Autophagy is an intracellular pathway that contributes to the degradation and recycling of unfolded proteins. Based on the knowledge that autophagy affects glycogen metabolism and that a 1 -antitrypsin (AAT) deficiency is associated with an autophagic response in the liver, we hypothesized that the conformational abnormalities of the Z-AAT protein interfere with hepatocyte glycogen storage and/or metabolism. Compared with wild-type mice (WT), the Z-AAT mice had lower liver glycogen stores (P , 0.001) and abnormal activities of glycogen-related enzymes, including acid aglucosidase (P , 0.05) and the total glycogen synthase (P , 0.05). As metabolic consequences, PiZ mice demonstrated lower blood glucose levels (P , 0.05), lower body weights (P , 0.001), and lower fat pad weights (P , 0.001) compared with WT. After the stress of fasting or partial hepatectomy, PiZ mice had further reduced liver glycogen and lower blood glucose levels (both P , 0.05 compared WT). Finally, PiZ mice exhibited decreased survival after partial hepatectomy (P , 0.01 compared with WT), but this was normalized with postoperative dextrose supplementation. In conclusion, these observations are consistent with the general concept that abnormal protein conformation and degradation affects other cellular functions, suggesting that diseases in the liver might benefit from metabolic compensation if glycogen metabolism is affected.Keywords: autophagy; partial hepatectomy; fasting; glycogen degradation a 1 -Antitrypsin (AAT), a 52-kD, 394-amino acid single-chain glycoprotein produced primarily by liver hepatocytes, functions as the major circulating inhibitor of neutrophil elastase (1, 2). The common Z-AAT mutation (glu342lys, referred to as ''PiZ'', for ''protease inhibitor Z'') results in a systemic deficiency of AAT (1, 2). The consequences of this single amino acid substitution are profound, including emphysema secondary to deficiency of lung antielastase protection and cirrhosis resulting from the toxic effects of the accumulation of the abnormal Z-AAT molecules in the liver (1-5).The liver disease associated with AAT deficiency is a prototype of conformational diseases, disorders due to misfolding of proteins, with consequent aberrant intermolecular protein aggregation (2-7). In contrast to the normal M-type AAT, which rapidly transits through the endoplasmic reticulum (ER) and is efficiently secreted by hepatocytes, the Z-AAT form of AAT accumulates in the hepatocyte ER secondary to abnormal folding of the Z molecule, resulting in interaction between the reactive center loop of one Z-AAT molecule with the b-pleated sheet of a second, causing loop-sheet polymerization and consequent accumulation of Z-AAT in the ER (3, 4, 8-10).The understanding of the mechanism of the liver disease associated with AAT deficiency has been significantly advanced by studies of the ''PiZ'' mouse, a transgenic murine model of the Z form of AAT by Woo and colleagues (11, 12) and Perlmutter and colleagues (13)(14)(15)(16)(17)(18)(19). Recent studies demonstrated tha...