UREA AND GLUCOSE-PRODUCTION IN THE LIVER OF PATIENTS WITH ALCOHOL-INDUCED CIRRHOSIS

Objective: To use stable isotopes for the analysis of hepatic metaboli c pathways (urea synthesis, glucose production), comparing them in alc oholic and normal liver, in order to obtain specific and quantitative information on metabolic functions of the liver. Patients and methods: Urea and glucose production as well as alanine metabolism in the live r were studied by means of stable isotopes in 7 males with alcoholic l iver cirrhosis (mean age 46 +/- 4 years; height 173 +/- 5 cm; weight 7 3 +/- 3 kg) and 7 healthy male volunteers as controls (age 26 +/- 3 ye ars; height 180 +/- 5 cm; weight 75 +/- 6 kg). The plasma concentratio ns of adrenaline, noradrenaline, insulin, glucagon and amino-acids wer e also measured. Results: Urea synthesis was fewer in the cirrhosis pa tients than in the controls (3.3 +/- 2.2 mu mol/kg . min vs 4.8 +/- 0. 9 mu mol/kg . min, P < 0.05). But there were no differences in glucose production, alanine metabolism and adrenaline concentrations. The con centrations of glutamine, phenylalanine, tyrosine, insulin, glucagon a nd noradrenaline were significantly raised in the cirrhotic patients, those of valine and leucine significantly lower. Conclusions: Contrary to hepatic glucose production, which was within normal limits, urea s ynthesis was reduced by 30% in the cirrhotic patients. The use of stab le isotopes provided detailed information on specific metabolic proces ses in cirrhotic livers.