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Liver Diseases

  • Martin H. Floch
Part of the Topics in Gastroenterology book series (TGEN)

Abstract

The liver is a pivotal organ in human nutrition. It modifies much of the nutrient material it receives through the portal circulation, it adds significantly to the intraluminal digestive process through bile secretion, and it has an important hormonal or humoral effect via feedback mechanisms such as exist in cholesterol and bile acid metabolism. There are undoubtedly many other nutritional systems it affects that are yet not fully understood. When the liver becomes diseased, these functions may be affected. A full text would be required to describe completely the biochemical role of the liver. In this chapter, an attempt is made to describe some major biochemical phenomena that are affected by disease and treatable by diet modifications.

Keywords

Liver Disease Fatty Liver Chronic Liver Disease Hepatic Encephalopathy Alcoholic Hepatitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Newsholme TA: Role of the liver in integration of fat and carbohydrate metabolism and clinical implications in patients with liver disease, in Popper H, Schaffner F (eds): Progress in Liver Disease. New York: Grune & Stratton, 1976, vol V.Google Scholar
  2. 2.
    Unger RH, Orco L: The essential role of glucagon in the pathogenesis of diabetes mellitus. Lancet 1: 14, 1975.CrossRefGoogle Scholar
  3. 3.
    Tranquada R: Lactic acidosis. Calif Med 101: 450, 1964.Google Scholar
  4. 4.
    Owen OE, Morgan AP, Kemp HG, et al: Brain metabolism during fasting. J Clin Invest 46: 1589, 1967.CrossRefGoogle Scholar
  5. 5.
    Record CO, Alberti KGMM, Williamson DH, et al: Glucose tolerance and metabolic changes in human viral hepatitis. Clin Sci 45: 677, 1973.Google Scholar
  6. 6.
    Alberti KGMM, Record CO, Williamson DH, et al: Metabolic changes in active chronic hepatitis. Clin Sci 42: 591, 1972.Google Scholar
  7. 7.
    Rehfeld JF, Juhl E, Hilden M: Carbohydrate metabolism in alcohol-induced fatty liver. Gastroenterology 64: 445, 1973.Google Scholar
  8. 8.
    Berkowitz D: Glucose tolerance, free fatty acid and serum insulin responses in patients with cirrhosis. Am J Dig Dis 14: 691, 1969.CrossRefGoogle Scholar
  9. 9.
    Holdsworth CD, Nye L, King E: The effect of portacaval anastomosis on oral carbohydrate tolerance and on plasma insulin levels. Gut 13: 58, 1972.CrossRefGoogle Scholar
  10. 10.
    Megyesi C, Samols E, Marks V: Glucose tolerance and diabetes in chronic liver disease. Lancet 2: 1051, 1967.CrossRefGoogle Scholar
  11. 11.
    Johnson DG, Alberti KGMM, Faber OK, et al: Hyperinsulinism of hepatic cirrhosis. Diminished degradation or hypersecretion. Lancet 1: 10, 1977.CrossRefGoogle Scholar
  12. 12.
    Hoyumpa AM Jr, Greene HL, Dunn GD, et al: Fatty liver: Biochemical and clinical considerations. Am J Dig Dis 20: 1142, 1975.CrossRefGoogle Scholar
  13. 13.
    Jenkins DJA, Leeds AR, Gassull MA, et al: Decrease in postprandial insulin and glucose concentration by guar and pectin. Ann Intern Med 86: 20, 1977.Google Scholar
  14. 14.
    Miller LL, Whipple GH: Liver injury, liver protection, and sulfur metabolism: Methionine protects against chloroform liver injury even after anesthesia. JExp Med 76: 421, 1942.CrossRefGoogle Scholar
  15. 15.
    Gabuzda GJ, Shear L: Metabolism of dietary protein in hepatic cirrhosis. Am J Clin Nutr 23: 479, 1970.Google Scholar
  16. 16.
    Lieber CS: Pathogenesis and early diagnosis of alcoholic liver injury. N Engl J Med 298: 888, 1978.CrossRefGoogle Scholar
  17. 17.
    Rothschild MA, Oratz M, Schreiber SS: Regulation of albumin metabolism. Annu Rev Med 26: 91, 1975.CrossRefGoogle Scholar
  18. 18.
    Peters T Jr: Serum albumin. Adv Clin Chem 13: 37, 1970.CrossRefGoogle Scholar
  19. 19.
    Rothschild MA, Oratz M, Schreiber SS: Serum albumin. Am J Dig Dis 14: 711, 1969.CrossRefGoogle Scholar
  20. 20.
