Validity of 13C‐phenylalanine breath test to evaluate functional capacity of hepatocyte in patients with liver cirrhosis and acute hepatitis

• Published in: Alimentary pharmacology & therapeutics Vol. 21; no. 7; pp. 851 - 859
• Main Authors: Koeda, N., Iwai, M., Kato, A., Suzuki, K.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.04.2005; Blackwell
• Subjects: Acute Disease; Biological and medical sciences; Breath Tests - methods; Digestive system; Female; Gastroenterology. Liver. Pancreas. Abdomen; Hepatitis - pathology; Hepatitis - physiopathology; Hepatocytes - physiology; Humans; Liver Cirrhosis - diagnosis; Liver Cirrhosis - physiopathology; Liver Function Tests - methods; Liver Function Tests - standards; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Phenylalanine; Sensitivity and Specificity; Human; Phenylalanine; Digestive system; Hepatic disease; In vitro; Functional capacity; Cirrhosis; Hepatitis; Validity; Breath test; Hepatocyte; Aminoacid; Digestive diseases
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2005.02409.x

Summary Background : No definitive method for quantitative evaluation of hepatic function has as yet been established. Aim : To investigate whether the 13C‐phenylalanine breath test would be useful for the evaluation of hepatic function in patients with liver cirrhosis and acute hepatitis. Methods : l‐[1‐13C]‐phenylalanine was administered orally in a dose of 100 mg to 25 patients with liver cirrhosis, 22 patients with acute hepatitis and 10 healthy subjects. The relationships of the cumulative excretion with the 13C‐%dose/h, blood biochemical parameters and asialoscintigraphy were investigated. Results : In liver cirrhosis patients, the cumulative excretion showed correlations with hepatic function tests, asialoscintigraphy, clinical stage and portal hypertension. In acute hepatitis patients, the cumulative excretion showed correlations with hepatic function tests. There were positive correlations between the cumulative excretion and the 13C‐%dose/h at 20 min (Phe20) and 13C‐%dose/h at 30 min (Phe30) in liver cirrhosis and acute hepatitis patients. Multiple regression analysis demonstrated that total bilirubin, total cholesterol and absence of varices were independent determinants of cumulative excretion in liver cirrhosis patients and prothrombin time in acute hepatitis patients. Conclusion : The 13C‐phenylalanine breath test may allow hepatic function to be evaluated non‐invasively in liver cirrhosis and acute hepatitis patients, and the Phe20 and Phe30 may be useful for determination of function at a single time‐point.