Abstract
Objective. To investigate serum amino acid pool changes in patients with liver cirrhosis.
 Materials and methods. 95 patients with liver cirrhosis were participated in the study. In the 1st group (class A disease severity according to Child- Pugh score) there were 18 (18.95%) patients, in the 2nd group (class B) - 25 (26.3%), in the 3rd groups (class C) - 52 (54.7%) patients. The amount of free amino acids in blood serum was determined by reversed-phase high-performance liquid chromatography in isocratic elution mode with electrochemical detection.
 Results. Violations of free amino acid reserves were revealed in patients with cirrhosis of the liver with a predominant accumulation of aromatic amino acids: phenylalanine - (162.45 ± 14.12) nmol/ml, tyrosine - (99.05 ± 10.07) nmol/ml, tryptophan - (76.10 ± 12.40) nmol/ml, as well as an increase in the content of proline, lysine, cysteine (p <0.05) . In parallel, the decreasing of free serum amino acids with branched side chain levels were observed: valine - up (150.10 ± 8.92) nmol/ml leucine - up (75.14 ± 5.12) nmol/ml (p < 0.05) and isoleucine - up to (80.40 ± 8.01) nmol/ml.
 Conclusions. The correlation between the second degree of thick guts dysbiosis and increased levels of tryptophan was determined (r = 0.77; p <0.01). III degree thick dysbiosis was correlated with increasing levels of phenylalanine (r = 0.71; p <0.01). In patients of 2nd group the correlations between levels of tryptophan and II degree of intestinal dysbiosis (r = 0.58; p <0.01) and the levels of tyrosine in phenylalanine in III stage intestinal dysbiosis were detected.
Highlights
The most pronounced changes in the amino acid pool of the blood were found in patients of the 2nd and 3rd groups, namely, a predominant decrease in the content of AA with a branched side chain, which has a positive effect on the human organism (Table. 1)
After performing a correlation analysis, we have found a relationship between the II and III degrees of colonic dysbiosis and an increase in the levels of predominantly aromatic AA in the blood serum in patients with hepatic cirrhosis (HC) (Table. 2)
A relationship was established between the second degree of colonic dysbiosis and an increase in tryptophan levels (r=0.77; p
Summary
The study involved 95 patients with HC, who underwent inpatient treatment in 2018-2020 yrs in the Department of Anesthesiology-Critical Care, Surgical and Gastroenterological departments of the Andrii Novak Zakarpattia Region Clinical Hospital (Uzhhorod) The criteria for excluding patients from the study were HC of viral etiology, primary biliary cirrhosis, hepatic cancer, and Budd-Chiari syndrome. The age of the examined patients ranged from 28 to 65 yrs old, the average age was (42.1 ± 6.8) yrs old. The control group consisted of 15 apparently healthy people aged 26 - 59 yrs olds, whose average age was (42.2 ± 3.4) yrs old. Group 1 (Class A - compensation stage) have included 18 (18.95%) patients, Group 2 (Class B – subcompensation stage) – 25 (26.3%), and group 3 (Class C - decompensation stage) – 52 (54.7%) patients
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