title: Detection of new amino acid markers of liver trauma by proton nuclear magnetic resonance spectroscopy.
abstract: OBJECTIVE
  We examined serum in patients of liver injury to explore the possible clinical application of abnormal micrometabolites as a marker of liver injury and severity in cases of traumatic liver damage.
  
  
  METHODS
  Serum were screened by proton nuclear magnetic resonance spectroscopy in 96 patients with varying degree of liver injury and compared with concentrations in healthy control volunteers.
  
  
  RESULTS
  Large quantities of phenylalanine and tyrosine were detected by spectroscopic analysis in patients with liver injury but not in those without liver injury (P < 0.001). Proton nuclear magnetic resonance spectroscopy revealed two unique amino acids, phenylalanine and tyrosine, in the sera of the subjects with liver injury, irrespective of the extent and type of injury gauged by radiology or laparotomy. Phenylalanine spectrum was obtained in all 84 patients with liver injury (100% sensitivity) whereas tyrosine spectrum was present in 83 out of 84 patients (98.8% sensitivity) suggesting that these amino acids were specifically released in the patients of liver injury. Significant correlations were observed between phenylalanine and tyrosine concentrations and total bilirubin levels and albumin levels. Serum phenylalanine and tyrosine concentrations correlated well with imaging and laparotomy findings of liver injury.
  
  
  CONCLUSIONS
  Phenylanaline and tyrosine appear to be specific and new markers of liver injury.
authors.affiliation: Department of Surgery, King George Medical University, Lucknow, UP, India.
authors.forename: Priyadarshi
authors.initials: P
authors.lastname: Ranjan
authors.forename: Ashish
authors.initials: A
authors.lastname: Gupta
authors.forename: Sandeep
authors.initials: S
authors.lastname: Kumar
authors.forename: Gowda Ajjapa Nagan
authors.initials: GA
authors.lastname: Gowda
authors.forename: Aseem
authors.initials: A
authors.lastname: Ranjan
authors.forename: Abhinav Arun
authors.initials: AA
authors.lastname: Sonker
authors.forename: Abhijit
authors.initials: A
authors.lastname: Chandra
authors.lastname: Ramakant
mesh_terms: D000596:Amino Acids / Q000097:blood*; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D006801:Humans; D008099:Liver / Q000293:injuries*; D009682:Magnetic Resonance Spectroscopy; D010649:Phenylalanine / Q000097:blood; D012016:Reference Values; D012709:Serum Albumin / Q000378:metabolism; D014443:Tyrosine / Q000097:blood
chemical_list: D000596:Amino Acids; D015415:Biomarkers; D012709:Serum Albumin; D014443:Tyrosine; D010649:Phenylalanine; D001663:Bilirubin