branched chain amino acid in a specific blending ratio, and containing at least one specific organic acid as a sour agent. Has been described. Patent Document 10 describes a method for producing a granulated pharmaceutical preparation with good content uniformity, in which only a specific branched chain amino acid particle is used as a main drug and a branched chain amino acid is granulated at a specific blending ratio. Patent Document 11 describes a pharmaceutical suspension containing a branched chain amino acid and containing at least one organic acid as a sour agent.

  However, even if the branched-chain amino acid preparation is a pharmaceutical product in Non-Patent Document 1, the treatment using this is a nutritional treatment, so the expected effect unless dietary guidance is strengthened with the cooperation of a dietitian is In recent years, it has been described that it cannot be obtained, and as described in the above-mentioned literature, branched-chain amino acids are not simply taken as infusions, preparations or beverages, but are taken as food in everyday meals. There is a need to be able to do it.

  For branched-chain amino acids that can be ingested as food in everyday meals, Patent Document 12 describes casein and milk protein separately hydrolyzed, adsorbed and removed hydrophobic components, and the latter for the former 1. It has a low bitterness characterized by mixing at a ratio of 0.5 to 3, preferably 1 to 2, has an amino acid balance similar to human milk, and a branched chain amino acid / aromatic amino acid molar ratio of 8 to 20. A method for preparing a peptide mixture is described, and further, a nutritional composition for patients with liver diseases comprising the peptide mixture is described, and a statement is made that the composition can be used in a pharmaceutical type and a food and drink type. Has been. Patent Document 13 discloses that one or more selected from branched chain amino acids, sulfur-containing amino acids, aromatic amino acids, heterocyclic amino acids, salts and derivatives of these amino acids, and α-L-aspartyl-L- An amino acid-containing composition containing phenylalanine methyl ester is described, and this amino acid-containing composition can be applied to amino acid preparations, nutrients, seasonings, beverages, various processed foods, etc. It is described that any of granulation, tablets, other solids, pastes, liquids, etc. can be applied.

However, none of the above-mentioned cases often hinders protein nutrition treatment due to problems of postprandial hyperglycemia due to impaired glucose tolerance in patients with cirrhosis and compliance problems. In addition to reducing the bitter taste of branched-chain amino acids, what can be ingested as a food has been awaited.
JP 58-165774 A Japanese Patent No. 3233155 Japanese Patent No. 2618653 Japanese Patent No. 3341766 Japanese Patent No. 3341769 Japanese Patent No. 3341770 Japanese Patent No. 3368897 Japanese Patent Application Laid-Open No. 2002-114674 Japanese Patent No. 3259931 Japanese Patent No. 3211824 Japanese Patent Application Laid-Open No. 2002-114674 Japanese Patent No. 2986764 JP-A-4-58305 Pharma Medica, Vol. 21, no. 6, 2003, p. 147-159

  An object of the present invention is to provide a nutritional composition for a hepatic disorder person who can easily take a branched chain amino acid, can suppress postprandial hyperglycemia due to impaired glucose tolerance, and is suitable for protein nutrition treatment. Moreover, an object of this invention is to provide the nutrition composition for hepatic impaired persons suitable also for a bedtime meal (Late Evening Snack) of hepatic impaired persons.

  As a result of intensive studies to achieve the above object, the present inventors have found that a nutritional composition for hepatic impairment containing a branched chain amino acid and palatinose is easy to ingest a branched chain amino acid, and has postprandial hyperglycemia due to impaired glucose tolerance. The present invention was completed by finding that it can be suppressed and suitable for protein nutrition treatment and further studies.

