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After the intake by tumor cells, branched-chain amino acid transaminase 1 and 2 (BCAT1/2) transfers nitrogen of BCAAs to -ketoglutarate (KG) to produce glutamine and branched-chain keto acid (BCKA), which is then metabolized by branched-chain alpha-keto acid dehydrogenase complex (BCKDH) and some other enzymes to produce tricarboxylic acid (TCA) cycle intermediates acetyl-CoA and/or succinyl-CoA, thus fueling tumor cell proliferation and providing some building bricks to biogenesis 253 (Fig

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95% CI 0.94, 1.03)