Changed lipid and apoprotein composition of serum lipoproteins is commonly found in chronic liver diseases. In this study we evaluated the serum total cholesterol (TC), triglyceride (TG), HDL-cholesterol (HDL-c), LDL-cholesterol (LDL-c), apolipoprotein-A (Apo-A), apolipoprotein-B (Apo-B), and Lp(a) levels in age, BMI, and sex matched patients with liver cirrhosis (LC) (n: 50), chronic hepatitis (CH) (n: 31) and compared with control subjects (n: 69). The increasing severity of the liver cirrhosis was evaluated according to the Child classification (Child-A, Child, B and Child-C). TC, TG, HDL-c levels were analysed in Hitachi autoanalyser using Sigma commercial kits. LDL-c was derived by the Friedewald equation. Serum Apo-A, Apo-B, Lp(a) levels were measured by immunoturbidometry using commercial Beckmann Apo-A, Apo-B, and Lp(a) reagents. Serum insulin levels were determined using DPC commercial kits. Insulin resistance (IR) was assessed using HOMA. Patients with LC and CH had higher fasting insulin levels, and HOMA-IR compared to control subjects (p<0,05). Patients with LC had lower levels of TC, TG, LDL-c, Apo-B, and Lp(a) when compared to patients with CH and control subjects (p<0,05). Patients with Child-C LC had significantly lower levels of TC, HDL-c, LDL-c, Apo-A compared to patients with Child A and B LC (p<0,05). There were no significant difference in TG and Lp(a) levels between them (p>0,05). These data suggest that insulin resistance precedes in early stages of chronic liver diseases as we determined in patients with CH. In addition Lp(a) levels were significantly lower in early stage of liver cirrhosis (Child-A) and there was no correlation with the degree of the severity of liver cirrhosis. However HDL-c and Apo-A levels were in normal range in early liver cirrhosis and were lower in advanced liver cirrhosis. Therefore lower levels of these parameters represent advanced paranchymal disease.
08 - 11 Apr 2002
British Endocrine Societies