Correlation between Branched Chain Amino Acids to Tyrosine Ratio and Child Pugh Score in Liver Cirrhosis Patients

Background
: The determination of branched
chain amino acids (BCAA) to tyrosine ratio (BTR) was
available in making differentiation of chronic hepatiti
s from liver cirrhosis, because there was a strong
association between BTR and staging (fibrosis) scores. Branched chain amino acids to tyrosine ratio
have
a correlation with Fischer ratio and the examination is easier because it can be done by enzymatic
assay.
Materials and Methods:
To evaluate the correlation between BTR and Child
-
Pugh score, we examined
the
amino gram of 52 liver cirrhosis patients consisted of 26 Child
-
Pugh A, 19 Child
-
Pugh B, and 7 Child
Pugh C.
The examination of amino gram was done
by High Pressure Liquid Chromatograph (HPLC) analyzer.
Branched
chain amino acids to tyrosine ratio were compared to Child
-
Pugh score, albumin, ammonia level, number
connection test to Fischer ratio.
Results
: Significant differences in BTR among Child
-
Pu
gh A, B, C were observed (Child
-
Pugh A 7.75 + 1.2;
Child Pugh B 6.0 + 1.23 and Child Pugh C 4.38 + 3.14 (p = 0.000)). Branched chain amino acids to tyr
osine
ratio
had a weak correlation with albumin (r = 0.292; p = 0.036), ammonia level (r = 0.376; p = 0.0
06) and
strong
correlation with Fischer ratio (r = 0.818; p = 0.000). There was no significant correlation between
BTR
and number
connection test.
Conclusion
: These results showed that the determination of the molar ratio of branched chain amino acids
to
tyrosine well reflected the severity of liver cirrhosis and it can be used as a substitute of Fische
r ratio.