Total serum bile acids, gamma-glutamyl transferase, prealbumin, and tyrosine: sensitive serum markers of hepatic dysfunction in alcoholic liver cirrhosis.

Of 33 components analyzed in overnight fasting serum from 30 patients with alcoholic liver cirrhosis, portal hypertension, and bleeding esophageal varices, total serum bile acids, gamma-glutamyltransferase, prealbumin, and tyrosine were the most frequently abnormal 'liver tests'. Total serum bile acids correlated significantly with bilirubin, immunoglobulin M, threonine, glycine, methionine, and tyrosine. Gamma-glutamyltransferase correlated with aspartate aminotransferase, glutamine, and alanine. Prealbumin correlated with albumin and immunoglobulins G and A. Tyrosine correlated with total bile acids, orosomucoid, and 10 amino acids. The amino acid ratio of valine + isoleucine + leucine to tyrosine + phenylalanine was lowered in all patients. It is concluded that the clinical picture and pattern of serum components in patients with alcoholic liver disease are influenced by many complex pathophysiological mechanisms.