    Schultze HE, Heremans JE: Molecular Biology of Human Proteins. New York: Elsevier, 1966.Google Scholar
  21. 21.
    Rothschild MA, Oratz M, Schreiber SS: Albumin metabolism. Gastroenterology 64: 324, 1973.Google Scholar
  22. 22.
    Waterlow JC: Observations on the mechanism of adaptation to low protein intake. Lancet 2: 1091, 1968.CrossRefGoogle Scholar
  23. 23.
    Wilkinson P, Mendenhall CL: Serum albumin turnover in normal subjects and patients with cirrhosis measured by I-labeled human albumin. Clin Sci 25: 281, 1963.Google Scholar
  24. 24.
    Tullis JL: Albumin. 1. Background and use. JAMA 237: 355, 1977.CrossRefGoogle Scholar
  25. 25.
    Tullis JL: Albumin. 2. Guidelines for clinical use. JAMA 237: 460, 1977.CrossRefGoogle Scholar
  26. 26.
    Soeters PB, Fischer JE: Insulin, glucagon, amino acid imbalance and hepatic encephalopathy. Lancet 2: 880, 1976.CrossRefGoogle Scholar
  27. 27.
    Baker AL: Amino acids in liver disease: A cause of hepatic encephalopathy? JAMA 242: 355, 1979.CrossRefGoogle Scholar
  28. 28.
    Freund H, Yoshimura N, Fischer JE: Chronic hepatic encephalopathy. Long-term therapy with a branched-chain amino acid-enriched elemental diet. JAMA 242: 347, 1979.CrossRefGoogle Scholar
  29. 29.
    Morgan MY, Milson JP, Sherlock S: Plasma ratio of valine, leucine and isoleucine to phenylalanine and tyrosine in liver disease. Gut 19: 1068, 1978.CrossRefGoogle Scholar
  30. 30.
    Rudman MD, Smith RB III, Salam AA, et al: Ammonia content of food. Am J Clin Nutr 26: 487, 1973.Google Scholar
  31. 31.
    Fenton JCB, Knight EJ, Humpherson PL: Milk and cheese diet in portal-systemic encephalopathy. Lancet 1: 164, 1966.CrossRefGoogle Scholar
  32. 32.
    Greenberger NJ, Carley J, Schenker S, et al: Effect of vegetable and animal protein diets in chronic hepatic encephalopathy. Am JDig Dis 22: 845, 1977.CrossRefGoogle Scholar
  33. 33.
    Leevy CM, Baker H, Tenhove W, et al: B-complex vitamins in liver disease of the alcoholic. Am J Clin Nutr 16: 339, 1965.Google Scholar
  34. 34.
    Klipstein FA, Lindenbaum J: Folate deficiency in chronic liver disease. Blood 25: 443, 1965.Google Scholar
  35. 35.
    Lindcheer WG: Malabsorption in cirrhosis. Am J Clin Nutr 23: 448, 1970.Google Scholar
  36. 36.
    Halsted CH, Robles EA, Mezey E: Decreased jejunal uptake of labeled folic acid (H-PGA) in alcoholic patients: Roles of alcohol and nutrition. Nengljmed 285: 701, 1971.CrossRefGoogle Scholar
  37. 37.
    Halsted CH, Robles EA, Mezey E: Intestinal malabsorption in folate-deficient alcoholics. Gastroenterology 64: 526, 1973.Google Scholar
  38. 38.
    Leevy CM, Tamburro C, Smith F: Alcoholism, drug addiction, and nutrition. Med Clin North Am 54: 1567, 1970.Google Scholar
  39. 39.
    Baker H, Frank O, Zetterman RK, et al: Inability of chronic alcoholics with liver disease to use food as a source of folates, thiamin, and vitamin Be. Am J Clin Nutr 28: 1377, 1975.Google Scholar
  40. 40.
    Sun DCH, Albacete RA, Chen JK: Malabsorption studies in cirrhosis of the liver. Arch Intern Med 119: 567, 1967.CrossRefGoogle Scholar
  41. 41.
    Marin GA, Clark ML, Senior JR: Studies of malabsorption occurring in patients with Laennec’s cirrhosis. Gastroenterology 56: 727, 1969.Google Scholar
  42. 42.
    Leevy CM, Thompson A, Baker H: Vitamins and liver injury. Am J Clin Nutr 23: 4, 1970.Google Scholar
  43. 43.
    Morgan AG, Kelleher J, Walker BE, et al: Nutrition in cryptogenic cirrhosis and chronic aggressive hepatitis. Gut 17: 113, 1976.CrossRefGoogle Scholar
  44. 44.
