URINARY LEVELS OF GAMMA-CARBOXYGLUTAMIC ACID AND ITS CLINICAL-SIGNIFICANCE

Urinary gamma-carboxyglutamic acid (gamma-Gla) levels were determined in healthy subjects of all ages. The urinary gamma-Gla levels were hig hest in infants (0-1 years), then fell in an age-dependent manner, aga in in subjects reaching a minimum value in adults, then gradually incr eased over 60 years of age. Urinary gamma-Gla levels therefore change markedly with aging. The relationships between the urinary gamma-Gla e xcretion and plasma levels of prothrombin and protein C in patients wi th various hepatic diseases or diabetes mellitus were examined and com pared with those in healthy adults. Both plasma prothrombin and protei n C levels were decreased in all patients with liver disease compared with healthy adults. In patients with hepatitis and liver cirrhosis, t he decrease did not, however, affect the gamma-Gla excretion. In addit ion, in patients with hepatoma or carcinoma with liver metastases, the urinary gamma-Gla levels were increased. In patients with diabetes me llitus, the urinary gamma-Gla levels and plasma levels of prothrombin and protein C tended to increase, but this was not significant. The pr esent results indicate that simultaneous measurement of the levels of urinary gamma-Gla and plasma prothrombin and protein C is a useful too l for the diagnosis of liver diseases and diabetes mellitus.