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Plasma lipids in extra hepatic biliary obstruction.

S P Mistilis, R Goren, A R Tall

    Australian and New Zealand Journal of Medicine
    |December 1, 1975
    PubMed
    Summary
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    Extra hepatic biliary obstruction (EHO) causes significant, persistent hypertriglyceridemia, distinct from endogenous forms. Lipid profiles normalize after obstruction relief, though Lipoprotein-X may persist.

    Area of Science:

    • Biochemistry
    • Clinical Medicine
    • Lipid Metabolism

    Background:

    • Extra hepatic biliary obstruction (EHO) is associated with altered plasma lipid profiles.
    • Previous studies suggested hypertriglyceridemia in EHO, but its consistency and significance required further investigation.

    Purpose of the Study:

    • To investigate the extent and consistency of hypertriglyceridemia in patients with EHO.
    • To compare plasma lipid and lipoprotein changes in EHO patients before and after surgical relief of obstruction.
    • To differentiate EHO-associated hypertriglyceridemia from endogenous (type IV) hypertriglyceridemia.

    Main Methods:

    • Analysis of plasma lipids and lipoproteins in 15 patients with EHO and 23 controls.
    • Comparison of lipid profiles before and after surgical intervention for EHO.

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  • Electrophoretic analysis of lipoproteins and assessment of cold aggregation tests.

    • Main Results:

    • Patients with EHO exhibited increased total cholesterol (unesterified fraction), phospholipids, and a marked, persistent elevation in triglycerides.
    • Triglyceride levels in EHO were comparable in magnitude to cholesterol and phospholipid increases and normalized post-obstruction relief.
    • EHO-associated hypertriglyceridemia presented with clear serum, negative cold aggregation, and a broad beta fraction, differing from type IV hypertriglyceridemia.
    • Lipoprotein-X was detected in EHO patients and persisted even after other lipid parameters normalized.

    Conclusions:

    • Extra hepatic biliary obstruction consistently causes significant hypertriglyceridemia, characterized by specific lipoprotein changes.
    • The hypertriglyceridemia in EHO is reversible upon relief of obstruction, unlike certain other lipid abnormalities.
    • Lipoprotein-X is a persistent marker associated with EHO, even when other lipid parameters return to normal.