Lipid profile in cirrhotic patients and its relation to clinical outcome

Abstract

Background Carriers of hepatitis C virus have lower levels of total cholesterol, high density lipoprotein-cholesterol, low density lipoprotein- cholesterol and triglycerides compared to uninfected patients. With the progression of liver disease, the values ​​for cholesterol and its fractions reduce linearly, with reduction ratio of lipid profile and markers Child-Pugh and MELD. Aim To determine the relationship between decrease dlipid profile with clinical outcome presented (liver transplantation or death pre-transplant). Methods Was conducted a cross sectional analytical study of a follow-up study performed by reviewing medical records. Cirrhotic patients treated at theClinic of Gastroenterology from a large tertiary hospital with cirrhosis of viral etiology and/or alcohol were studied. The clinical characteristics (gender, age and etiology of cirrhosis) and lipid profile data from150 patients were collected in the year 2010.To analyze the occurrence of clinical outcomes (liver transplantation or death pre-transplant) patients were evaluated after four years. Results The prevalent cause was hepatitis C virus (53,3%), followed by alcohol (32%) and hepatitis C and alcohol (14,6%). Males represented 62% of the sample and the average age was 63.1±9.11 years. The prevalent lipid changes were hypocholesterolemia associated with hypotriglyceridemia (36,6%) and isolated hypocholesterolemia (34,6%). Analyzing groups of patients that showed abnormalities related to lipid profile, was identified a significant association between isolated hypocholesterolemia and clinical outcome-liver transplant(p <0.025) and 18% probability of performing liver transplantation in this group of patients. There was no association between decreased lipid profile and death. Conclusion Isolated hypocholesterolemia contributes to assess the progression of liver disease, because of the association between lowering cholesterol and its fractions and the clinical outcome - liver transplant

Study of Biochemical Changes, Antioxidant Status and Oxidative Stress in Patients With Alcoholic Liver Disease

“…Similar result documented by Boemeke L et al, (2015) [22] have found that markedly significantly increased (p<0.001) levels of total cholesterol (TC), triglyceride (TG), LDL-C and HDL-C in ALD. The role of liver in lipid and lipoprotein metabolism, therefore hypertriglyceridemia has been correlated with hepatocyte fat accumulation.…”

A comparative study of serum lipid contents in pre and post IFN-alpha treated acute hepatitis C patients

“…The significance and mechanism of these changes is not clear, but it has been reported that HCV may alter expression profile of lipid metabolism–associated with genes [ 18 ]. Sterol regulatory element-binding proteins (SREBPs) are genes encoding enzymes involved in cholesterol and fatty acid biosynthesis, whereas SREBP-2 plays an important role in cholesterol biosynthesis, SREBP-1c is involved in fatty acid biosynthesis, which regulates the expression of its enzymes in the liver, e.g., fatty-acid synthase (FAS) and SCD [ 19 ].…”

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“…Such changes, in our opinion, are associated with the progression of dysfunction of the liver as an organ that plays a central role in the regulation of the synthesis, degradation and deposition of cholesterol and lipoproteins. According to the literature, lowering TG levels in serum is associated with a decrease in their synthesis and a decrease in the processes of esterification; low level of VLDLC and LDLC is associated with a deficiency of microsomal triglyceride transferase protein and inhibition of cholesterol synthesis; a decrease in HDLC is associated with a decrease in the synthesis of apolipoprotein AI [4,6].…”

“…Excessive input of FFA in adipose tissue leads to «overloading» of fat cells that are no longer able to contain such an amount of FFA and the accumulation of fat in other tissues of the body that is not adapted for such function -in the liver, pancreas, muscles, etc. [4,5]. Such ectopia and large amount of FFA in the body result in a decrease in insulin sensitivity and the development of glucose-and lipo-toxicity.…”