GLYCINE CONJUGATION OF PARA-AMINOBENZOIC ACID (PABA) - A QUANTITATIVETEST OF LIVER-FUNCTION

Objective: To evaluate glycine conjugation of para-aminobenzoic acid ( PABA) to the hippurated metabolites, para-aminohippuric acid (PAHA), a nd para-acetamidohippuric acid (PAAHA) as a quantitative liver functio n test in patients with liver disease. Design and Methods: Serum conce ntrations of PABA and metabolites were measured by high pressure liqui d chromatography in 24 controls and 50 patients with hepatobiliary dis ease. Results: Hippurate formation was significantly decreased in all patient groups with chronic liver disease versus controls. The hippura te ratio (% hippurated metabolites formed) correlated with severity of disease, serum albumin, and factor VII concentrations. PAHA concentra tion was a better prognostic indicator than factor VII concentrations in patients with acute liver disease; concentrations of zero correctly predicted a poor outcome in patients with fulminant liver failure. Co nclusions: Glycine conjugation of PABA may be useful as a quantitative liver function test in patients with hepatobiliary disease and as a p rognostic index in patients with fulminant liver failure.