Abstract
Background/AimsEmerging data links different aspects of lipid metabolism to liver regeneration. In patients with acute liver failure (ALF), low levels of lipids may correlate with disease severity. Thus, we determined whether there is an etiology-specific link between lipid levels in patients suffering from ALF and aimed to investigate an effect of lipid levels on the prognosis of ALF.MethodsIn this retrospective single center study, we reviewed 89 consecutive ALF patients, who met the criteria of the “Acute Liver Failure Study Group”. Patient characteristics, clinical data and laboratory parameters were individually analyzed at admission and correlated with the patients' outcome after a four week follow up. Possible endpoints were either discharge, or death or liver transplantation.ResultsHigh-density lipoprotein (HDL), cholesterol and triglyceride levels were significantly lower in patients who died or required a liver transplant. HDL levels were significantly higher in patients with ALF caused by acetaminophen intoxication, compared to fulminant HBV infection or drug induced liver injury. HDL levels correlated with hepatic injury by ALT levels, and Albumin, and inversely correlated with the MELD score, INR, and bilirubin.ConclusionIn our cohort of patients with ALF, we could show that HDL and cholesterol are suppressed. In addition novel etiology specific patterns between acteminophen and non-acteminophen induced liver failure were detected for serum lipid components. Further studies are needed to address the role of cholesterol and lipid metabolism and the according pathways in different etiologies of ALF.
Highlights
High density lipoprotein (HDL) is a major lipid component of the serum
For example low HDL concentrations are associated with poor outcome in sepsis [6]
acute liver failure (ALF) was diagnosed by the assessment of laboratory parameters, the international normalized ratio (INR), and neurological status
Summary
HDL serves as transport molecule for cholesterol to various sites in the organism, among them the adrenal gland for steroidogenesis [1] and to the liver as building block for cell membranes and as energy supply [2]. These two functions are especially important in times of tissue damage and repair or regeneration. For example low HDL concentrations are associated with poor outcome in sepsis [6]. Reduced liver function could indirectly aggravate systemic infections or inflammatory processes due to higher LPS concentrations
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