Abnormality of energy metabolism in the skeletal muscle of patients with liver cirrhosis and changes under administration of glucose and branched-chain amino acids.
We assessed changes in skeletal muscle energy metabolism by 31P-magnetic resonance spectroscopy (31P-MRS) and oxygen supply by near-infrared spectroscopy (NIR), after exercise and after administration of glucose and a branched-chain amino acids (BCAA), in healthy volunteers and patients with liver cirrhosis. As for the patients with liver cirrhosis, 4 were classified in Child-Pugh Grade A and the other 4 in Grade B. In patients with liver cirrhosis, the intramuscular pH and PCr index (PCr/PCr + Pi) were lower than in healthy subjects after exercise in the fasting state; the deltapH and deltaPCr index were statistically siginificant (p<0.05), indicating a disorder of aerobic metabolism. NIR revealed normality with oxygen supply and suggested a decreased oxygen utilization efficiency; that is, failure of the TCA cycle. The deltapH improved slightly after the administration of glucose alone, while it was definitely low (p<0.05) after co-administration of glucose and BCAA, which acts directly on the TCA cycle, indicating improvement of skeletal muscle energy metabolism.
Doi
Jun
J
Department of Gastroenterology, Tokai University Hachioji Hospital, Hachioji, Tokyo 192-0032, Japan.
Shiraishi
Koichi
K
Haida
Munetaka
M
Matsuzaki
Shohei
S
D000368:Aged; D000597:Amino Acids, Branched-Chain / Q000008:administration & dosage*; D016022:Case-Control Studies; D002952:Citric Acid Cycle; D004734:Energy Metabolism; D015444:Exercise; D005215:Fasting; D005260:Female; D005947:Glucose / Q000008:administration & dosage* / Q000378:metabolism; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008103:Liver Cirrhosis / Q000378:metabolism*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000378:metabolism*; D010100:Oxygen / Q000378:metabolism; D010725:Phosphocreatine / Q000378:metabolism; D019265:Spectroscopy, Near-Infrared
D000597:Amino Acids, Branched-Chain; D010725:Phosphocreatine; D005947:Glucose; D010100:Oxygen