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Query: UMLS:C0023890 (
cirrhosis
)
42,195
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Hepatic diseases differ from most other causes of secondary dyslipidaemia in that the circulating lipoproteins are not only present in abnormal amounts but they frequently also have abnormal composition, electrophoretic mobility and appearance. Pre-beta and alpha bands can be absent on electrophoresis in all types of liver disease although material in the VLDL and HDL ranges can be isolated in the ultracentrifuge. Cholestatic liver disease has been the most extensively studied and the hyperlipidaemia can be extreme with marked elevations of free cholesterol and phospholipids. This results largely from the presence of LP-X, an abnormal LDL, with a vesicular structure that appears in rouleaux formation under the electron microscope. It is virtually specific for cholestasis and familial LCAT deficiency. The LDL, however, is heterogeneous and may also contain a large triglyceride-rich particle (LP-Y) as well as more normal-looking particles, which are none the less depleted in cholesteryl esters and rich in triglycerides. Indeed, when patients with cholestasis are hypertriglyceridaemic the excess triglyceride is to be found predominantly in these two LDL fractions rather than in VLDL. HDL in cholestasis may contain disc-like particles, similar to those newly secreted by the liver and intestine, as well as more normal-looking spherical particles. In extrahepatic obstruction concentrations of HDL and its major apolipoproteins, apoAI and apoAII, are frequently reduced, although a subfraction rich in apoE is often found. In all but the latest stages of chronic intrahepatic cholestasis due to primary biliary cirrhosis, however, HDL, especially
HDL2
, concentrations are increased, probably due to the presence of a circulating inhibitor of HL. Many of these lipoprotein changes found in cholestasis resemble those of familial LCAT deficiency, although the hyperlipidaemia is not usually so severe in the latter condition. Indeed, in patients with cholestasis but well-preserved LCAT activity many of the characteristic lipoprotein changes, such as LP-X, LP-Y and discoidal HDL, may not be seen. In acute hepatocellular disease, such as alcoholic or viral hepatitis, it is not unusual for the patient to go through a cholestatic phase and many of the same lipoprotein changes may be seen. In
cirrhosis
without cholestasis the patients are not usually significantly hyperlipidaemic and in advanced cases cholesterol and apoB levels may be reduced. Although LCAT activity and the proportion of plasma cholesterol esterified may also be markedly reduced, LP-X is not usually seen, possibly because the flux of free cholesterol and phospholipid (lecithin), the LCAT substrates, is relatively low. Discoidal HDLs are often present.(ABSTRACT TRUNCATED AT 400 WORDS)
...
PMID:Dyslipoproteinaemia of liver disease. 208 7
Serum apoprotein A-I and A-II levels were determined by electroimmunoassay in patients with liver diseases and cholestasis. Significant decreases in apoprotein A-I and A-II levels were observed in such patients. The decreases were especially pronounced in the early phase of acute hepatitis and cholestasis. The decreases in A-II levels were more prominent than the decreases in A-I in severe hepatic dysfunction or cholestasis. Accordingly, the A-I/A-II ratio showed no change in the convalescent phase of acute hepatitis or chronic hepatitis but increased significantly in the early phase of acute hepatitis,
cirrhosis of the liver
, hepatoma, and cholestasis. The results suggested the existence of a high density lipoprotein with an abnormal apoprotein composition or a more profound decrease of HDL3 than of
HDL2
in severe hepatocellular dysfunction of cholestasis.
...
PMID:Serum apoprotein A-I and A-II levels in liver diseases and cholestasis. 627 23
To elucidate the role of the liver in the metabolism of HDL subfractions, the levels of
HDL2
and HDL3 were determined in the sera obtained from patients with liver disease. The determinations were carried out either by zonal ultracentrifugation or by gradient gel electrophoresis combined with HDL cholesterol measurement. Mean HDL3 cholesterol level in patients with
liver cirrhosis
was about one third of the normal controls whereas no significant changes were observed in
HDL2
cholesterol concentration. HDL3 cholesterol levels in patients with chronic hepatitis were about a half of the controls. The levels of HDL3 cholesterol correlated significantly to the levels of serum albumin and to choline esterase activities. The results suggest either that HDL3 is synthesized in the liver or that there is a metabolic defect in the conversion of
HDL2
to HDL3 in liver disease.
