Increased catabolism of high density lipoprotein in alcoholic hepatitis

The kinetics of high density lipoprotein apoprotein A-I were determined in three subjects with severe alcoholic hepatitis. Lipoprotein was obtained from three healthy subjects, radioiodinated, and injected into the patients and the donors. The catabolic rate of A-I was two to four times higher in the patients compared to a group of 18 control subjects studied previously. In the patients only, about 20% of the radiolabeled apoproteins rapidly appeared in the lipoprotein-poor fraction of plasma, which also contained substantial amounts of unlabeled A-I. The findings show that the reduced concentration of A-I in alcoholic hepatitis (less than half-normal), is due not to diminished synthesis (synthesis was normal) but to rapid degradation. This may reflect disruption of abnormal high density lipoproteins due to lack of cofactors.