Hepatic antipyrine metabolism in malnourished patients: influence of the type of malnutrition and course after nutritional rehabilitation.

The present study of hepatic mixed function oxidase activity was carried out by determining antipyrine clearance in 49 patients presenting with energy malnutrition (group E, n = 26) or global protein-calorie malnutrition (group P, n = 23). A control group (group C, n = 25) was composed of subjects with good nutritional status. The metabolic clearance rate and weight-corrected clearance in group P were significantly lower than those in groups E and C. The weight clearances in the latter two groups were not significantly different, suggesting that mixed function oxidase activity decreases only in protein-calorie malnutrition. Antipyrine clearance was studied again in 27 patients after nutritional rehabilitation with artificial nutrition for 31 +/- 4 days (means +/- SEM). Concomitant with an improvement in nutritional state, clearances tended towards normal values in group P (n = 17) and were not significantly modified in group E (n = 10). It is thus important to take the type of malnutrition into account in pharmacological studies of malnourished humans in order to correctly adapt therapeutic doses.