    Smith FR, Goodman DS: The effects of diseases of the liver, thyroid, and kidneys on the transport of vitamin A in human plasma. J Clin Invest 50: 2426, 1971.CrossRefGoogle Scholar
  45. 45.
    Carney MWP: Serum folate and cyanocobalamin in alcoholics. Q J Stud Alcohol 31: 816, 1970.Google Scholar
  46. 46.
    Cowling DC, Mackay IR: Serum vitamin B12 levels in liver disease. Med Jaust 2: 558, 1959.Google Scholar
  47. 47.
    Shapiro SS: Disorders of the vitamin K-dependent coagulation factors, in Williams WJ, et al (eds): Hematology, ed 2. New York: McGraw-Hill Book Co, 1977.Google Scholar
  48. 48.
    Sherlock S: Diseases of the Liver and Biliary System, ed 5. Oxford: Blackwell Scientific Publications, 1975.Google Scholar
  49. 49.
    Wacker WEC, Parisi AF: Magnesium metabolism. Nengljmed 278: 712, 1968.CrossRefGoogle Scholar
  50. 50.
    Lim P, Jacob E: Magnesium deficiency in liver cirrhosis. Q JMed 41: 291, 1972.Google Scholar
  51. 51.
    Hersh T, Siddiqui DA: Magnesium and the pancreas. Am J Clin Nutr 26: 362, 1973.Google Scholar
  52. 52.
    Vallee BL, Wacker WEC, Bartholomay AF, et al: Zinc metabolism in hepatic dysfunction. Serum zinc concentrations in Laennec’s cirrhosis and their validation by sequential analysis. N Engl J Med 256: 403, 1956.CrossRefGoogle Scholar
  53. 53.
    Vallee BL, Wacker WEC, Bartholomay AF, et al: Zinc metabolism in hepatic dysfunction. II. Correlation of metabolic patterns with biochemical findings. Nengl J Med 257: 1055, 1957.CrossRefGoogle Scholar
  54. 54.
    Walker BE, Dawson JB, Kelleher J, et al: Plasma and urinary zinc in patients with malabsorption syndromes or hepatic cirrhosis. Gut 14: 943, 1973.CrossRefGoogle Scholar
  55. 55.
    Sternlieb I, Scheinberg IH: Chronic hepatitis as a first manifestation of Wilson’s disease. Ann Intern Med 76: 59, 1972.Google Scholar
  56. 56.
    Deiss A, Lynch RE, Lee GR, et al: Long-term therapy of Wilson’s disease. Ann Intern Med 75: 57, 1971.Google Scholar
  57. 57.
    Strickland TG, Leu ML: Wilson’s disease. Clinical and laboratory findings in 40 patients. Medicine 54: 113, 1975.Google Scholar
  58. 58.
    Crosby WH: Certain things physicians do. Red cell indices. Arch Intern Med 139: 23, 1979.CrossRefGoogle Scholar
  59. 59.
    Grace ND, Powell LW: Iron storage disorders of the liver. Gastroenterology 64: 1257, 1974.Google Scholar
  60. 60.
    Bothwell TH, et al: Iron overload in Bantu subjects. Studies on the availability of iron in Bantu beer. Am J Clin Nutr 14: 47, 1964.Google Scholar
  61. 61.
    Bothwell TH, Bradlow BA: Siderosis in the Bantu. A combined histopathological and chemical study. Arch Pathol 70: 279, 1960.Google Scholar
  62. 62.
    Charlton RW, et al: Effect of alcohol on iron absorption. Br Med J 2: 1427, 1964.CrossRefGoogle Scholar
  63. 63.
    Buchanan WM: The importance of protein malnutrition in the genesis of Bantu siderosis. S Afrjmed Sci 36: 99, 1971.Google Scholar
  64. 64.
    Finch SC, Finch CA: Idiopathic hemochromatosis: Au vin storage disease. Medicine 34: 381, 1955.CrossRefGoogle Scholar
  65. 65.
    Kidd KK: Genetic linkage and hemochromatosis. N Engl JMed 301: 209, 1979.CrossRefGoogle Scholar
  66. 66.
    Beaumont C, Simon M, Fauchet R, et al: Serum ferritin as a possible marker of the hemochromatosis allele. N Engl J Med 301: 169, 1979.CrossRefGoogle Scholar
  67. 67.
    Olssen KS, Heedman PA, Staugard F: Preclinical hemochromatosis in a population on a highiron-fortified diet. JAMA 239: 1999, 1978.Google Scholar
  68. 68.
