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- Title
Role of Gluconeogenesis from Amino acids in Determining Fasting and Absorptive Levels of Plasma Ammonia in Cirrhosis.
- Authors
Trevisani, F.; Bernardi, M.; Grilli, F.; De Palma, Rossana; Gasbarrini, G.; Piazzi, S.; Patrono, Daniela
- Abstract
The aim of this study was to evaluate the contribution of gluconeogenesis from amino acids in the development of fasting and absorptive hyperammonemia in cirrhosis. Somatostatin (SRIF), which is known to inhibit the hepatic disposal of gluconeogenic amino acids, was administered in a continuous infusion (500 µg/h) for 90 rain before and 5 h after a protein meal (240 g of meat) in 11 overnight fasting patients. Plasma glucagon, insulin, gluconeogenic amino acids (GAA: alanine, serine, glycine, and threonine) and ammonia (NH3) were evaluated before the infusion, immediately before, and at 1, 3, and 5 h after the meal. As control study, the same protocol was randomly repeated in a different day with saline infusion. During the latter, a direct correlation was found between fasting glucagon and ammonia (r = 0.68; <em>p</em> < 0.05). Fasting glucagon, insulin, and NH3 did not change, whereas alanine (<em>p</em> < 0.05) and the GAA sum decreased (<em>p</em> < 0.01). When SRIF was infused, fasting glucagon (p < 0.05), insulin (<em>p</em> < 0.05), and NH3 (<em>p</em> < 0.05) decreased. Alanine did not change, and GAA sum increased (<em>p</em> < 0.02). No correlations were found by plotting changes in glucagon or GAA sum and NH3. After the meal, SRIF infusion abolished the plasma response of glucagon and markedly reduced that of insulin, so that their area under the curve (AUC0-5) were reduced (<em>p</em> < 0.005, for both), with respect to control study. Moreover, the AUC0-5 of alanine (<em>p</em> < 0.005) and GAA sum (<em>p</em> < 0.005) were increased, suggesting a reduced disposal of these compounds. In spite of this, the meal-induced early increase and the AUC0-5 of plasma NH3 observed during SRIF and saline infusion did not differ. Our results do not confirm the importance of gluconeogenesis from α-amino-nitrogens in determining the fasting.
- Publication
American Journal of Gastroenterology (Springer Nature), 1988, Vol 83, Issue 6, p646
- ISSN
0002-9270
- Publication type
Academic Journal