Plasma Glutamine Concentrations in Liver Failure

PLoS One. 2016 Mar 3;11(3):e0150440. doi: 10.1371/journal.pone.0150440. eCollection 2016.


Background: Higher than normal plasma glutamine concentration at admission to an intensive care unit is associated with an unfavorable outcome. Very high plasma glutamine levels are sometimes seen in both acute and chronic liver failure. We aimed to systematically explore the relation between different types of liver failure and plasma glutamine concentrations.

Methods: Four different groups of patients were studies; chronic liver failure (n = 40), acute on chronic liver failure (n = 20), acute fulminant liver failure (n = 20), and post-hepatectomy liver failure (n = 20). Child-Pugh and Model for End-stage Liver Disease (MELD) scores were assessed as indices of liver function. All groups except the chronic liver failure group were followed longitudinally during hospitalisation. Outcomes were recorded up to 48 months after study inclusion.

Results: All groups had individuals with very high plasma glutamine concentrations. In the total group of patients (n = 100), severity of liver failure correlated significantly with plasma glutamine concentration, but the correlation was not strong.

Conclusion: Liver failure, regardless of severity and course of illness, may be associated with a high plasma glutamine concentration. Further studies are needed to understand whether high glutamine levels should be regarded as a biomarker or as a contributor to symptomatology in liver failure.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • End Stage Liver Disease / blood*
  • Female
  • Glutamine / adverse effects
  • Glutamine / blood*
  • Glutamine / chemistry
  • Hepatectomy
  • Hospitalization
  • Humans
  • Intensive Care Units
  • Liver Failure, Acute / blood*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prospective Studies
  • Severity of Illness Index
  • Young Adult


  • Biomarkers
  • Glutamine

Grants and funding

The study was supported by grants from the Swedish Medical Research Council (projects 04210 and 14244) and the County Council of Stockholm (projects 502033 and 511126). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.