That is, the present invention
[1] A nutritional composition for hepatic impaired patients, comprising a branched chain amino acid and palatinose,
[2] The nutrition composition for hepatic impairment according to [1], wherein the branched chain amino acid is one or more selected from isoleucine, leucine and valine,
[3] The nutritional composition for hepatic impairment according to the above [1], wherein the branched chain amino acids are isoleucine, leucine and valine;

[4] The nutritional composition for hepatic impairment according to any one of [1] to [3], wherein the content of palatinose is 0.1 to 20 parts by mass with respect to 1 part by mass of the branched chain amino acid,
[5] The nutritional composition for hepatic impairment according to any one of [1] to [4], further comprising a gelatin hydrolyzate,
[6] The nutrition composition for hepatic impairment according to any one of [1] to [5], further comprising dietary fiber.
[7] The nutritional composition for liver disorders according to any one of [1] to [6], further comprising zinc and selenium,

[8] The nutritional composition for liver disorders according to any one of the above [1] to [7], which is a nutritional composition for cirrhosis patients,
[9] A nutritional composition for cirrhosis patients comprising at least the components shown in Table 1 below,

[10] A nutritional composition for cirrhosis patients comprising at least the components shown in Table 2 below,

および
［１２］ 肝硬変患者用の就寝前食である前記［１］〜［１１］のいずれかに記載の栄養組成物、
に関する。 [11] A nutritional composition for cirrhosis patients comprising at least the components shown in Table 3 below,

And [12] The nutritional composition according to any one of the above [1] to [11], which is a bedtime meal for cirrhosis patients,
About.

  The nutritional composition for hepatic disorder of the present invention is easy for a hepatic impaired person to take a branched chain amino acid, can suppress postprandial hyperglycemia due to impaired glucose tolerance, and is suitable for protein nutrition therapy.

  The nutritional composition for hepatic disorders of the present invention contains a branched chain amino acid and palatinose, and preferably further contains some or all of gelatin hydrolyzate, dietary fiber, zinc, and selenium.

  Examples of the branched chain amino acid include isoleucine, leucine, and valine. In the present invention, one or more of these can be used as branched chain amino acids, and it is particularly preferable to use three types of isoleucine, leucine and valine as branched chain amino acids.

The palatinose is a disaccharide produced by allowing a transferase to act on sucrose. Sucrose is an α-1,2 bond between glucose and fructose, and palatinose is a transfer of this bond to an α-1,6 bond by an enzyme.
Content of the said palatinose in the nutrition composition of this invention is 0.1-20 mass parts normally with respect to 1 mass part of branched chain amino acids.

  Gelatin hydrolyzate is preferred due to its high Fischer ratio and excellent taste masking. The content of the gelatin hydrolyzate is preferably 2 to 6% by mass, more preferably 3 to 5% by mass with respect to the nutritional composition for the hepatic impaired person.

As dietary fiber, for example, indigestible polysaccharides such as indigestible dextrin are suitable. The content of dietary fiber is preferably 1 to 8% by mass with respect to the nutrition composition for hepatic impaired people.
Zinc and selenium can be used, for example, in the form of zinc yeast and selenium yeast. It is preferable that the zinc content is 0.001 to 0.005 mass% with respect to the nutritional composition for the liver impaired. The content of selenium is preferably 0.000002 to 0.000025% by mass with respect to the nutrition composition for the liver impaired.

  Examples of the dosage form of the nutritional composition for hepatic disorders of the present invention include tablets, pills, powders, solutions, suspensions, emulsions, granules, capsules and the like. The form of the nutritional composition of the present invention may be solid, liquid, sol, or gel, but is preferably gel. In the case where the nutritional composition for the hepatic disorder of the present invention is in the form of a gel, a gelling agent is usually used for its production. Examples of the gelling agent include agar, gelatin, alginate, carrageenan, gellan gum and the like, and these can be used alone or in admixture of two or more. Although the usage-amount of a gelatinizer is not specifically limited, It is preferable that it is 0.05-5 mass% with respect to the nutrition composition for liver disorders of this invention, and it is 0.1-2 mass%. Further preferred.

  Moreover, the nutrition composition for hepatic impaired persons of this invention may contain the additive other than the said raw material. Examples of additives include carbohydrates, vitamins, zinc, trace elements other than selenium, pH adjusters, and fragrances. In the present invention, one or more of these may be used as the additive.

  Examples of the saccharide include dextrin, maltodextrin, powder cake, monosaccharides such as glucose and fructose, disaccharides such as maltose and lactose, granulated sugar, and oligosaccharide.

