Hyperglucagonemia and hyperammonemia: Which is the chicken and which the egg?
Harold O. Conn, L. Siw Eriksson – 1 March 1986 – Elevated plasma ammonia level in hepatic cirrhosis has been attributed to a lack ofconversion of enteric ammonia into urea or to its entry into systemic circulation via portasystemic shunting, or to both. It is exaggerated by excessive protein intake. Because hyperglucagonemia is well documented in cirrhosis and a protein meal is an effective glucagon secretogogue, plasma glucose, insulin, glucagon, and ammonia levels were determined in 50 cirrhotic patients after an overnight fast.