Plasma Glutamine Concentrations in Liver Failure

Higher than normal plasma glutamine concentration at admission to an intensive care unit is associated with an unfavorable outcome. Very high plasma glutamine levels are sometimes seen in both acute and chronic liver failure. We aimed to systematically explore the relation between different types of...

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Bibliographic Details
Published in:	PloS one Vol. 11; no. 3; p. e0150440
Main Authors:	Helling, Gunnel, Wahlin, Staffan, Smedberg, Marie, Pettersson, Linn, Tjäder, Inga, Norberg, Åke, Rooyackers, Olav, Wernerman, Jan
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 03-03-2016 Public Library of Science (PLoS)
Subjects:	Adolescent Adult Aged Aged, 80 and over Analysis Biology and Life Sciences Biomarkers Biomarkers - blood Development and progression End Stage Liver Disease - blood Failure Female Gastroenterology Glutamine Glutamine - adverse effects Glutamine - blood Glutamine - chemistry Hepatectomy Hepatology Hospitalization Humans Hypertension Intensive care Intensive Care Units Liver Liver diseases Liver failure Liver Failure, Acute - blood Liver transplants Longitudinal Studies Male Medical research Medicin och hälsovetenskap Medicine and Health Sciences Metabolism Middle Aged Mortality Nutrition Parenteral nutrition Patients Physical Sciences Plasma Prospective Studies Severity of Illness Index Young Adult Sweden
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Summary:	Higher than normal plasma glutamine concentration at admission to an intensive care unit is associated with an unfavorable outcome. Very high plasma glutamine levels are sometimes seen in both acute and chronic liver failure. We aimed to systematically explore the relation between different types of liver failure and plasma glutamine concentrations. Four different groups of patients were studies; chronic liver failure (n = 40), acute on chronic liver failure (n = 20), acute fulminant liver failure (n = 20), and post-hepatectomy liver failure (n = 20). Child-Pugh and Model for End-stage Liver Disease (MELD) scores were assessed as indices of liver function. All groups except the chronic liver failure group were followed longitudinally during hospitalisation. Outcomes were recorded up to 48 months after study inclusion. All groups had individuals with very high plasma glutamine concentrations. In the total group of patients (n = 100), severity of liver failure correlated significantly with plasma glutamine concentration, but the correlation was not strong. Liver failure, regardless of severity and course of illness, may be associated with a high plasma glutamine concentration. Further studies are needed to understand whether high glutamine levels should be regarded as a biomarker or as a contributor to symptomatology in liver failure.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Conceived and designed the experiments: GH SW OR JW. Performed the experiments: GH MS LP IT. Analyzed the data: GH SW MS LP IT ÅN OR JW. Contributed reagents/materials/analysis tools: MS LP OR. Wrote the paper: GH SW MS LP IT ÅN OR JW. Competing Interests: The authors have declared that no competing interests exist.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0150440