Novel Tracer Methods to Evaluate Muscle Protein Metabolism in Cirrhosis

The goal of this study is to identify the molecular regulatory mechanisms that result in loss
of skeletal muscle in cirrhotic patients. Current strategies involve prolonged tracer
infusion and multiple muscle biopsies. We will use an innovative approach to determine the
rates of skeletal muscle protein synthesis and breakdown using multiple tracers administered
at short intervals followed by a single muscle biopsy. These studies are likely to provide a
conceptual advance in determining the cellular and molecular responses of the skeletal muscle
in cirrhosis.

Inclusion Criteria:

- The diagnosis of cirrhosis based on liver biopsy and/or clinical, biochemical, and
imaging criteria.

- Patients with Child Pugh score from A5- to B7

- Control group: Subject in control group should have serum ALT and AST within normal
range.

Exclusion Criteria for both groups (cirrhotic and control) are:

- diabetes

- cancer

- kidney failure

- pregnancy

- recent surgery (bowel resection or Gastric bypass operation)

- Advanced cardiac or pulmonary disease

- patient with thyroid disease & Coagulopathy ( INR >1.4 and platelet count <80,000/ml)