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Intravenous tryptophan tolerance test for liver function.

S S Zhu1, F Hu, D G Li

  • 1Department of Medicine, 411 Hospital, PLA.

Chinese Medical Journal
|February 1, 1990
PubMed
Summary
This summary is machine-generated.

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The intravenous tryptophan tolerance test (ITrpTT) shows promise for assessing liver function by measuring tryptophan metabolism. This sensitive test can detect various liver diseases, but interpretation requires considering confounding factors.

Area of Science:

  • Biochemistry
  • Hepatology
  • Clinical Diagnostics

Background:

  • Tryptophan (Trp) is extensively metabolized by the liver (95%).
  • Altered tryptophan metabolism is indicative of liver dysfunction.
  • Conventional liver function tests may lack sensitivity in early-stage disease.

Purpose of the Study:

  • To develop and validate an intravenous tryptophan tolerance test (ITrpTT) for assessing liver function.
  • To establish normal reference ranges for serum free and total tryptophan levels post-infusion.
  • To evaluate the diagnostic accuracy of ITrpTT in patients with different liver diseases.

Main Methods:

  • Administered an intravenous loading dose of 4 mg/kg body weight of tryptophan.
  • Measured serum free (F) and total (T) tryptophan levels at 45 and 60 minutes post-dose.

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  • Defined upper normal limits for F45(60), T45(60), and the F/T ratio.

    • Main Results:

    • Established normal cutoffs: F45(60) ≤ 7 μmol/L, T45(60) ≤ 80 μmol/L, F/T ratio ≤ 0.14.
    • ITrpTT abnormal in 87.5% of chronic persistent hepatitis (elevated T45(60)).
    • ITrpTT abnormal in 100% of chronic active hepatitis (elevated F45(60) and/or T45(60)).
    • ITrpTT abnormal in 100% of hepatic cirrhosis (elevated F45(60), F/T ratio).

    Conclusions:

    • The ITrpTT demonstrates high sensitivity for detecting liver dysfunction across various hepatic diseases.
    • ITrpTT shows potential as a more sensitive diagnostic tool compared to conventional liver function tests.
    • Interpretation requires careful consideration of factors influencing tryptophan metabolism (e.g., exercise, alcohol, corticosteroids).