Plasma lipoprotein alterations in patients with chronic hepatocellular liver disease resulting from alcohol abuse: effects of alcohol intake cessation

Serum lipid and lipoprotein alterations represent recovery of liver function after hepatectomy

BACKGROUND

The assessment of liver function during human liver regeneration is necessary to prevent unexpected liver failure and to prepare for further treatment. We selected patients prospectively and measured serum lipid and lipoprotein levels to identify which lipids and lipoproteins could represent recovery of liver function in human liver regeneration.

METHODS

Thirty selected patients who underwent hepatectomy were divided into three groups depending on the serum hyaluronate (HA) level and the type of liver resection.

RESULTS

We found three patterns of lipid and lipoprotein alterations after hepatectomy. Among the lipids and lipoproteins examined, the serum beta-lipoprotein and low-density lipoprotein (LDL) levels were significantly different among the groups at 7 days after hepatectomy. The alteration of the apolipoprotein (Apo) B level was similar to that of LDL. The LDL level was correlated with both beta-lipoprotein and Apo B before hepatectomy (r=0.653 and 0.894, respectively) and at 7 days after hepatectomy (r=0.841 and 0.943, respectively).

CONCLUSION

Serum HA before hepatectomy can reflect postoperative liver function depending on the type of liver resection. Recovery of the beta-lipoprotein and LDL levels can reflect the recovery of liver function in human liver regeneration within the early period in association with the Apo B level.

Dose-dependent effect of alcohol on insulin-like growth factor systems in male rats

1. Chronic alcohol treatment has been reported to be associated with liver and kidney damage. The insulin-like growth factor (IGF) is the major growth factor related to alcohol consumption. However, the effect of alcohol on the IGF system in the liver and kidney has not been fully elucidated. Thus, the present study was conducted to investigate this issue. 2. Alcohol reduced the level of IGF-I in a dose-dependent manner in the serum, liver and kidney. Alcohol also decreased the level of IGF-II in the liver. In contrast, alcohol increased the level of IGF-II in the serum and kidney. These observations were correlated with IGF-I and IGF-II mRNA expression in the liver and kidney. 3. To examine the effect of alcohol on IGF receptors in the liver and kidney, IGF-I receptor mRNA was measured. Alcohol decreased IGF-I receptor mRNA in the liver and kidney. 4. In experiments performed to examine the regulation of IGF-binding proteins (IGFBP), alcohol increased serum levels of IGFBP-1. However, alcohol had no effect on serum levels of IGFBP-2, -3 and -4. These effects were also observed in the liver and kidney. 5. In conclusion, alcohol alters the IGF system in rat liver and kidney in a tissue-specific manner, which may contribute to the metabolic dysfunction following chronic alcohol consumption.

Effect of alcohol on lipids and lipoproteins in relation to atherosclerosis

Several studies indicate that light-to-moderate alcohol consumption is associated with a low prevalence of coronary heart disease. An increase in high-density lipoprotein (HDL) cholesterol is associated with alcohol intake and appears to account for approximately half of alcohol's cardioprotective effect. In addition to changes in the concentration and composition of lipoproteins, alcohol consumption may alter the activities of plasma proteins and enzymes involved in lipoprotein metabolism: cholesteryl ester transfer protein, phospholipid transfer protein, lecithin:cholesterol acyltransferase, lipoprotein lipase, hepatic lipase, paraoxonase-1 and phospholipases. Alcohol intake also results in modifications of lipoprotein particles: low sialic acid content in apolipoprotein components of lipoprotein particles (e.g., HDL apo E and apo J) and acetaldehyde modification of apolipoproteins. In addition, "abnormal" lipids, phosphatidylethanol, and fatty acid ethyl esters formed in the presence of ethanol are associated with lipoproteins in plasma. The effects of lipoproteins on the vascular wall cells (endothelial cells, smooth muscle cells, and monocyte/macrophages) may be modulated by ethanol and the alterations further enhanced by modified lipids. The present review discusses the effects of alcohol on lipoproteins in cholesterol transport, as well as the novel effects of lipoproteins on vascular wall cells.

Lipoprotein alterations in liver cirrhosis: a possible contribution to changes in plasma oncotic pressure and viscosity

BACKGROUND/AIMS

To investigate whether physicochemical alterations in plasma lipoproteins are associated with changes in plasma oncotic pressure and viscosity in liver cirrhosis.

METHODS

The study included 66 patients with cirrhosis (confirmed by liver biopsy) and 58 healthy volunteers. The constituents measured were: the concentration, density and composition of plasma lipoproteins; plasma oncotic pressure and viscosity; and the concentrations of albumin, total protein, haptoglobin, transferrin, immunoglobulin M and alpha2-macroglobulin.

RESULTS

Step-wise multiple regression analysis indicated that, in the patients with cirrhosis, plasma oncotic pressure was significantly correlated with plasma albumin+viscosity (r=+0.85; p<0.001) and with plasma total protein+the density of low density lipoprotein (r=+0.74; p<0.001). The inclusion of viscosity and the density of low density lipoprotein in the regression equations significantly improved the observed correlation between albumin and plasma oncotic pressure (r=+0.70; p<0.001). Similarly, plasma viscosity was significantly correlated with the sum of plasma total protein and cholesterol (r=+0.68; p<0.001). The inclusion of cholesterol in the regression equation significantly increased the observed correlation between total protein and plasma viscosity (r=+0.59; p<0.001).

CONCLUSIONS

These results suggest that lipoprotein alterations associated with liver cirrhosis may play a role in determining plasma oncotic pressure and viscosity, and thus could influence the progression of the disease.