Liver function in protein-energy malnutrition measured by cinnamic acid tolerance and benzoic acid tolerance: effect of carnitine supplementation.

1. Rats fed on a protein-depleted diet for 8 weeks were repleted for 5 weeks on high-protein (HP), high-protein + 20 g DL-carnitine/kg (HP + C), or low-protein + 20 g DL-carnitine/kg (LP + C) diets. At 4 and 8 weeks of depletion, and 1 and 5 weeks of repletion, rats from each treatment group were given a benzoic acid tolerance test (BATT) or a cinnamic acid tolerance test (CATT) as a measure of liver function. 2. BATT and CATT measured the molar percentage of a test dose (1 mmol/kg body-weight) of benzoic acid or cinnamic acid excreted in the urine as hippuric acid within 24 h. Liver weight, liver lipid levels, and carnitine concentration in plasma and liver were also measured following liver-function testing. 3. BATT and CATT were severely impaired in protein-depleted rats, but returned rapidly to control levels following protein refeeding. Correlations of BATT and CATT with liver lipid concentration were high (r -0.49 and -0.62 respectively), and both tests show promise as clinical tests for liver function in protein-energy malnutrition. 4. Carnitine supplementation was required to return liver carnitine concentration of protein-depleted rats to control levels during repletion, but was not associated with accelerated reduction in liver fat concentration in protein-repleted rats.