Department of Clinical and Experimental Medicine, Garibaldi Hospital, University of Catania, Via Palermo, 636, 95122, Catania, Italy.
Dig Dis Sci. 2018 Jan;63(1):16-26. doi: 10.1007/s10620-017-4862-x. Epub 2017 Nov 25.
Progressive lipoprotein impairment occurs in liver cirrhosis and is associated with increased morbidity and mortality. The present review aims to summarize the current evidence regarding the prognostic value of lipoprotein abnormalities in liver cirrhosis and to address the need of a better prognostic stratification of patients, including lipoprotein profile assessment. Low levels of lipoproteins are usual in cirrhosis. Much evidence supports the prognostic role of hypolipidemia in cirrhotic patients. In particular, hypocholesterolemia represents an independent predictor of survival in cirrhosis. In cirrhotic patients, lipoprotein impairment is associated with several complications: infections, malnutrition, adrenal function, and spur cell anemia. Alterations of liver function are associated with modifications of circulating lipids. Decreased levels of lipoproteins significantly impact the survival of cirrhotic patients and play an important role in the pathogenesis of some cirrhosis-related complications.
进行性脂蛋白损伤发生于肝硬化,与发病率和死亡率的增加相关。本综述旨在总结脂蛋白异常在肝硬化中的预后价值的现有证据,并探讨对患者进行更好的预后分层的必要性,包括脂蛋白谱评估。肝硬化中通常存在脂蛋白水平降低。大量证据支持低血脂症在肝硬化患者中的预后作用。特别是,低胆固醇血症是肝硬化患者生存的独立预测因子。在肝硬化患者中,脂蛋白损伤与多种并发症相关:感染、营养不良、肾上腺功能和棘状细胞贫血。肝功能改变与循环脂质的变化相关。脂蛋白水平降低显著影响肝硬化患者的生存,并在一些肝硬化相关并发症的发病机制中发挥重要作用。