Hepatic and renal extraction of circulating type I procollagen aminopropeptide in patients with normal liver function and in patients with alcoholic cirrhosis

The circulating level and splanchnic and renal extraction of serum type I p rocollagen aminoterminal propeptide (PINP) was studied in 20 patients with normal liver function and in 15 patients with alcoholic liver cirrhosis. In patients with alcoholic cirrhosis, the concentration of PINP in the femora l artery blood was significantly higher than in the group of patients with normal liver function (median 145 mu g/l, 95% CI 98-195 versus 57 mu g/l, 9 5% CI 42-92, p < 0.001). A significant decrease in the concentration of PIN P between the femoral artery (median 57 mu g/l, 95% CI 42-92) and the hepat ic vein (median 45 mu g/l, 95% CI 40-70, p < 0.001) was found in patients w ith normal liver function. rn this group we also observed a significantly h igher concentration of PINP in femoral artery blood (median 60 mu g/l, 95% CI 45-87) as compared with that in renal vein (median 50 mu g/l, 95% CI 40- 65, p < 0.001). In contrast, serum-PINP did not differ between arterial and hepatic or venous venous blood in patients with alcoholic cirrhosis. Size- chromatography revealed no significant change in the ratio of the high and low molecular forms of PINP following extraction in liver and kidney. It is concluded that circulating PINP is extracted in the normal liver and kidne y, and that the serum concentration of PINP is significantly higher in pati ents with alcoholic cirrhosis than in patients with normal liver function. Both the hepatic and the renal clearance of PINP are seriously impaired/red uced in patients with alcoholic cirrhosis.