Ammonia and Carbohydrate Metabolism in Cirrhosis

Chris H. Gips, Roger H Unger

Research output: Contribution to journalLetterpeer-review


To the Editor: The article of Walker et al. (N Engl J Med 291:168–171, 1974) is interesting, but prompts these comments. In our own four patients with cirrhosis, ammonia levels fell in none and rose in one after oral glucose loading. 1, 2 Ammonia may be liberated from 3 as well as removed by 4 muscle. Exercise liberates ammonia, and the rise of peripheral venous ammonia is greater in patients with cirrhosis than in controls. 5 Therefore, we have to know whether or not the patients of Walker et al. were recumbent and at rest before and during the nine hours of study. As has.

Original languageEnglish (US)
Pages (from-to)795-796
Number of pages2
JournalNew England Journal of Medicine
Issue number15
StatePublished - Oct 10 1974

ASJC Scopus subject areas

  • Medicine(all)


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