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Amino acid metabolism in liver disease

Holm, Eggert; Sedlaczek, Oliver; Grips, Eva

Current Opinion in Clinical Nutrition & Metabolic Care:
Review Article

The impairment of transsulphuration during methionine degradation in hepatic failure can be counteracted by treatment with S-adenosylmethionine. Regarding the pathogenesis of hepatic encephalopathy, no convincing evidence exists for tryptophan, glutamine or glutamate being involved. Portal-systemic shunting-induced hyperammonaemia may reduce plasma branched-chain amino acids. The glucose effect on urea synthesis does not exist in cirrhosis.

Author Information

Department of Pathophysiology, Medical Clinic I Mannheim, University of Heidelberg, Germany

Correspondence to Professor Dr Eggert Holm, Department of Pathophysiology, Medical Clinic I, Theodor Kutzer Ufer, D-68167 Mannheim, Germany Tel: +49 621 3832643; fax: +49 621 3832191; e-mail:

© 1999 Lippincott Williams & Wilkins, Inc.