ABSTRACT
The free amino acid levels in plasma of 24 chronic liver disease patient with chronic active hepatitis, cirrhosis and hepatoma and in 10 patients with acute hepatitis as well as 10 healthy controls were measured using high performance liquid chromatography. The aim of this work was to detect the free amino acid pattern in each group, to study the level of the molar ratio of branched chain amino acids, to aromatic amino acids, to correlate this ratio with conventional liver function tests and to detect its role in discrimination between chronic active hepatitis and cirrhosis. Plasma chromatograms of amino acids revealed significant increased fasting levels of aromatic amino acids and methionine in all chronic groups versus control group, while branched chain amino acids were significantly decreased. The mean molar ratio of branched chain amino acids/aromatic amino acids was 2.59, 1.43, 1.94 and 4.48 in chronic active hepatitis, cirrhosis, hepatoma and controls respectively. All groups showed significant difference compared with the controls [p<0.001]. The mean molar ratio of cirrhotic patients was significantly decreased compared to chronic active hepatitis [CAH] [p<0.001]. The molar ratio correlated significantly with albumin [r=0.73] and showed a significant negative correlation with aspartate aminotransferase in cirrhotic patients [r=0.62]. A decreased molar ratio was also detected in acute liver disease in comparison with the control group [p<0.001]. We concluded that the mean molar ratio decreases in chronic and acute liver disease. It correlates well with the synthetic capacity of the liver as indicated by albumin and correlates negatively with parenchymal damage as indicated by aspartate aminotransferase. It can be used as a useful indicator in discrimination between chronic active hepatitis and cirrhosis