Carbohydrate metabolism in infants with biliary atresia.

Carbohydrate metabolism in 9 infants with biliary atresia (BA) was investigated preoperatively and during the early postoperative period when these infants were on parenteral nutrition for 7 days. Findings were compared with data on infants without liver dysfunction. Changes of plasma glucose, immunoreactive insulin (IRI) and C-peptide immunoreactivity (CPR) in the biliary atresia group with moderate liver fibrosis were the same as those in the control group. However, in one patient with marked liver fibrosis, the molar IRI/CPR ratio was significantly low, thereby suggesting an increased hepatic insulin extraction. This change, however, was transient and the molar IRI/CPR ratio gradually returned to the level of other BA patients and the control groups after the 1st postoperative day. This study shows that in infants with BA, the glucose intolerance seen in adults with obstructive jaundice is absent and the parenteral nutrition can be performed without severe changes of carbohydrate metabolism.