Essential Amino Acid Supplementation May Attenuate Systemic Inflammation and Improve Hypoalbuminemia in Subacute Hemiplegic Stroke Patients

Abstract

Background: Post-stroke inflammation and hypoalbuminemia can negatively affect neurocognitive recovery. This study evaluated whether oral amino acid (AA) supplementation with prevalently essential amino acids (EAAs, 82.1%) could improve inflammation and albumin levels in post-stroke patients undergoing neurorehabilitation. Methods: Sixty-four patients with subacute stroke (less than three 3 months from acute event) and elevated inflammation markers (C-reactive protein, CRP > 0.5 mg/dL) were enrolled. All underwent anthropometric assessments and blood tests for CRP (normal value < 0.5 mg/dL), albumin (normal range: 3.5–4.76 g/dL), prealbumin (18–32 mg/dL), and white blood cell count. Participants were randomly assigned to receive either oral EAAs (8.4 g/day) or placebo (maltodextrin, 8.4 g/day) for 55 days. Measurements were taken at baseline (T0) and at discharge (T1), approximately two months later. Results: At baseline, both groups had comparable levels of systemic inflammation, albumin and prealbumin: CRP, 2.13 ± 1.82 mg/dL (placebo) vs. 2.89 ± 2.12 mg/dL (EAAs), p = 0.13; albumin, 3.10 ± 0.46 g/dL (placebo) vs. 3.07 ± 0.57 g/dL (EAAs), p = 0.82; prealbumin, 18.3 ± 6.2 mg/dL (placebo) vs. 16.9 ± 3.9 mg/dL (EAAs), p = 0.28. During rehabilitation, only the EAA group showed significant reductions in CRP (p = 0.036 vs. placebo) and improvements in albumin (p = 0.033 vs. placebo) and prealbumin levels (p = 0.05 vs. placebo). However, full normalization of CRP and albumin was not achieved. Conclusions: This study demonstrates that a physiological dose of supplemented EAAs may attenuate, but not fully resolve, post-stroke inflammation and hypoalbuminemia. Further research is needed to determine whether higher EAA doses and/or modifications in EAA composition could enhance or normalize systemic inflammation.