    Clowdus BF II, Summerskill WHJ, Casey TH, et al: Isotope studies of development of water and electrolyte disorders and azotemia during the treatment of ascites. Gastroenterology 41: 360, 1961.Google Scholar
  69. 69.
    Birkenfeld LW, Leibman J, O’Meara MP, et al: Total exchangeable sodium, total exchangeable potassium, and total body water in edematous patients with cirrhosis of the liver and congestive heart failure. J Clin Invest 37: 687, 1958.CrossRefGoogle Scholar
  70. 70.
    Hecker R, Sherlock S: Electrolyte and circulatory changes in terminal liver failure. Lancet 2: 1121, 1956.CrossRefGoogle Scholar
  71. 71.
    Casey TH, Summerskill WHJ, Orvis AL: Body and serum potassium in liver disease. I. Relationship to hepatic function and associated factors. Gastroenterology 48: 198, 1965.Google Scholar
  72. 72.
    Casey TH, Summerskill WHJ, Bickford RH, et al: Body and serum potassium in liver disease. II. Relationships to arterial ammonia, blood pH, and hepatic coma. Gastroenterology 48: 208, 1965.Google Scholar
  73. 73.
    Atkins EL, Schwartz WB: Factors governing correction of the alkalosis associated with potassium deficiency: The critical role of chloride in the recovery process. J Clin Invest 41: 218, 1962.CrossRefGoogle Scholar
  74. 74.
    Atkinson M, Losowsky M: The mechanism of ascites formation in chronic liver disease. Q J Med 30: 153, 1961.Google Scholar
  75. 75.
    Witte M, Witte C, Dumont A: Progress in liver disease: Physiological factors involved in the causation of cirrhotic ascites. Gastroenterology 61: 742, 1971.Google Scholar
  76. 76.
    Epskin M, Berk D, Hollenberg N, et al: Renal failure in the patient with cirrhosis: The role of active vasoconstriction. Am JMed 49: 175, 1970.Google Scholar
  77. 77.
    Chaimovitz C, Szylman P, Alroy G, et al: Mechanism of increased renal tubular sodium reabsorption in cirrhosis. Am J Med 52: 198, 1959.CrossRefGoogle Scholar
  78. 78.
    Denison E, Lieberman F, Reynolds T: 9-alpha-fluorohydrocortisone induced ascites in alcoholic liver disease. Gastroenterology 61: 497, 1971.Google Scholar
  79. 79.
    LeVeen HH, Christoudias G, Ip M, et al: Peritoneo-venous shunting for ascites. Ann Surg 180: 580, 1974.CrossRefGoogle Scholar
  80. 80.
    Berkowitz HD, Mullen JL, Miller LD, et al: Improved renal function and inhibition of renin and aldosterone secretion following peritoneovenous (LeVeen) shunt. Surgery 84: 120, 1978.Google Scholar
  81. 81.
    Smith FR, Henkin RI, Dell RB: Disordered gustatory acuity in liver disease. Gastroenterology 70: 568, 1976.Google Scholar
  82. 82.
    Eckhardt RD, Falcon WW, Davidson CS, et al: Improvement of active liver cirrhosis in patients maintained with amino acids intravenously as the source of protein and lipotropic substances. JClin Invest 28: 603, 1949.CrossRefGoogle Scholar
  83. 83.
    Freeman JB, Stegink LD, Meyer PD, et al: Metabolic effects of amino acids vs. dextrose infusion in surgical patients. Arch Surg 110: 916, 1975.CrossRefGoogle Scholar
  84. 84.
    Chalmers TC, et al: The treatment of acute infectious hepatitis. Controlled studies of the effects of diet, rest, and physical reconditioning on the acute course of the disease and on the incidence of relapses and residual abnormalities. J Clin Invest 34:1163, 1955.CrossRefGoogle Scholar
  85. 85.
    Fung WP, Tan KK, Tye CY: The effect of diet on the severity of liver damage in acute alcoholic hepatitis. Singapore Med J L3: 224, 1972.Google Scholar
  86. 86.
    Schiff L, Klatskin G: Toxic and drug-induced hepatitis, in Diseases of the Liver, ed 4. Philadelphia: JB Lippincott Co, 1975.Google Scholar
  87. 87.
    Rudman D, Galambos JT, Smith RB III, et al: Comparison of the effect of various amino acids upon the blood ammonia concentration of patients with liver disease. Am J Clin Nutr 26: 916, 1973.Google Scholar
  88. 88.
    Mitchell HS, Rymberger HJ, Anderson L, et al: Nutrition in Health and Disease. Philadelphia: JB Lippincott Co, 1976.Google Scholar
  89. 89.
