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Lipid parameters in childhood cirrhosis and chronic liver disease
Mukadder Ayşe Selimoglu1, Sema Aydogdu, Rasit Vural Yagci
1Department of Pediatric Gastroenterology and Nutrition, School of Medicine, Ege University, Izmir, Turkey. ayseselimoglu@hotmail.com
Insights
Childhood liver disease impacts lipid metabolism, particularly apolipoprotein A-I (apo A-I). Apo A-I levels were most affected by liver injury, suggesting potential as a prognostic marker in pediatric cirrhosis.
Area of Science:
- Pediatric Gastroenterology
- Hepatology
- Clinical Biochemistry
Background:
- Lipid metabolism alterations are known in adult liver disease.
- Limited research exists on pediatric lipid profiles, especially apolipoprotein A-I (apo A-I) and apolipoprotein B (apo B).
- This study addresses the gap in understanding lipid changes in children with chronic liver disease and cirrhosis.
Purpose of the Study:
- To investigate serum lipid parameters in children with chronic liver disease and cirrhosis.
- To compare lipid profiles between pediatric patients and healthy controls.
- To assess the impact of disease severity (e.g., Child-Pugh score) on lipid metabolism.
Main Methods:
- Serum triglyceride, cholesterol, LDL, HDL, apo A-I, and apo B levels were measured in 82 children with chronic liver disease (41 with cirrhosis).
- Twenty healthy children served as controls.
- Lipid parameters were analyzed in relation to disease status (hepatitis vs. cirrhosis) and severity (Child-Pugh A, B, C).
Main Results:
- Apolipoprotein B (apo B) was elevated in cirrhotic children compared to controls.
- Children with chronic hepatitis showed lower LDL and HDL, and higher apo B levels than controls.
- Apolipoprotein A-I (apo A-I) levels were lower in cholestatic cirrhotic children and decreased with worsening liver function (Child-Pugh B/C).
Conclusions:
- Apolipoprotein A-I (apo A-I) is the most significantly affected lipid parameter in pediatric liver injury.
- Further research is needed to determine if apo A-I can serve as a prognostic criterion for childhood cirrhosis.
Background:
Alterations in lipid metabolism are well defined in liver disease. As there has not been an ample amount of work published regarding this topic in children, especially about apolipoprotein A-I (apo A-I) and apolipoprotein B (apo B), theoretical knowledge depends on adult studies. In this study, we investigated serum lipid parameters of children with chronic liver disease and cirrhosis.
Methods:
Serum triglyceride, cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), plasma apo A-I and apo B levels of 82 children with chronic liver disease, 41 of whom had cirrhosis as well, were investigated. Twenty healthy children were selected as controls.
Results:
While mean serum triglyceride and cholesterol levels were not different in chronic hepatitis, cirrhosis and healthy children, mean apo B level of cirrhotic group was higher than that of the control group (P < 0.05). Mean LDL and HDL values of children with chronic hepatitis were lower and mean apo B value was higher than those of the control group (P < 0.05, P < 0.05 and P < 0.001, respectively). Apolipoprotein A-I level was lower in cholestatic cirrhotic children than non-cholestatic children (P < 0.05). No statistical difference was detected in lipid parameters of children with or without malnutrition (P > 0.05). The mean HDL value of Child-Pugh B group was significantly lower when compared to Child-Pugh A group (P < 0.05). The mean apo A-I value of Child-Pugh A group was higher than those of Child-Pugh B and C groups (P < 0.05 and P < 0.001).
Conclusion:
Consequently, we found that among lipid parameters apo A-I was the most affected parameter in liver injury. Whether apo A-I level can be used as a prognostic criterion in childhood cirrhosis may require further study.