Clinical research on liver reserve function by 13C-phenylalanine breath test in aged patients with chronic liver diseases.
BACKGROUND
The objective of this study was to investigate whether the 13C-phenylalanine breath test could be useful for the evaluation of hepatic function in elderly volunteers and patients with chronic hepatitis B and liver cirrhosis.


METHODS
L-[1-13C] phenylalanine was administered orally at a dose of 100 mg to 55 elderly patients with liver cirrhosis, 30 patients with chronic hepatitis B and 38 elderly healthy subjects. The breath test was performed at 8 different time points (0, 10, 20, 30, 45, 60, 90, 120 min) to obtain the values of Delta over baseline, percentage 13CO2 exhalation rate and cumulative excretion (Cum). The relationships of the cumulative excretion with the 13C-%dose/h and blood biochemical parameters were investigated.


RESULTS
The 13C-%dose/h at 20 min and 30 min combined with the cumulative excretion at 60 min and 120 min correlated with hepatic function tests, serum albumin, hemoglobin, platelet and Child-Pugh score. Prothrombin time, total and direct bilirubin were significantly increased, while serum albumin, hemoglobin and platelet, the cumulative excretion at 60 min and 120 min values decreased by degrees of intensity of the disease in Child-Pugh A, B, and C patients (P < 0.01).


CONCLUSIONS
The 13C-phenylalanine breath test can be used as a non-invasive assay to evaluate hepatic function in elderly patients with liver cirrhosis. The 13C-%dose/h at 20 min, at 30 min and cumulative excretion at 60 min may be the key value for determination at a single time-point. 13C-phenylalanine breath test is safe and helpful in distinguishing different stages of hepatic dysfunction for elderly cirrhosis patients.
Zhang
Gan-sheng
GS
Department of Gastroenterology, Huadong Hospital, Fudan University, Shanghai 200040, China.
Bao
Zhi-jun
ZJ
Zou
Jian
J
Yin
Shu-ming
SM
Huang
Yi-qin
YQ
Huang
Hai
H
Qiu
De-kai
DK
D000368:Aged; D000369:Aged, 80 and over; D001944:Breath Tests / Q000379:methods*; D002247:Carbon Isotopes; D005260:Female; D019694:Hepatitis B, Chronic / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008099:Liver / Q000502:physiology*; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000503:physiopathology; D008111:Liver Function Tests / Q000379:methods* / Q000592:standards; D008297:Male; D010649:Phenylalanine
D002247:Carbon Isotopes; D010649:Phenylalanine
Am J Physiol Endocrinol Metab. 2002 Dec;283(6):E1223-31
12424105
World J Gastroenterol. 2007 Sep 14;13(34):4579-85
17729409
Am J Surg. 1997 Apr;173(4):270-3; discussion 273-4
9136778
Liver. 2001 Aug;21(4):260-5
11454189
Dig Liver Dis. 2000 Apr;32(3):226-32
10975773
Am J Physiol. 1993 Jan;264(1 Pt 1):E109-18
8430779
Aliment Pharmacol Ther. 2002 Dec;16(12):1977-96
12452932
Eur J Clin Invest. 2001 Apr;31(4):356-61
11298784
Am J Clin Nutr. 1980 Nov;33(11):2375-85
6776794
Eur Rev Med Pharmacol Sci. 2004 Jan-Feb;8(1):47-9
15209154
Hepatology. 1989 Feb;9(2):297-301
2643548
Gastroenterology. 1989 Jun;96(6):1560-5
2714580
J Surg Res. 2003 Oct;114(2):120-5
14559436
J Surg Res. 2003 Jun 1;112(1):38-42
12873431
Digestion. 2001;63(2):130-8
11244252
J Gastroenterol Hepatol. 1990 Jul-Aug;5(4):468-82
2129819
Hepatology. 1988 Sep-Oct;8(5):1079-83
3417228
Chem Pharm Bull (Tokyo). 1998 Aug;46(8):1330-2
9734317
Am J Physiol. 1994 Jul;267(1 Pt 1):E140-9
8048503
Zhonghua Gan Zang Bing Za Zhi. 2005 Dec;13(12):881-91
16491521
Pharmacotherapy. 1995 Nov-Dec;15(6):693-700
8602375
Aliment Pharmacol Ther. 2003 Jan;17(2):271-7
12534413
Chem Pharm Bull (Tokyo). 2001 Dec;49(12):1507-11
11767066
World J Gastroenterol. 2005 Jan 7;11(1):142-8
15609414
Aliment Pharmacol Ther. 2005 Apr 1;21(7):851-9
15801920
Eur J Clin Invest. 2005 Oct;35(10):644-52
16178884