Serum free fatty acid concentration as a surrogate marker for serum carnitine status in patients with liver cirrhosis

Abstract

Aim: Carnitine (CA) is essential for β-oxidation of long-chain fatty acid in mitochondrial matrix in the muscle, liver and kidney. Although liver cirrhosis (LC) may present secondary CA deficiency caused by disturbed biosynthesis in the liver, inadequate food intake and muscle atrophy. Although renal dysfunction has been known to be associated with the CA dynamics, the CA status in the blood in LC patients has not been fully studied, at least in part, because expensive cost of CA measurement. Therefore, we tried to find an alternative parameter reflecting the serum CA status in patients with LC. Subjects and methods: Sixty-two patients with LC (male 41, female 21, age between 35 and 80, etiologies; HBV 5, HCV 26, HCV+Alcohol 2, Alcohol 18, nonBnonC 5, NASH 3, PBC 1, AIH 1, cryptogenic 1) were evaluated the CA status in the blood. Serum CA [total CA (T-CA), free-CA (F-CA) and acyl-CA (Ac-CA)] levels were determined using the enzymatic cycling method (KAINOS Laboratories Inc., Tokyo, Japan). Liver function tests including prothrombin time, ammonia, urea nitrogen, creatinine and free fatty acid (FAA) were measured simultaneously. Results: Serum T-CA, F-CA and Ac-CA levels showed no correlations with the parameters of liver function test except serum creatinine. In contrast, serum FFA levels showed positive correlations with Ac-CA level and with the Ac-CA/T-CA ratio. Conclusion: The serum FAA levels may be potentially useful as a parameter reflecting abnormal status of serum CA in patients with LC.