Amino acid tolerance in cirrhotic patients following oral protein and amino acid loads. 1990

M Y Morgan, and K E Hawley, and D Stambuk
Academic Department of Medicine, Royal Free Hospital, Hampstead, London, UK.

Plasma amino acid and venous blood ammonia concentrations were measured in six patients with well-compensated cirrhosis and in six healthy volunteers, both in the fasting state and serially for 5 h following ingestion of 30 g mixed protein and 30 g amino acid mixture, administered on separate occasions. Mean fasting plasma concentrations of threonine, serine, proline, glycine, and of the three branched-chain amino acids, valine, isoleucine and leucine, were significantly reduced in the cirrhotic patients compared with the control subjects, while mean (+/- 1 s.d.) fasting venous blood ammonia concentrations were comparable 71.2 +/- 31.4 cf. 56.0 +/- 25.4 mumol/L. Following the oral protein and amino acid loads, increases were observed in plasma amino acid concentrations in the majority of subjects with a return to baseline values by the end of the study. Changes in the circulating concentrations of most amino acids were independent of their concentration in the oral protein and amino acid loads, and their relative distribution in the circulation varied over time. The increases in the concentrations of the three branched-chain amino acids did, however, reflect their concentrations in the two nitrogen loads and did remain constant, relative to one another, over time. There were wide intra- and inter-individual variations in plasma amino acid concentrations following protein and amino acid ingestion in both study groups, and in general no significant differences in responses were observed between them. Similarly, no significant inter-group differences were observed in the ammonia response to the two nitrogen loads. No fundamental differences exist in the ways in which patients with well-compensated cirrhosis handle oral protein or amino acid loads of the magnitude employed in the present study.

UI MeSH Term Description Entries
D008103 Liver Cirrhosis Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. Cirrhosis, Liver,Fibrosis, Liver,Hepatic Cirrhosis,Liver Fibrosis,Cirrhosis, Hepatic
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D004044 Dietary Proteins Proteins obtained from foods. They are the main source of the ESSENTIAL AMINO ACIDS. Proteins, Dietary,Dietary Protein,Protein, Dietary
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000596 Amino Acids Organic compounds that generally contain an amino (-NH2) and a carboxyl (-COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. Amino Acid,Acid, Amino,Acids, Amino
D000641 Ammonia A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. Note that the aqueous form of ammonia is referred to as AMMONIUM HYDROXIDE.

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