ALBUMIN SYNTHESIS RATES IN CIRRHOSIS - CORRELATION WITH CHILD-TURCOTTE CLASSIFICATION

Albumin-synthesis rates were measured in nine patients with stable cir rhosis and compared with those of eight healthy volunteers by means of a new technique using stable isotopes. Four grams of L-[1-C-13]leucin e was injected over 10 min, and blood samples were drawn at intervals. Serum free [C-13]leucine enrichment, taken to be the precursor for al bumin synthesis, and C-13 enrichment of leucine in albumin, isolated w ith differential solubility in absolute ethanol from trichloroacetic a cid-precipitated serum proteins, were measured on mass spectrometry. A lbumin synthesis, expressed as a fractional rate, was 7.9% +/-0.3%/day in the controls and 7.9% +/- 1.1%/day in the cirrhotic patients. Albu min synthesis, expressed as an absolute rate, was lower in the cirrhot ic group (cirrhotic, 119 +/- 17 mg/kg/day, controls, 146 +/- 8 mg/kg/d ay), but because of the relatively small number of patients the differ ence was not significant. However, the absolute rate of albumin synthe sis significantly correlated with the Child-Turcotte score (p = 0.024) and its Pugh modification (p = 0.027). The rate of albumin synthesis also correlated with serum phenylalanine concentration but not with se rum albumin concentration and intravascular albumin mass or with other clinical indexes of liver function or integrity when taken separately . However, the significant correlation between albumin synthesis and C hild score suggests that albumin synthesis might be useful for the cli nical judgment of patients with cirrhosis.