Effect of low caloric diet on endogenous carbon monoxide production: normal adults and Gilbert's syndrome.

Abstract

In 1906 Gilbert (1) observed that caloric deprivation produced an elevation of serum bilirubin concentration. Recently this observation has been confirmed (2-4) and various mechanisms have been suggested for the indirect hyperbilirubinemia that occurs (2, 3). Studies by Bloomer et al. (3) showed that fasting-induced hyperbilirubinemia was secondary to impaired hepatic clearance.Since the catabolism of heme yields carbon monoxide (CO) and bilirubin in equimolar amounts (5, 6), measurement of endogenous CO production therefore reflects heme turnover (7) and bilirubin production (5, 6). Because of the possibility that fasting itself produces an increase in heme turnover (and therefore CO and bilirubin production), we studied the effect of caloric deprivation on the endogenous production of CO.Subjects and Methods. Five normal volunteers (two male and three female) and nine patients with Gilbert's syndrome (all male) were studied. All subjects were carefully screened to preclude intake of any drugs or diagnos...