Nutritional modulation of liver regeneration by carbohydrates, lipids, and amino acids: a review.

The survival of patients after a life-threatening hepatic injury of varying etiology depends on the ability of the remaining hepatocytes to regenerate. Thus, the stimulation of hepatic regeneration can have tremendous therapeutic relevance. Experimental studies--performed mostly on a model of regenerating rat liver after partial hepatectomy--indicate that glucose administration inhibits, whereas infusion of a lipid emulsion can enhance, the rate of liver regeneration. However, the inhibitory effect of glucose on liver regeneration is not observed when glucose is administered together with other nutrients. The results further indicate that administration of a standard amino acid mixture without energy substrate has an inhibitory effect and that development of liver regeneration can be favorably influenced by branched-chain amino acids (valine, leucine, and isoleucine) and glutamine.