Evidence for Valine Intolerance in Patients with Cirrhosis
Article first published online: 24 JUL 2008
Copyright © 1984 American Association for the Study of Liver Diseases
Volume 4, Issue 4, pages 667–670, July-August 1984
How to Cite
Schauder, P., SchrÖDer, K., Herbertz, L., Langer, K. and Langenbeck, U. (1984), Evidence for Valine Intolerance in Patients with Cirrhosis. Hepatology, 4: 667–670. doi: 10.1002/hep.1840040417
- Issue published online: 24 JUL 2008
- Article first published online: 24 JUL 2008
- Manuscript Accepted: 13 MAR 1984
- Manuscript Received: 25 OCT 1983
- Deutsche Forschungsgemeinschaft. Grant Number: Grants Scha 246/6–2 and La 201
Valine (62.5 mg per kg), leucine (70 mg per kg) and equal amounts of the calcium salts of the corresponding keto acids, i.e., α1-ketoisovaleric acid (KIVA) and α1-ketoisocaproic acid (KICA) were orally administered to patients with cirrhosis and to control subjects.Valine or leucine ingestion increased serum valine and leucine levels and the corresponding keto acids, KIVA and KICA, in cirrhotics and controls. KIVA or KICA ingestion increased serum KIVA and KICA concentrations within a few minutes associated with a rise in valine and leucine.
In cirrhotics, administration of valine or KIVA resulted in significantly higher serum valine or KIVA concentrations than in control subjects. The clearance of valine and KIVA from blood was also delayed in cirrhotic patients. No such differences were observed after leucine or KICA ingestion.
It is suggested that cirrhotics have a diminished tolerance for valine. Since the tolerance for KIVA, but not KICA, is also impaired, it appears that cirrhotics have a derangement in one or more metabolic steps distal to the branched-chain keto acid dehydrogenase.