Characteristic Profiles of Plasma Amino Acids before and after Glucose Loading in Patients with Acute Hepatitis compared with Chronic Liver Diseases

Abstract

Changes in glucose, immunoreactive insulin (IRI) , C-peptide immunoreactivity (CPR) , immunoreactive glucagon (IRG) and amino acid concentrations in plasma during 100g oral glucose tolerance test were investigated in normal controls and patients with acute hepatitis in the acute stage (AHa) , acute hepatitis in the convalescent stage (AHc) , chronic active hepatitis (CAH) , chronic persistent hepatitis (CPH) and liver cirrhosis (LC) . Concentrations of alanine (Ala) , tryptophan (Trp) , histidine (His) and glucose in plasma in the fasted state were significantly lower, and the concentration of cystine (Cys) was significantly higher only in AHa than the control level. The glutamic acid (Glu) concentration was significantly higher than the control level in AHa (p<0. 02) , CAH (p<0. 001) and CPH (p<0. 001) patients. Tyrosine (Tyr) was higher than the control level in AHa (p<0. 02) , CPH (<0. 001) , CAH (p<0. 001) and LC (p<0. 001) patients, the lysine (Lys) level was significantly higher in the AHa (p<0. 02) and CPH (p<0. 05) patients, the IRG level was significantly higher in AHa (p<0. 001) , AHc (p<0. 01) and LC (p<0. 01) patients than the control level, and the valine (Val) level was lower in AHa (p<0. 01) and LC (p<0. 001) patients than the control level. The Trp concentration (sum of albumin bound and unbound type) was low in AHa patients whose aspartate transferase activity was on the increasing stage, but soon recovered to the normal level during the recovery stage. Significantly positive correlations were observed between plasma Ala and Trp (p<0. 01) , Ala and Val (p<0. 01) , Ala and FPG (p<0. 01) , Trp and His (p<0. 01) , Trp and Val (p<0. 01) , Trp and Glu (p<0. 01) , Trp and Tyr (p<0. 02) , His and Glu (p<0. 01) , Cys and Lys (p<0. 01) and Val and Glu (p<0. 01) in AHa, CAH and CPH. Significant negative correlations were found between Ala and Lys (p<0. 01). Trp and Lys (p<0. 01), Trp and IRG (p<0. 02) , Cys and Val (p<0. 02) , Cys and Glu (p<0. 01) , Val and Lys (p<0. 01), Lys and fasted plasma glucose (FPG) (p<0. 01) and between Glu and IRG (p<0. 05) in AHa, CAH and CPH. 6) Decrease ratio (DR) was defined as decrease at 3 hrs after glucose loading divided by it's initial value. The DRs which differed significantly from the control level in AHa were AlaDR and IRG DR (lower) , and leucine DR (Leu DR) and arginine DR (Arg DR) (higher) . The sum (total values of before, O. 5hr, lhr, 2hr and 3hr after glucose loading) of IRI (TIRO was higher than the control level in the LC, AHa, CAH, CPH and AHc patients in this order. The sum of CPR (XCRR) was higher than the control level in the AHa, LC, CAH, CPH and AHc patients. The concentration of Ala in plasma did not increase after glucose loading in any of the cases except in those with AHa, whose Ala gradually increased after glucose loading. The 4Ala (concentration of Ala at 3hrs after glucose loading minus that before loading) value correlated significantly with the initial concentration of Ala in plasma in all liver diseases examined including AHa, in which diAla was exclusively above zero.