[Effects of discontinuous intravenous infusion of ramified amino acids on blood insulin, blood glucagon and protein metabolism in cirrhotic patients after 10 days. Results of a controlled comparative study with sorbitol].

In order to evaluate the effects of ramified amino acids on insulinaemia, glucagonaemia and protein metabolism, a 3-hour infusion of ramified amino acids (24 g in a 750 ml solution) was given daily during 10 days to 10 cirrhotic patients without hepatic encephalopathy (group I). Changes between the first and tenth day in plasma concentrations of plasma insulin, glucagon, ammonium, ramified and aromatic amino acids and 3 proteins (albumin, prealbumin and transferrin) markers of protein malnutrition were measured comparatively with 10 other cirrhotic patients who received daily a 750 ml infusion of 5 p. 100 sorbitol (group II). The patients, who had been randomized to group I or II, had à 2,200 calorie/day diet representing a 6 to 12 g nitrogen intake. The ramified amino acid infusions were well tolerated. They produced a significant (p less than 0.001) increase in glucagonaemia without significant change in insulinaemia, and a non-significant decrease of the plasma insulin/glucagon molar ratio. The arterial blood ammonium level was significantly (p less than 0.05) lowered in group I as compared to group II. The plasma ramified/aromatic amino acid molar ratio significantly (p less than 0.01) increased in group I but did not reach normal values; this increase was not significant when compared to group II. Finally, plasma concentrations of the 3 proteins indicating protein malnutrition remained low in both groups. These results suggest that daily intravenous administration of ramified amino acids for 10 days, to supplement a conventional diet failed to correct the protein hypercatabolism associated with cirrhosis; induced, however, a decrease in arterial blood ammonium levels.(ABSTRACT TRUNCATED AT 250 WORDS)