Changes in Plasma Amino Acids during Oral Glucose Tolerance Test in Liver Cirrhosis with impaired Glucose Tolerance

Changes in plasma amino acids, insulin, C-peptide, , glucose and glucagon levels were investigated during 100g oral glucose tolerance test (OGTT) in patients with liver cirrhosis (LC) , LC with impaired glucose tolerance (IGT) and delayed hypersecretion of insulin during OGTT (LC-IGT-1) , LC with IGT and low response of insulin secretion during OGTT (LCIGT-2) , LC with hepatocellular carcinoma (LC-HCC) , chronic active hepatitis (CAH) , chronic persistent hepatitis (CPH) , untreated diabetes mellitus without hepatic diseases (DM) and healthy controls. The decrease ratio (DR) of plasma amino acids was defined as the decrease at 3 hrs after glucose loading/initial concentration. Among the liver diseases examined, except LC-HCC, significant relationships and differences of amino acids and the above hormones in liver diseases were as follows ; Tyr (i) and Phe (i) correlated negatively with cholinesterase activity (Ole) and cholesterol concentration (Cho (i) ), and correlated positively with indocyanine green retention rate (ICG) and sum of plasma glucose (IPG) (i means value before loading, I means sum of five sampling points during OGTT) . Ser (i) correlated negatively with Che (i) , Cho (i) and albumin (Alb) (i) and positively with ICG, and was higher in LC and LC-IGT-1 compared to the controls. Cit (i) had a positive correlation with £PG, PG (i) and ICG, a negative correlation with Che (0 and was significantly higher in LC-IGT-2, LC-IGT-1 and LC in this order than that of the control. Cit DR showed a positive correlation with Che (i) and Alb (i) and a negative correlation with ICG and /PG. Trp DR had a negative correlation with ICG, EPG and PG (i) , and was lower in liver diseases accompanying LC. Despite lower Orn (i) in DM, it was higher in LC-IGT-1 than in LC. In LC-HCC, Glu DR was higher than in LC and Gly DR was higher than in control. Ala and Trp tend to increase at 1 hr after loading in LC with IGT, but they decreased in the control and DM. The higher level of Ser (i) and Tyr (i), and the lower level of Glu (i) , Ile +Leu +Val/Phe + Tyr (BCAA/AAA) (i) and Trp DR might imply the shift to LC from chronic hepatitis.