抄録
Measurements of the concentration of pyruvate, lactate, citrate, α-ketoglutarate, NEFA, glucose and IRI in blood of patients with liver diseases including acute hepatitis (icteric phase and convalescence), chronic hepatitis (active and inactive form), cirrhosis of the liver, fatty liver and diabetes mellitus revealed the following:
1) The enzymatically determined fasting value of blood pyruvate increased significantly in patients with acute hepatitis (icteric phase and convalscence), chronic hepatitis (inactive form), fatty liver and cirrhosis of the liver (types A, A' and B), confirming the reported results obtained by colorimetric analysis.
2) The increased blood pyruvate level was not necessarily associated with further pronounced increase in 30 or 60 minutes after a 30g oral glucose load. The case with a high fasting pyruvate level, except for acute hepatitis (icteric phase) and cirrhosis of the liver, showed rather a decrease in pyruvate concentration at 120 minutes of the glucose load below the fasting level. Therefore, the increased fasting pyruvate value associated with its decrease below the fasting level at 120 minutes after the glucose load was characteristic of the patients with acute hepatitis (convalescence), chronic hepatitis (inactive form) and fatty liver, and the high fasting pyruvate value associated with its retarded restoration to the fasting or normal 120-minute level after the glucose load was characteristic of the patients with acute hepatitis (icteric phase) and was also found in cirrhosis of the liver and diabetes mellitus. A normal fasting pyruvate value and a higher 120-minute level than the fasting was frequently seen in patients with diabetes mellitus, chronic hepatitis (active form) and cirrhosis of the liver.
3) These results together with the result of other blood metabolites estimation suggest that the relative rate of increased pyruvate production from glycogen (in fasting) or glucose (in glucose load) to impairment in pyruvate metabolism in mitochondria is important in the control of blood pyruvate levels in liver diseases.
