(13)C-phenylalanine breath test correlates with liver fibrosis in postoperative biliary atresia.
BACKGROUND
Values derived from the (13)C-phenylalanine breath test (PBT) may serve as an index for liver fibrosis and clinically predictive readings for liver diseases in adults. In the present study the PBT was conducted in postoperative biliary atresia (BA) children to evaluate phenylalanine metabolism in the liver, and the results based on biochemical data, especially the index on liver fibrosis, were compared with PBT findings.


METHODS
Hepatofunctional evaluations were conducted in 10 postoperative BA children with moderate (group B; n = 4) and severe (group A; n = 6) liver dysfunction, and the PBT results were compared with those of 13 normal healthy children (group C). Subjects were orally given single-bolus (13)C-phenylalanine at 3.5 mg/kg (maximum dosing: 100 mg) in the morning. Time-related exhaled gas was periodically collected until 120 min after dosing. The (13)CO(2) levels were monitored with gas chromatography-mass spectrometry before and after administration, and the (13)C excretion rate, (13)C cumulative excretion and time of maximum (13)C excretion rate were monitored accordingly.


RESULTS
Total bile acid, hyaluronic acid, type IV collagen 7S, total bilirubin or albumin and the PBT findings were significantly correlated. The PBT findings in group A were significantly lower those of group B, indicating that phenylalanine metabolism was markedly attenuated in the former.


CONCLUSIONS
The PBT values correlated well with liver fibrosis in postoperative BA children. Because PBT is a non-invasive approach, results from this method may serve as a useful and reliable index for post-surgical monitoring of children operated on for liver fibrosis.
Division of Pediatrics, Department of Homeostatic Regulation and Development, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. nicuwada@tymc.twmu.ac.jp
Masaki
M
Wada
Yuko
Y
Wada
Makoto
M
Uchiyama
Masahiro
M
Kajiwara
Kazuhiko
K
Takatori
D000293:Adolescent; D001656:Biliary Atresia / Q000601:surgery*; D001944:Breath Tests; D002245:Carbon Dioxide / Q000032:analysis; D002247:Carbon Isotopes / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D008099:Liver / Q000378:metabolism; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000378:metabolism; D008111:Liver Function Tests; D008297:Male; D010649:Phenylalanine / Q000378:metabolism; D011184:Postoperative Period; D012016:Reference Values
D002247:Carbon Isotopes; D002245:Carbon Dioxide; D010649:Phenylalanine