Albumin and fibrinogen synthesis rates in advanced chronic liver disease

Am J Physiol Gastrointest Liver Physiol. 2023 Aug 22. doi: 10.1152/ajpgi.00072.2023. Online ahead of print.ABSTRACTSynthesis of plasma proteins is an important function of the liver that has sparsely been investigated by modern techniques in patients with advanced chronic liver disease (CLD). Twenty-eight well-characterized patients with CLD under evaluation for liver transplantation were included. Albumin and fibrinogen synthesis rates were measured by the flooding dose technique using stable isotope labelled phenylalanine. Transcapillary escape rate of albumin and plasma volume were assessed by radio-iodinated human serum albumin. The absolute albumin synthesis rates were low (65 mg/kg/day, range 32-203), and associated with impaired liver function, as reflected by the risk-scores Child-Pugh (p = 0.025) and Model for End-stage Liver Disease rs = -0.62, p=0.0005. The fibrinogen synthesis rate (12.8 mg/kg/day, range 2.4-52.9) was also negatively associated with liver function. The synthesis rates of albumin and fibrinogen were positively correlated. Plasma volume was high (51 ± 9 mL/kg body weight), which contributed to an almost normal intravascular albumin mass despite low plasma concentration. Autoimmune inflammatory etiologies to CLD were associated with higher fibrinogen synthesis. De novo synthesis rates of albumin and fibrinogen in advanced chronic liver failure were negatively correlated to prognostic scores of liver disease. Albumin synthesis rate was low and associ...
Source: American Journal of Physiology. Gastrointestinal and Liver Physiology - Category: Physiology Authors: Source Type: research