13C-aminopyrine demethylation is decreased in cirrhotic patients with normal biochemical markers |
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Authors: | Paul Afolabi Mark Wright Steve A. Wootton Alan A. Jackson |
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Affiliation: | 1. National Institute for Health Research Biomedical Research Centre (Nutrition), Southampton Centre for Biomedical Research, Southampton General Hospital, Southampton, UKpra2@soton.ac.uk;3. University Hospital Southampton NHS Foundation Trust, Southampton, UK;4. National Institute for Health Research Biomedical Research Centre (Nutrition), Southampton Centre for Biomedical Research, Southampton General Hospital, Southampton, UK |
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Abstract: | This study determined the rates of 13C-aminopyrine metabolism in patients with varying degrees of liver cirrhosis as defined by clinical scores. Twenty-five cirrhotic patients and 18 healthy subjects underwent a 13C-aminopyrine breath test. The cumulative per cent dose recovery (cPDR) of 13C on breath expressed as a percentage of the administered dose at 2 h was significantly lower in cirrhotic patients than in healthy subjects (median: 1.7% versus 9.0%; p<.0001). Significant inverse associations between cPDR at 2 h and the model for end-stage liver disease score, Child–Pugh score, international normalised ratio and bilirubin (all p<.05), but not alanine aminotransferase or alkaline phosphatase were observed in the cirrhotic patients. Taking each biochemical marker independently, cirrhotic patients with normal biochemistry had a significantly lower cPDR at 2 h than healthy subjects (all p<.05). Differences in 13C-aminopyrine metabolism were evident in cirrhotic patients with less severe disease and may mark hepatic dysfunction when conventional biochemical markers appear unchanged. |
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Keywords: | biochemical markers 13C-aminopyrine breath test carbon-13 Child–Pugh score cirrhosis health hepatic function human isotope application in medicine stable isotope tracer techniques |
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