Gentile S, Persico M, Orlando C, Le Grazie C, Di Padova C, Coltorti M
Istituto di Medicina Generale e Metodologia Clinica, I Facoltà di Medicina, Napoli, Italy.
Scand J Clin Lab Invest. 1988 Oct;48(6):525-9. doi: 10.3109/00365518809085768.
S-adenosyl-L-methionine (SAMe) has been shown to increase hepatocyte membrane fluidity thereby relieving signs of oestrogen-induced cholestasis. S-adenosyl-L-methionine might therefore prove effective in improving the efficiency of the transport of organic anions such as nicotinic acid (NA) and bilirubin which is impaired in Gilbert's syndrome (GS). In this study the effects on the metabolization rate of NA and bilirubin of two dosages of SAMe were evaluated in respect to placebo in ten male inpatients (mean age 24 years, range 16-31) with GS. Each patient received both SAMe (800 and 200 mg/day, respectively) and placebo treatment i.v. over a period of 10 days. The NA test (5.9 mumol/kg b.w. i.v.) was carried out in the same volunteers after each treatment. Unconjugated bilirubin (UCB) levels were significantly lower (p less than 0.01) after 800 mg/day SAMe than after placebo while the lower dosage of SAMe did not affect UCB values. The bilirubin time curve concentration, expressed as area under the curve (AUC), was significantly reduced (p less than 0.01) after 800 mg SAMe in comparison with the values obtained after placebo and 200 mg SAMe. Also plasma NA half-life was significantly reduced (p less than 0.01) by the higher dose of SAMe in respect to placebo and not by the lower dose.
S-腺苷-L-蛋氨酸（SAMe）已被证明可增加肝细胞膜流动性，从而缓解雌激素诱导的胆汁淤积症状。因此，S-腺苷-L-蛋氨酸可能在改善吉尔伯特综合征（GS）中受损的有机阴离子如烟酸（NA）和胆红素的转运效率方面有效。在本研究中，针对10名患有GS的男性住院患者（平均年龄24岁，范围16 - 31岁），评估了两种剂量的SAMe相对于安慰剂对NA和胆红素代谢率的影响。每位患者在10天内静脉接受SAMe（分别为800和200毫克/天）和安慰剂治疗。在每次治疗后，对相同的志愿者进行NA测试（静脉注射5.9微摩尔/千克体重）。800毫克/天SAMe治疗后的未结合胆红素（UCB）水平显著低于安慰剂治疗后（p < 0.01），而较低剂量的SAMe对UCB值无影响。与安慰剂和200毫克SAMe治疗后获得的值相比，800毫克SAMe治疗后的胆红素时间曲线浓度（以曲线下面积表示，AUC）显著降低（p < 0.01）。较高剂量的SAMe相对于安慰剂也显著降低了血浆NA半衰期（p < 0.01），而较低剂量则无此作用。
