Determination of branched-chain amino acids and tyrosine in serum of patients with various hepatic diseases, and its clinical usefulness.

We developed an automated enzymatic method for determination of the branched-chain amino acids (BCAAs; valine, isoleucine, leucine) and tyrosine in serum, and applied it to the clinical evaluation of patients with various hepatic diseases. Analytically, the test results were acceptably precise and reproducible, and correlated well with results obtained with an amino acid analyzer. Clinically, we found that a decrease in BCAAs, an increase in tyrosine, and the BCAAs/tyrosine ratio in serum paralleled the severity of hepatic parenchymal damage. We conclude that this enzymatic determination of BCAAs and tyrosine is simple and convenient enough for routine clinical laboratory use, and that the ratio of BCAAs/tyrosine obtained may be a good indicator of the severity of hepatic disorders.