Son Dönem Karaciğer Yetmezliğinde Yüksek Yoğunluklu Lipoprotein Subfraksiyon Değişiklikleri

Öz

AMAÇ: Bu çalışma, son dönem karaciğer yetmezliğinde (ESLF) yüksek yoğunluklu lipoprotein (HDL) alt fraksiyonlarını ve HDL ile ilişkili enzim değişikliklerini belirlemek için tasarlanmıştır. YÖNTEMLER: Çalışma için 20 ESLF hastası ve 20 kontrol (karaciğer donörü) kişi seçildi. Nakil öncesinde her hasta ve kontrolden alınan serum örnekleri değerlendirildi. HDL alt fraksiyon değişikliklerini belirlemek için sürekli disk poliakrilamid jel elektroforezi yapıldı ve lesitin-kolesterol asiltransferaz (LCAT), apolipoprotein A-1 (ApoA-I) ve kolesteril ester transfer proteininin (CETP) serum seviyelerini belirlemek için ELISA yapıldı. BULGULAR: Karaciğer yetmezliği olan hastalarda, sağlıklı donörlerle karşılaştırıldığında anlamlı derecede yüksek trigliserit (TG) ve çok düşük yoğunluklu lipoprotein (VLDL) seviyeleri vardı. Ek olarak, bu hastalarda aspartat aminotransaminaz (AST), alkalin fosfataz (ALP), alanin aminotransaminaz (ALT) ve kan üre nitrojeni (BUN) düzeylerinde önemli artışlar görülürken, albümin kontrollere kıyasla belirgin şekilde düşüktü. HDL kolesterol konsantrasyonları iki grup arasında önemli ölçüde değişmese de, ESLF hastalarında kontrollerin aksine HDL-büyük alt bölümünde belirgin bir artış ve HDL-küçük alt bölümünde önemli bir düşüş vardı. Ayrıca karaciğer yetmezliği olan hastaların serum ApoA1 düzeyleri sağlıklı kontrollere göre oldukça düşüktü ancak LCAT ve CETP düzeyleri açısından iki grup arasında anlamlı bir fark yoktu. SONUÇ: HDL alt fraksiyon profili, sağlıklı donörler ile karaciğer yetmezliği olan hastaları birbirinden ayırabilir. Sonuçlar ayrıca HDL metabolizmasında çok önemli bir işlevi yerine getiren ApoA-1 düzeylerinin ESLF'de daha düşük olduğunu göstermektedir. HDL-küçük alt fraksiyonlarındaki bu azalma, hepatik yetmezlikten kaynaklanan bozulmuş anabolizmaya bağlı olabilir.

Anahtar Kelimeler

• Son Dönem Karaciğer Yetmezliği
• HDL Subfraksiyonları
• Apo A1
• CETP
• LCAT

High-Density Lipoprotein Subfraction Changes in End-Stage Liver Failure

Abstract

BACKGROUND: This work was designed to ascertain high-density lipoprotein (HDL) subfractions and HDL-related enzyme alterations in end stage liver failure (ESLF). METHODS: Twenty patients with ESLF and twenty control subjects (liver donors) were chosen for the study. Before the transplant, serum samples from each patient and control were evaluated. Continuous disc polyacrylamide gel electrophoresis was performed to determine HDL subfraction changes and ELISA was carried out to determine serum levels of lecithin–cholesterol acyltransferase (LCAT), apolipoprotein A-1 (ApoA-I) and cholesteryl ester transfer protein (CETP). RESULTS: Liver failure patients had significantly higher levels of triglycerides (TG) and very low-density lipoprotein (VLDL) compared to healthy donors. Additionally, these patients showed significant increases in levels of aspartate aminotransaminase (AST), alkaline phosphatase (ALP), alanine aminotransaminase (ALT), and blood urea nitrogen (BUN), while albumin was notably lower compared to controls. Even though HDL cholesterol concentrations were not considerably altered between the two groups, ESLF patients had a marked raise in the HDL-large subfraction and a significant decline in the HDL-small subfraction in contrast to controls. Moreover, liver failure patients had considerably lower serum ApoA1 levels compared to healthy controls, but there was no significant difference in LCAT and CETP levels between the two groups. CONCLUSION: HDL subfraction profile can distinguish between healthy donors and liver failure patients. The results also indicate that levels of ApoA-1, which performs a crucial function in HDL metabolism, are lower in ESLF. This decrease in HDL-small subfractions may be due to impaired anabolism resulting from hepatic failure.

Keywords

• End stage liver failure
• HDL Subfractions
• Apo A1
• CETP
• LCAT

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