title: Impaired homocysteine transsulfuration is an indicator of alcoholic liver disease.
abstract: OBJECTIVE
  Although abnormal hepatic methionine metabolism plays a central role in the pathogenesis of experimental alcoholic liver disease (ALD), its relationship to the risk and severity of clinical ALD is not known. The aim of this clinical study was to determine the relationship between serum levels of methionine metabolites in chronic alcoholics and the risk and pathological severity of ALD.
  
  
  METHODS
  Serum levels of liver function biochemical markers, vitamin B6, vitamin B12, folate, homocysteine, methionine, S-adenosylmethionine, S-adenosylhomocysteine, cystathionine, cysteine, alpha-aminobutyrate, glycine, serine, and dimethylglycine were measured in 40 ALD patients, of whom 24 had liver biopsies, 26 were active drinkers without liver disease, and 28 were healthy subjects.
  
  
  RESULTS
  Serum homocysteine was elevated in all alcoholics, whereas ALD patients had low vitamin B6 with elevated cystathionine and decreased alpha-aminobutyrate/cystathionine ratios, consistent with decreased activity of vitamin B6 dependent cystathionase. The alpha-aminobutyrate/cystathionine ratio predicted the presence of ALD, while cystathionine correlated with the stage of fibrosis in all ALD patients.
  
  
  CONCLUSIONS
  The predictive role of the alpha-aminobutyrate/cystathionine ratio for the presence of ALD and the correlation between cystathionine serum levels with the severity of fibrosis point to the importance of the homocysteine transsulfuration pathway in ALD and may have important diagnostic and therapeutic implications.
authors.affiliation: Department of Internal Medicine, University of California Davis, Sacramento, CA 95817, USA. valentina.medici@ucdmc.ucdavis.edu
authors.forename: Valentina
authors.initials: V
authors.lastname: Medici
authors.forename: Janet M
authors.initials: JM
authors.lastname: Peerson
authors.forename: Sally P
authors.initials: SP
authors.lastname: Stabler
authors.forename: Samuel W
authors.initials: SW
authors.lastname: French
authors.forename: Jesse F
authors.initials: JF
authors.lastname: Gregory
authors.forename: Maria Catrina
authors.initials: MC
authors.lastname: Virata
authors.forename: Antony
authors.initials: A
authors.lastname: Albanese
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Bowlus
authors.forename: Sridevi
authors.initials: S
authors.lastname: Devaraj
authors.forename: Edward A
authors.initials: EA
authors.lastname: Panacek
authors.forename: Nazir
authors.initials: N
authors.lastname: Rahim
authors.forename: John R
authors.initials: JR
authors.lastname: Richards
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Rossaro
authors.forename: Charles H
authors.initials: CH
authors.lastname: Halsted
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000097:blood; D000613:Aminobutyrates / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003540:Cystathionine / Q000097:blood; D018450:Disease Progression; D005260:Female; D006710:Homocysteine / Q000097:blood* / Q000737:chemistry; D006801:Humans; D008099:Liver / Q000473:pathology; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood / Q000473:pathology; D008108:Liver Diseases, Alcoholic / Q000097:blood* / Q000473:pathology; D008297:Male; D008715:Methionine / Q000097:blood; D008875:Middle Aged; D013455:Sulfur / Q000737:chemistry; D055815:Young Adult
chemical_list: D000613:Aminobutyrates; D015415:Biomarkers; D006710:Homocysteine; D003540:Cystathionine; D013455:Sulfur; C012223:alpha-aminobutyric acid; D008715:Methionine