In the present study, we demonstrated that serum LCA levels and LCA ratio were positively associated with skeletal muscle mass in CLD rats treated with BCAA, as well as human subjects, and that LCA-induced skeletal muscle cell hypertrophy occurs through TGR5-IGF-1-Akt3 activation. The gene discussed is AKT3; the disease is congenital secretory chloride diarrhea 1.