Splanchnic and leg exchange of free fatty acids in patients with liver cirrhosis

Splanchnic and leg exchange of free fatty acids (FFA), glycerol and ketone bodies, as well as FFA turnover, were determined in the post-absorptive state in 8 patients with liver cirrhosis and in 6 healthy control subjects. The catheter technique was used together with tracer ([14C]oleate) infusion. The arterial concentrations of FFA, glycerol and ketone bodies were 2-6-fold higher in the patients than in the controls. The FFA turnover was 230% greater in the patients, while the fractional turnover was similar in the two groups. In the splanchnic region as well as in the leg, both FFA uptake and release were increased 2-4-fold in the patients. The fractional uptake of FFA was reduced in both areas, indicating that the augmented uptake was due to the high circulating FFA levels alone. The splanchnic production of ketone bodies was four times higher in the patients than in the controls (295 +/- 30 vs 87 +/- 11 mumol/min). The fraction of FFA converted to ketone bodies was greater (42 +/- 6 vs 20 +/- 5%, P less than 0.05), indicating that the accelerated ketone body production was a combined effect of raised FFA uptake and altered intrahepatic metabolism of FFA. The splanchnic production of glucose was reduced by approximately 50% in the patients, while the uptake of glycerol was augmented. The leg uptake of 3-hydroxybutyrate was increased 300% and the release of glycerol was 200% greater in the patients.(ABSTRACT TRUNCATED AT 250 WORDS)