    Berlyne GM, Epstein N: Dialysed milk in low-sodium and low-potassium diets for renal, hepatic, and cardiac disease. Lancet July 3, 1971.Google Scholar
  90. 90.
    Skillman JJ, Rosenoer VM, Smith PC, et al: Improved albumin synthesis in postoperative patients by amino acid infusion. N Engl J Med 295: 1037, 1976.CrossRefGoogle Scholar
  91. 91.
    Fessel JM, Conn HO: Lactulose in the treatment of acute hepatic encephalopathy. Am J Med Sci 226: 103, 1973.CrossRefGoogle Scholar
  92. 92.
    Lieber CS: Hepatic and metabolic effects of alcohol. Gastroenterology 65: 821, 1973.Google Scholar
  93. 93.
    Best CH, Hartcroft WS, Lucas CC: Liver damage produced by feeding alcohol or sugar and its prevention by choline. Br Med J 2: 1001, 1949.CrossRefGoogle Scholar
  94. 94.
    Barak AJ, Tuma DJ, Sorrell MF: Relationship of ethanol to choline metabolism in the liver: A review. A m J Clin Nutr 26: 1234, 1973.Google Scholar
  95. 95.
    Krasner N, Cochran KM, Russell RI, et al: Alcohol and absorption from the small intestine. Gut 17: 245, 1976.CrossRefGoogle Scholar
  96. 96.
    Tomasulo PA, Kater RM, Iber FL: Impairment of thiamin absorption in alcoholism. Am J Clin Nutr 21: 1341, 1968.Google Scholar
  97. 97.
    Lindenbaum J, Lieber CS: Alcohol-induced malabsorption of vitamin B12 in man. Nature (London) 224: 806, 1969.CrossRefGoogle Scholar
  98. 98.
    Halsted CH, Robles EA, Mezey E: Decreased jejunal uptake of labelled folic acid (H3-PGA) in alcoholic patients: Roles of alcohol nutrition. NEngl JMed 285: 701, 1971.CrossRefGoogle Scholar
  99. 99.
    O’Keane M, Russell RI, Goldberg A: Ascorbic acid status of alcoholics. J Alcohol 7: 6, 1972.Google Scholar
  100. 100.
    Wilson FA, Hoyumpa AM Jr: Ethanol and small intestine transport. Gastroenterology 76: 388, 1979.Google Scholar
  101. 101.
    Malagelada JR, Linscheek WG, Houtsmuller UMT, et al: Effect of medium-chain triglycerides on liver fatty acid composition in alcoholics with or without cirrhosis. Am J Clin Nutr 26: 738, 1973.Google Scholar
  102. 102.
    Oettle AG: The aetiology of primary carcinoma of the liver in Africa: A critical appraisal of previous ideas with an outline of mycotoxin hypothesis. S Afr Med J 39: 817, 1965.Google Scholar
  103. 103.
    Krishnamachari KAVR, Bhat RV, Nagarajan V, et al: Hepatitis due to aflatoxicosis. An outbreak in Western India. Lancet 1:1061, 1975.CrossRefGoogle Scholar
  104. 104.
    Applebaum MN, Thaler MM: Reversibility of extensive liver damage in galactosemia. Gastroenterology 69: 496, 1975.Google Scholar
  105. 105.
    Isselbacher KJ, Anderson EP, Kurahashi K, et al: Congenital galactosemia, a single enzymatic block in galactose metabolism. Science 123: 635, 1956.CrossRefGoogle Scholar
  106. 106.
    Silverberg M, Davidson M: Nutritional requirements of infants and children with liver disease. Am J Clin Nutr 23: 604, 1970.Google Scholar
  107. 107.
    Baker L, Winegrad AI: Fasting hypoglycemia and metabolic acidosis associated with deficiency of hepatic fructose-1–6-diphosphate activity. Lancet 2: 13, 1970.CrossRefGoogle Scholar
  108. 108.
    Brunt PW: Genetics of liver disease. Clin Gastroenterol 2: 615, 1973.Google Scholar
  109. 109.
    Hsia YE: Inherited hyperammonemic syndromes. Gastroenterology 67: 347, 1974.Google Scholar
  110. 110.
    Kiilerich S, Dietrichson O, Loud FB, et al: Zinc depletion in alcoholic liver disease. Scand J Gastroenterol 15: 363, 1980.CrossRefGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1981

Authors and Affiliations

  • Martin H. Floch
    • 1
    • 2
  1. 1.Yale University School of MedicineUSA
  2. 2.Department of Medicine, Section of Gastroenterology and NutritionNorwalk HospitalUSA

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