Rate of Synthesis of Albumin in Relation to Serum Levels of Essential Amino Acids in Patients with Bacterial Overgrowth in the Small Bowel

Abstract

Summary. Bacterial overgrowth in the small bowel has been recognised in 11 patients with the aid of the breath‐test with [glyco‐1‐14C] cholic acid and by the determination of the amount of bacteria in the jejunal juice. In all but one patient hypoalbuminaemia, from 21.9 to 42.9 g/1, was observed. This low level of serum albumin can be due to an excessive intestinal protein‐loss or to a decreased rate of synthesis of albumin as the result of an insufficient delivery of amino acids to the liver. In 11 patients with bacterial overgrowth the rate of synthesis of albumin has been determined by the 14C‐carbonate method. Compared to a control group the rate of albumin synthesis and the serum level of valine, leucine, lysine and tryptophan were significantly decreased in the patients with bacterial overgrowth. A positive correlation was found between the rate of albumin synthesis and the serum levels of valine, isoleucine, leucine and tryptophan. When the serum levels of these 4 essential amino acids were low, the rate of albumin synthesis was depressed.