[Lipid and lipoprotein metabolism in acute pancreatitis]

In 10 patients with acute pancreatitis the lipid- and lipoprotein-metabolism was studied. In all patients blood samples were drawn for estimation of the fasting concentration of the lipoproteins. In 7 patients the postheparinlipasesystem was testet by an intravenous heparintest. Afterwards, 0.2 g fat/kg bodyweight were injected intravenously in 2 min. Before, 5, 10, 30 and 40 min after injection blood was drawn. Lipids were estimated by means of full encymatic methods, lipoproteins were determined according to the lipid research clinics method, NIH, using a combination of ultracentrifuge and polyanion precipitation. In comparison with healthy people the cholesterol, specially the LDL fraction was low. Additionally the triglycerides were elevated in 3 patients, caused by elevation of the VLDL fraction. After injection of heparin in all patients the triglyceride concentrations fell. That shows a functionating lipoprotein lipase system. Intravenously injected fat was eliminated in all patients with an elimination rate between 1 and 2 %/min. From these results it is concluded that exogenous fat is eliminated sufficiently from serum in acute pancreatitis. There is no sign for disturbed fat metabolism in these patients. Therefore the contraindication for fat emulsions in acute pancreatitis does not seem to be justified. Due to the fact of glucose intolerance in these patients fat emulsions could be used for an adequate supply of energy. Patients with a hyperlipoproteinemia should be excluded from this therapy by daily detection of triglycerides.