13C-Methacetin metabolism in patients with cirrhosis: relation to disease severity, haemoglobin content and oxygen supply

Aliment Pharmacol Ther. 2003 Jun 15;17(12):1559-62. doi: 10.1046/j.1365-2036.2003.01604.x.

Abstract

Background: Hypoxia may contribute to impairment of liver function and thus interfere with results of liver tests. In patients with cirrhosis, cytochrome P-450 mediated metabolism of substrates is facilitated in the presence of supplemental oxygen. It has not been studied how this relates to liver function and haemoglobin content.

Aim: We questioned how oxygen supplementation would influence the hepatic microsomal function as assessed by the 13C-methacetin breath test in patients with cirrhosis of different severity and different degrees of anaemia.

Methods: 13C/12C ratios in exhaled breath assessed by non-dispersive infrared spectrometry were studied in 34 patients with cirrhosis (Child A/B/C 9/17/8) after administration of 75 mg 13C-methacetin p.o. with and without oxygen inhalation (4 L/min).

Results: In patients breathing room air the total amount of 13C exhaled weakly correlated both with the Child-Pugh score (r = - 0.41, P < 0.02) and haemoglobin concentrations (r = 0.46; p = 0.006). Oxygen supplementation increased the total amount of 13C exhaled by 68 +/- 90% (P < 0.001). This effect was similar in Child-Pugh classes A (43 +/- 55%), B (83 +/- 80%) and C (66 +/- 123%) and not related to the Child-Pugh score.

Conclusions: Our results suggest that tests of microsomal liver function are independently influenced both by oxygen delivery and the Child-Pugh score.

MeSH terms

  • Acetamides / metabolism*
  • Breath Tests
  • Female
  • Hemoglobins / analysis
  • Humans
  • Hypoxia / complications
  • Hypoxia / physiopathology
  • Liver / blood supply
  • Liver Cirrhosis / metabolism*
  • Liver Cirrhosis / physiopathology
  • Male
  • Middle Aged
  • Oxygen / therapeutic use*

Substances

  • Acetamides
  • Hemoglobins
  • methacetin
  • Oxygen