Plasma Amino Acid Concentrations Predict Mortality in Patients with End-Stage Liver Disease.
The liver plays a key role in amino acid metabolism. In former studies, a ratio between branched-chain and aromatic amino acids (Fischer's ratio) revealed associations with hepatic encephalopathy. Furthermore, low concentrations of branched-chain amino acids were linked to sarcopenia in literat...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2016-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4943589?pdf=render |
| _version_ | 1818477119529811968 |
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| author | Benedict Kinny-Köster Michael Bartels Susen Becker Markus Scholz Joachim Thiery Uta Ceglarek Thorsten Kaiser |
| author_facet | Benedict Kinny-Köster Michael Bartels Susen Becker Markus Scholz Joachim Thiery Uta Ceglarek Thorsten Kaiser |
| author_sort | Benedict Kinny-Köster |
| collection | DOAJ |
| description | The liver plays a key role in amino acid metabolism. In former studies, a ratio between branched-chain and aromatic amino acids (Fischer's ratio) revealed associations with hepatic encephalopathy. Furthermore, low concentrations of branched-chain amino acids were linked to sarcopenia in literature. Encephalopathy and sarcopenia are known to dramatically worsen the prognosis. Aim of this study was to investigate a complex panel of plasma amino acids in the context of mortality in patients with end-stage liver disease.166 patients evaluated for orthotopic liver transplantation were included. 19 amino acids were measured from citrated plasma samples using mass spectrometry. We performed survival analysis for plasma amino acid constellations and examined the relationship to established mortality predictors.33/166 (19.9%) patients died during follow-up. Lower values of valine (p<0.001), Fischer's ratio (p<0.001) and valine to phenylalanine ratio (p<0.001) and higher values of phenylalanine (p<0.05) and tyrosine (p<0.05) were significantly associated with mortality. When divided in three groups, the tertiles discriminated cumulative survival for valine (p = 0.016), phenylalanine (p = 0.024) and in particular for valine to phenylalanine ratio (p = 0.003) and Fischer's ratio (p = 0.005). Parameters were also significantly correlated with MELD and MELD-Na score.Amino acids in plasma are valuable biomarkers to determine increased risk of mortality in patients with end-stage liver disease. In particular, valine concentrations and constellations composed of branched-chain and aromatic amino acids were strongly associated with prognosis. Due to their pathophysiological importance, the identified amino acids could be used to examine individual dietary recommendations to serve as potential therapeutic targets. |
| first_indexed | 2024-12-10T09:34:05Z |
| format | Article |
| id | doaj.art-ab30a972dd9646b49d6160f7fb5a1ea3 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-10T09:34:05Z |
| publishDate | 2016-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-ab30a972dd9646b49d6160f7fb5a1ea32022-12-22T01:54:14ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01117e015920510.1371/journal.pone.0159205Plasma Amino Acid Concentrations Predict Mortality in Patients with End-Stage Liver Disease.Benedict Kinny-KösterMichael BartelsSusen BeckerMarkus ScholzJoachim ThieryUta CeglarekThorsten KaiserThe liver plays a key role in amino acid metabolism. In former studies, a ratio between branched-chain and aromatic amino acids (Fischer's ratio) revealed associations with hepatic encephalopathy. Furthermore, low concentrations of branched-chain amino acids were linked to sarcopenia in literature. Encephalopathy and sarcopenia are known to dramatically worsen the prognosis. Aim of this study was to investigate a complex panel of plasma amino acids in the context of mortality in patients with end-stage liver disease.166 patients evaluated for orthotopic liver transplantation were included. 19 amino acids were measured from citrated plasma samples using mass spectrometry. We performed survival analysis for plasma amino acid constellations and examined the relationship to established mortality predictors.33/166 (19.9%) patients died during follow-up. Lower values of valine (p<0.001), Fischer's ratio (p<0.001) and valine to phenylalanine ratio (p<0.001) and higher values of phenylalanine (p<0.05) and tyrosine (p<0.05) were significantly associated with mortality. When divided in three groups, the tertiles discriminated cumulative survival for valine (p = 0.016), phenylalanine (p = 0.024) and in particular for valine to phenylalanine ratio (p = 0.003) and Fischer's ratio (p = 0.005). Parameters were also significantly correlated with MELD and MELD-Na score.Amino acids in plasma are valuable biomarkers to determine increased risk of mortality in patients with end-stage liver disease. In particular, valine concentrations and constellations composed of branched-chain and aromatic amino acids were strongly associated with prognosis. Due to their pathophysiological importance, the identified amino acids could be used to examine individual dietary recommendations to serve as potential therapeutic targets.http://europepmc.org/articles/PMC4943589?pdf=render |
| spellingShingle | Benedict Kinny-Köster Michael Bartels Susen Becker Markus Scholz Joachim Thiery Uta Ceglarek Thorsten Kaiser Plasma Amino Acid Concentrations Predict Mortality in Patients with End-Stage Liver Disease. PLoS ONE |
| title | Plasma Amino Acid Concentrations Predict Mortality in Patients with End-Stage Liver Disease. |
| title_full | Plasma Amino Acid Concentrations Predict Mortality in Patients with End-Stage Liver Disease. |
| title_fullStr | Plasma Amino Acid Concentrations Predict Mortality in Patients with End-Stage Liver Disease. |
| title_full_unstemmed | Plasma Amino Acid Concentrations Predict Mortality in Patients with End-Stage Liver Disease. |
| title_short | Plasma Amino Acid Concentrations Predict Mortality in Patients with End-Stage Liver Disease. |
| title_sort | plasma amino acid concentrations predict mortality in patients with end stage liver disease |
| url | http://europepmc.org/articles/PMC4943589?pdf=render |
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