Glucagon-induced alterations of plasma levels of cyclic AMP and glucose in patients with liver disease.

Following an intravenous bolus of 1 mg glucagon plasma level time profiles of glucagon, cyclic AMP and glucose were monitored for two hours in 6 healthy adult volunteers, 6 patients with decompensated cirrhosis, 6 patients with acute viral hepatitis and at recovery, 6 patients with extrahepatic and 4 patients with intrahepatic cholestasis. Elimination half-livers of glucagon (controls = 22.5 +/- 5.6 min) were significantly prolonged in patients with cirrhosis (52.2 +/- 30.8 min) amd acute hepatitis (58.6 +/- 26.3 min). The glucagon - induced rise in cyclic AMP was similar in all subjects but independent of the phase of the hepatitis (acute or recovery) maximal cyclic AMP values were significantly higher in those patients compared to controls. In contrast glucose response was much lower (p less than 0.001) in patients with hepatitis (acute and recovery). All measured parameters, demonstrated considerable individual variations and a large overlap between the different groups of subjects. Therefore it is concluded that these observations negate the diagnostic and functional usefulness of the glucagon test as a predictive liver function index.