Examples of vitamins include vitamin A, vitamin B ₁ , vitamin B ₂ , vitamin B ₆ , vitamin B ₁₂ , niacin, folic acid, pantothenic acid, vitamin C, vitamin D, vitamin E, vitamin K, and the like.

Examples of trace elements other than zinc and selenium include manganese, copper, molybdenum, iron, magnesium, chromium, iodine and the like, and these may be used in the form of mineral yeast. Examples of the mineral yeast include manganese yeast, copper yeast, molybdenum yeast, iron yeast, magnesium yeast, chromium yeast, iodine yeast and the like.
Examples of the pH adjuster include citric acid (buffer solution), sodium hydroxide, carbonic acid (buffer solution), phosphoric acid (buffer solution), acetic acid (buffer solution), hydrochloric acid, and the like.
Examples of the fragrance include apple fragrance.
Furthermore, examples of the additive that can be blended as needed include sweeteners, colorants, stabilizers, preservatives, preservatives and the like.

  The nutritional composition for hepatic impairment of the present invention is usually produced by blending the above components, that is, branched chain amino acid, palatinose, gelatin hydrolyzate, dietary fiber, zinc, selenium and the above additives according to a conventional method. . In the present invention, heating and stirring may be appropriately performed at the time of mixing raw materials and additives. Further, when the nutritional composition for liver disorders of the present invention is a gel composition, the above components are dissolved by heating in a solvent (for example, water), added with a gelling agent, and cooled. Is done.

  The nutritive composition obtained as described above has a reduced bitterness peculiar to amino acids and is easy to ingest branched-chain amino acids, and is used for food as, for example, jelly. Moreover, the nutritional composition for hepatic impaired persons of the present invention can suppress postprandial hyperglycemia due to impaired glucose tolerance, is suitable for protein nutrition treatment, and is preferably used as a nutritional composition for hepatic impaired persons.

  In the case of a nutritional composition for cirrhosis patients, the nutritional composition preferably includes the components described in Table 1, more preferably includes the components described in Table 2, and the components described in Table 3 above. Most preferably it contains.

[Example 1]
A sol-like nutritional composition was obtained based on the formulation shown in Table 4 below. Specifically, to 500 g of hot water at about 60 ° C., branched chain amino acid, gelatin hydrolyzate, dextrin, palatinose, indigestible dextrin, vitamins, trace elements, pH adjuster, fragrance are added in order, and dissolved by stirring. Water was added to the obtained mixture to make exactly 1 kg. After filling the mixed solution into a pouch, the mixture was sterilized by heating at 95 ° C. for 20 minutes, and then cooled to obtain a sol-like nutritional composition for the liver impaired.

[Example 2]
A sol-like nutritional composition for hepatic impairment was obtained in the same manner as in Example 1 except that it was based on the formulation shown in Table 5 below.

[Example 3]
Based on the formulation shown in Table 6 below, a gel nutritional composition was obtained. Specifically, to 500 g of hot water at about 60 ° C., branched chain amino acid, gelatin hydrolyzate, dextrin, palatinose, indigestible dextrin, vitamins, trace elements, pH adjuster, fragrance are added in order, and dissolved by stirring. This mixed solution was designated as solution A. Separately, a gelling agent was added to 400 g of cold water, dissolved by heating and stirring to 95 ° C., and then this solution and the A solution were mixed, and water was further added to the mixed solution to make exactly 1 kg. After filling the pouch with the mixed-up mixture, the mixture was sterilized by heating at 95 ° C. for 20 minutes, and then cooled to obtain a gel-like nutritional composition for hepatic disabled.

[Example 4]
A gel-like nutritional composition for liver disorders was obtained in the same manner as in Example 3 except that it was based on the formulation shown in Table 7 below.

[Comparative Example 1]
A sol-like nutritional composition for hepatic impairment was obtained in the same manner as in Example 1 except that it was based on the formulation shown in Table 8 below.

[Test Example 1]
The nutritional composition for hepatic impaired persons obtained in Examples 1 to 4 and the nutritional composition obtained in Comparative Example 1 were evaluated for the edible propriety, the presence or absence of bitterness and ease of ingestion, and a comprehensive evaluation of these results. It was evaluated by a sensory test by adults. The evaluation results are shown in Table 9 below.

