Correlation of Fasting Lipid Profile in Patients With Chronic Liver Disease: A Descriptive Cross-Sectional Study in Tertiary Care Hospital

Abstract

Introduction: Chronic liver disease (CLD) is a term used to describe a wide spectrum of disorders, including idiopathic, infectious, genetic, drug-induced, toxin-induced, and autoimmune disorders. The common consequence of chronic damage to the liver is cirrhosis. Cirrhotic patients are further classified by their severity based on the Child-Pugh scoring system. Currently, Child-Pugh scoring consists of ascites, hepatic encephalopathy (HE), prothrombin time, serum albumin level, and total bilirubin level. Lipid panel in CLD is a great marker in determining the severity of CLD. Method and methodology: It was a descriptive cross-sectional study conducted at a tertiary care hospital. A sample size of 122 was calculated by using a RaoSoft Digital Sample Size Calculator (RaoSoft, Inc., Seattle, WA) in which we used 5% as a margin of error, 95% as confidence interval (CI), 178 as population size, and response distribution as 50%. Non-complicated CLD patients having age in between 15 and 80 years with no cirrhotic complications including HE, spontaneous bacterial peritonitis, hepato-pumonary, or hepato-renal syndrome were included in our study; the rest of the CLD patients were excluded from our study. Results: The mean age of the study population was 47.09 ± 12.30 years with more than half of the patients lying among the age group 25-50 years. The study population included 76% of males (n=93) and 24% of females (n=29), with a mean age of females higher than the males. Diabetes mellitus (58.19%) was the most frequent comorbidity associated with CLD in subjects included in our study. Parameters of lipid panel were decreased exponentially as the severity of CLD increases from Child score A to C. Total cholesterol, lowdensity lipoprotein (LDL), very-low-density lipoprotein (VLDL), high-density lipoprotein (HDL), and triglyceride (TG) level decreased as the severity increases in our study. The mean model for end-stage liver disease (MELD) score increased as per hypothesized as the severity increases from Child score A to Child score C, respectively. Conclusion: Our study concluded that as the severity of CLD increases from Child class A to Child class C, the lipid panel profile decreases exponentially which proved the idea that had been hypothesized at the beginning of our study.

Association of lipid profile with severity of hepatitis B virus related chronic liver disease in adult

“…This was supported by many previous studies and in their studies, they showed that the amount of decrement in the serum LDL was significant with increasing severity of liver damage. 10,12,13,15 The level of serum HDL in this study, was significantly decreased in cases of CLD when compared to control (p<0.001) and inversely co-related with severity of liver damage, were consistent with some of publications on this subject. 12,15 The serum triglyceride levels were significantly lower in cases of CLD than in control group (p= 0.047).…”

“…This observation was supported by some reports. [10][11][12][13][14] The probable explanation for the reduced serum total cholesterol was due to the decline in synthetic function and altered metabolism. 12 Further comparison of the total cholesterol values in different Child Pugh and MELD scores showed a direct relation between the severity of liver damage and reduction in the cholesterol and this was supported by few previous studies.…”

“…This was in accordance with many previous studies. 10,[12][13][14][15] In a study, it was suggested that the LDL concentration was decreased in patients with chronic liver disease. As these patients had a very low VLDL which is thought to be the precursor of LDL, it seems likely that their LDL metabolism was greatly altered resulting in reduced level of LDL.…”

The Pattern of Dyslipidemia in Chronic Liver Disease Patients

“…Several hepatic disorders in which normal liver tissue is replaced by fibrotic tissue are collectively termed chronic liver disease (CLD) [1]. Several metabolic abnormalities are common in CLD like dyslipidemias, 1 2 3 3 4 5 6 7 8 9 clotting factor deficiencies, and in some cases venous thromboembolism due to deficiency of anticoagulation factors [2].…”

Effects of Preoperative Oral Carbohydrate on Cirrhotic Patients under Endoscopic Therapy with Anesthesia: A Randomized Controlled Trial

“…Low energy intake and poor nutritional status facilitate the development of hepatic encephalopathy, which is associated with poor prognosis in patients with cirrhosis [ 24 ]. Therefore, avoiding long-term fasting with the intake of carbohydrates 4 h prior to anesthesia may have beneficial effects on ameliorating malnutrition in patients with cirrhosis; however, further research is warranted [ 25 , 26 ].…”