EFFECT OF CHOLINE AND METHIONINE, TESTOSTERONE PROPIONATE, AND DIETARY PROTEIN ON NITROGEN BALANCE IN PATIENTS WITH LIVER DISEASE 12

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Abstract
Five patients with cirrhosis of the liver and one patient with infectious hepatitis were maintained on basal diets providing from 0 to 100 g. of protein daily. Initial control N balances averaged from -4.2 to +7.0 g. daily. The effect of supplements of choline and DL-methionine, of testosterone, and of dietary protein upon these balances was detd. The oral admn. of choline chloride and DL-methionine simultaneously to these patients did not spare urine N. In no instance did increases in N balance during the admn. of these agents exceed the quantity of N they contained. Testosterone propionate was administered intramusc. to 3 of the patients. Their ability to respond to this protein anabolic stimulus was demonstrated by decreases in urine N and increases in N balance occurring at the same levels of dietary protein intake and urine N excretion at which choline and methionine had previously failed to spare urine N. Increases in dietary protein of 25 to 50 g. daily were accompanied by the most marked increases in N retention in these patients. No alterations in the course of these patients, as determined clinically or by laboratory tests of liver function, could be attributed specifically to the admn. of choline and methionine, of testosterone propionate, or of supplements of dietary protein. Although testosterone propionate had a protein anabolic effect in these patients with liver disease, it is concluded that positive N balance was most effectively achieved by adequate dietary protein. A sparing of urine N could not be attributed to choline and methionine administered orally.