  From Table 9 above, it can be seen that the nutritional composition for hepatic impaired persons of the present invention is suitable for protein nutritional treatment because it is easy to ingest branched chain amino acids for hepatic impaired persons and is suitable for food.

[Test Example 2]
Because cirrhosis patients often have a decrease in respiratory quotient the next morning, they may take a Late Evening Snack (LES) to prevent it. One of the properties required for LES carbohydrates is to improve early morning respiratory quotient decline. It is also desirable to prevent postprandial hyperglycemia due to impaired glucose tolerance in cirrhotic patients. Then, in order to confirm the effect by mix | blending palatinose in the nutrition composition of this invention, the following test was done.
A saccharide solution was prepared by dissolving palatinose and dextrin in water in the proportions shown in Table 10 below.

  SD male rats (6 rats per group) were fasted for 24 hours from 9:00 am, and each sugar solution of 25 kcal / kg was orally administered, blood was collected over time, and blood glucose level was measured. The result is as shown in FIG.

  As can be seen from FIG. 1, the higher the palatinose content in the sugar solution, the milder the increase in blood glucose level after oral administration.

  SD male rats (6 rats per group) were fasted for 24 hours from 9:00 am, then each sugar solution of 25 kcal / kg was orally administered, and the respiratory quotient was measured. The respiratory quotient was measured using a small animal respiratory quotient measuring apparatus (ARCO-1000, manufactured by Arco System). The result is as shown in FIG.

  As can be seen from FIG. 2, the respiratory quotient of the P0 group rapidly increased to around 1 after administration of the sugar solution, rapidly decreased after about 3 hours after administration, and around 0.8 after the 4th hour. It changed in. The respiratory quotient of the P50 group also rapidly increased and maintained until the 4th hour, and then decreased to around 0.8. In the P75 group, the increase in respiratory quotient was mild and kept higher for a longer time compared to the P0 and P50 groups. In the P100 group, the increase in respiratory quotient was even milder.

  From the above results, by adding palatinose as a carbohydrate source, the increase in blood glucose level after administration is moderate, and the respiratory quotient can be kept high for a long time, and the carbohydrate is gradually burned. It was suggested that Therefore, it can be said that the nutritional composition for hepatic handicapped persons of the present invention containing palatinose has extremely favorable characteristics as a night meal for cirrhotic patients.

  The nutritional composition for hepatic disorder of the present invention is easy for a hepatic impaired person to take a branched chain amino acid, can suppress postprandial hyperglycemia due to impaired glucose tolerance, and is suitable for protein nutrition therapy.

It is a diagram which shows a time-dependent change of the blood glucose level after carbohydrate administration. It is a diagram which shows the time-dependent change of the respiratory quotient after carbohydrate administration.

Claims (12)

  A nutritional composition for a hepatic disorder characterized by containing a branched chain amino acid and palatinose.   The nutritional composition for hepatic impairment according to claim 1, wherein the branched chain amino acid is one or more selected from isoleucine, leucine and valine.   The nutritional composition for hepatic impaired patients according to claim 1, wherein the branched chain amino acids are isoleucine, leucine and valine.   The nutritional composition for hepatic impairment according to any one of claims 1 to 3, wherein the content of palatinose is 0.1 to 20 parts by mass with respect to 1 part by mass of the branched chain amino acid.   Furthermore, the nutrition composition for hepatic impaired persons in any one of Claims 1-4 containing a gelatin hydrolyzate.   Furthermore, the nutrition composition for hepatic impaired persons in any one of Claims 1-5 containing a dietary fiber.   Furthermore, the nutrition composition for hepatic impaired persons in any one of Claims 1-6 containing zinc and selenium.   It is a nutrition composition for cirrhosis patients, The nutrition composition for liver disorders in any one of Claims 1-7. A nutritional composition for cirrhosis patients comprising at least the following components.

A nutritional composition for cirrhosis patients comprising at least the following components.

A nutritional composition for cirrhosis patients comprising at least the following components.

The nutritional composition according to any one of claims 1 to 11, which is a pre-sleeping meal for cirrhosis patients.

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