...
PMID:Quantitative determinations of HDL2 and HDL3 in patients with liver disease. 683 48
In order to further investigate plasma lipoproteins abnormalities secondary to serious liver damage, we studied plasma lipids and lipoproteins, and in particular HDL subfractions (
HDL2
, HDL3), in 12 patients with
cirrhosis of the liver
and in 12 sex, age and weight matched healthy volunteers. Enzymatic methods were used to determine total cholesterol and triglycerides, while the extractive method of Abell et al. was used for the determination of HDL-cholesterol levels after LDL and VLDL precipitation with polyanions (MnCl2 and Na-heparin) and of HDL3-cholesterol values after
HDL2
precipitation with dextran-sulphate 15,000 m.w. Total cholesterol and HDL-cholesterol levels were significantly lower in cirrhotic patients compared to normal subjects. We must emphasize that only HDL3-cholesterol was decreased in cirrhotics, whereas
HDL2
-cholesterol values were normal or high. We suggest that a diminished activity of hepatic triglyceride lipase might account for the decrease in HDL3-cholesterol in
liver cirrhosis
.
...
PMID:[HDL2 and HDL3 cholesterol in hepatic cirrhosis]. 686 Apr 95
In order to study the role and metabolism of high density lipoprotein (HDL) subfractions, the serum
HDL2
-cholesterol (HDL2-C) and HDL3-cholesterol (HDL3-C) were measured by the new method using high performance liquid chromatography in the normal subjects and patients with various diseases. It was highly characteristic that the serum HDL3-C levels of the patients with
liver cirrhosis
(LC) were remarkably lower than those of the normal subjects. The result suggests that HDL3 may be produced in the liver. Both the serum
HDL2
-C and HDL3-C levels were significantly lower in the patients with coronary heart disease (CHD) or cerebral thrombosis (CT) than in the normal subjects (P less than 0.001). In the normal subjects, the changes in the serum HDL-cholesterol (HDL-C) levels were mainly due to those in the serum
HDL2
-C levels. On the other hand, in the patients with atherosclerotic diseases (CHD, or CT) the changes in the serum HDL-C levels Were attributed to those of both the serum
HDL2
-C and HDL3-C levels. So it is suggested that in the atherosclerotic diseases, in which the HCL-C is usually lower, the HDL3-C also may play an important role in the regulation of the total HDL-C and its anti-atherogenetic effect.
...
PMID:Role and metabolism of high density lipoprotein subfractions--analysis of serum HDL2-cholesterol and HDL3-cholesterol in patients with various diseases by high performance liquid chromatography. 695 38
High-density lipoproteins (HDL) are important endogenous inhibitors of inflammatory responses. Functional impairment of HDL might contribute to the excess mortality experienced by patients with liver disease, but the effect of
cirrhosis
on HDL metabolism and function remain elusive. To get an integrated measure of HDL quantity and quality, we assessed several metrics of HDL function using apolipoprotein (apo) B-depleted sera from patients with compensated
cirrhosis
, patients with acutely decompensated
cirrhosis
and healthy controls. We observed that sera of cirrhotic patients showed reduced levels of HDL-cholesterol and profoundly suppressed activities of several enzymes involved in HDL maturation and metabolism. Native gel electrophoresis analyses revealed that cirrhotic serum HDL shifts towards the larger
HDL2
subclass. Proteomic assessment of isolated HDL identified several proteins, including apoA-I, apoC-III, apoE, paraoxonase 1 and acute phase serum amyloid A to be significantly altered in cirrhotic patients. With regard to function, these alterations in levels, composition and structure of HDL were strongly associated with metrics of function of apoB-depleted sera, including cholesterol efflux capability, paraoxonase activity, the ability to inhibit monocyte production of cytokines and endothelial regenerative activities. Of particular interest, cholesterol efflux capacity appeared to be strongly associated with liver disease mortality. Our findings may be clinically relevant and improve our ability to monitor cirrhotic patients at high risk.
...
PMID:Liver disease alters high-density lipoprotein composition, metabolism and function. 2710 40