Lipid profile and antibodies against oxidized low density lipoprotein in alcoholic cirrhosis

Abstract

Mechanisms different from those described about direct toxic effect of ethanol, may be involved in the pathogenesis of alcoholic cirrhosis. Enhanced lipid peroxidation and autoimmune events induced by ethanol are postulated as important additional mechanisms. The objective of this study was, (1) to demonstrate that antibodies against oxidized low density lipoprotein (ox-LDL) are present in the serum of patients with chronic liver damage particularly in alcoholic cirrhosis, and (2) to look for associations between these autoantibodies in alcoholic cirrhosis and abnormalities in the lipid profile. Twenty-six alcoholic cirrhotic patients were studied and classified according to Child's criteria. As a control group 15 healthy volunteers were included. Liver function tests, total cholesterol (TC), triglycerides (TG), total lipids (TL), cholesterol bound to LDL (LDL-c) and cholesterol bound to HDL (HDL-c), were measured. ELISA antibody determination against ox-LDL were performed. Also 26 cirrhotic patients secondary to chronic hepatitis C were included and a group of 14 habitual drinkers without liver dysfunction. Antibodies against ox-LDL were present in 42% of alcoholic cirrhotic patients, compared to 0% of the healthy subjects ( P=0.0001). Statistically significant difference in the antibody titer of Child C compared to Child A and B patients was exhibited (6 S.D. above the cut off point; P<0.05). HDL-c levels decreased in parallel to liver damage in alcoholic cirrhotic patients. Comparison between Child A patient HDL-c levels against Child C patients, and Child B patient HDL-c levels against Child C patients showed statistically difference ( P=0.002 and P=0.02, respectively). Low titer positivity (2 S.D. above the cut off point) was found in the group of cirrhotic patients secondary to chronic hepatitis C in 34% of the cases. In habitual drinkers 14% showed positivity to ox-LDL antibodies of 1 S.D. above the cut off point. Antibodies against ox-LDL were present in both group of cirrhotic patients studied and in habitual drinkers without liver dysfunction, however in the group of alcoholic cirrhotic patients a relationship between increasing titer of ox-LDL antibodies and low HDL-c circulating levels were associated to severe liver damage. This observation supports the enhanced lipid peroxidation as an additional mechanism of injury particularly in advances stages of alcoholic cirrhosis.