Abnormality of energy metabolism in the skeletal muscle of patients with liver cirrhosis and changes under administration of glucose and branched-chain amino acids.

We assessed changes in skeletal muscle energy metabolism by 31P-magnetic resonance spectroscopy (31P-MRS) and oxygen supply by near-infrared spectroscopy (NIR), after exercise and after administration of glucose and a branched-chain amino acids (BCAA), in healthy volunteers and patients with liver cirrhosis. As for the patients with liver cirrhosis, 4 were classified in Child-Pugh Grade A and the other 4 in Grade B. In patients with liver cirrhosis, the intramuscular pH and PCr index (PCr/PCr + Pi) were lower than in healthy subjects after exercise in the fasting state; the deltapH and deltaPCr index were statistically siginificant (p<0.05), indicating a disorder of aerobic metabolism. NIR revealed normality with oxygen supply and suggested a decreased oxygen utilization efficiency; that is, failure of the TCA cycle. The deltapH improved slightly after the administration of glucose alone, while it was definitely low (p<0.05) after co-administration of glucose and BCAA, which acts directly on the TCA cycle, indicating improvement of skeletal muscle energy metabolism.