Issue: Vojnosanit Pregl 2017; Vol. 74 (No. 2)
Diagnostic and pathogenetic significance of apolipoprotein disorders in patients with alcoholic fatty liver
Authors:
Bojan Mladenović, Vesna Brzački, Daniela Benedeto-Stojanov, Nikola Mladenović
fatty liver. Alcohol metabolism takes place in the liver by alcoholdehydrogenase, to toxic acetaldehyde, with fatty acids
accumulation in the liver as a consequence. By daily intake
of the amount greater than 80 g/day for men and 20 g for
women, there is the risk for developing the alcoholic fatty
liver (AFLD). The aim of this study was to determine the
profile of atherogenic factors in plasma of patients with
AFLD compared to patients with non-alcoholic fatty liver
(NAFLD) and determine its diagnostic significance. Methods.
The study included 74 patients with AFLD who consumed
alcoholic beverages daily in large quantities and over
80 g [for men: 3–4 units (U) of alcohol and for women 2–3
U]; the control group consisted of 70 patients with NAFLD
verified with ultrasound. A total holesterol (TC), triglycerides
(TG), high-density lipoprotein cholesterol (HDL-C),
low-density lipoprotein cholesterol (LDL-C) and apoliporoteins
(ApoA1 and ApoB) were determined and the ratios
TC/HDL-C, ApoB/ApoA1 and LDL-C/HDL-C were calculated.
Results. The study included two group: 74 AFLD
patients (21% of women and 79% of men), mean age
42.65 ± 9.73 years, who consumed alcoholic beverages daily
in the amounts of 80 g, or greter, during the average
2.31 ± 0.96 years and 70 patients with NAFLD (37.5% of
women and 63.5% of men) with the average 41.3 ± 4.1
years. There was no significant difference in gender distribution
and the average age between the examined groups.
Higher values of TG – 9.94 ± 2.94 mmol/L, TC
14.53 ± 2.81 mmol/L, LDL-C 8.57 ± 2.15 mmol/L and
ApoB 3.97 ± 0.28 g/L and lower values of HDL-C
0.43 ± 0.11 mmol/L, Apo A1 0.49 ± 0.09 g/L and
ApoB/ApoA1 ratio 2.43 ± 1.27 were registered in the
AFLD group compared to those registered in the NAFLD
group, (TG 8.74 ± 2.54 mmol/L TC 9.87 ± 2.36, LDL-C
6.72 ± 1.98 mmol/L, Apo B 2.38 ± 0.16 g/L, HDL-C
0.78 ± 0.09 mmol/L, Apo A1 0.98 ± 0.04 g/L and
ApoB/ApoA1 ratio 7.81±1.42). There were no differences
in albumin concentration, international normalized ratio
(INR) and values of haemoglobin and haematocrit between
the groups. Conclusion. Lipids and the ApoB/ApoA1 ratio,
besides markers of hepatocelular damage, can serve as a
diagnostic criteria for the presence of AFLD, and as a better
indicator of atherogenic risk.