GASTRIC PROTEIN LOSS IN ALCOHOLIC CIRRHOS IS - ASSESSMENT BY MEASUREMENT OF GASTRIC CLEARANCE OF ALPHA(1)-ANTITRYPSIN

Objective. - The aim of the study was to assess gastric protein loss i n alcoholic cirrhotic patients, and to determine its role in the low s erum albumin levels frequently observed in these patients. Methods. - Twenty-six alcoholic cirrhotic patients with ascites and serum albumin levels < 30 g/L were studied and compared to 6 healthy volunteers. Ga stric protein loss was determined by measuring gastric clearance of al pha(1)-antitrypsin. Results. - Gastric clearance of alpha(1)-antitryps in was 0.96 +/- 1.42 mL/h (median: 0.52; range: 0.11-6.54) in cirrhoti c patients and 0.48 +/- 0.20 mL/h (median: 0.51) in healthy volunteers . Values in cirrhotic patients were not significantly different from h ealthy volunteers. However, 3 cirrhotic patients had high values of ga stric clearance of alpha(1)-antitrypsin (2.84, 3.99 and 6.54 mL/h). Th eir serum albumin and protein levels were significantly lower than tho se in the 23 other patients (P < 0.05 and < 0.03, respectively. Severe portal hypertensive gastropathy was present in two out of these 3 pat ients and in two out of the 23 other patients. Conclusion. - Gastric p rotein loss is not significantly increased in liver cirrhosis. However , in a few patients, this loss is high and may play a role in low seru m albumin levels.