Malmendier C L, Mailier E L, Amerijckx J P, Fischer M L
Hepatogastroenterology. 1983 Dec;30(6):236-9.
In 101 alcoholic patients, plasma apolipoproteins A-I, A-II and B, and lipids were studied in relation to liver function tests, albumin and bilirubin. As compared with controls, the entire population revealed a slight increase in triglycerides, transaminases and bilirubin, and a marked increase in gamma glutamyl transferase. The population was divided into 3 groups according to histological liver microscopy: no lesion, steatosis and cirrhosis. In group 1, apo A-I, A-II and HDL-C were significantly increased. In steatosis, apo A-I, apo A-II and HDL-C had almost normal levels. In cirrhosis, the 3 parameters were significantly decreased, but the apo A-I/apo A-II ratio was increased in relation to the predominant decrease in apo A-II. Liver enzymes were not discriminative, not even gamma GT, which was increased in all 3 groups. Apolipoprotein B, total cholesterol and LDL-cholesterol were insensitive to the degree of hepatic involvement, but a low apo A-I/B ratio might be indicative of a cardiovascular risk. It is suggested that apoproteins and their ratios be used as new markers for the degree of alcoholic intoxication and the risk of cardiovascular complications.
对101例酒精性肝病患者的血浆载脂蛋白A-I、A-II和B以及血脂水平与肝功能检查、白蛋白和胆红素进行了相关性研究。与对照组相比,总体患者的甘油三酯、转氨酶和胆红素略有升高,γ-谷氨酰转移酶显著升高。根据肝脏组织显微镜检查结果将患者分为3组:无病变组、脂肪变性组和肝硬化组。在第1组中,载脂蛋白A-I、A-II和高密度脂蛋白胆固醇(HDL-C)显著升高。在脂肪变性组中,载脂蛋白A-I、A-II和HDL-C水平几乎正常。在肝硬化组中,这3项参数显著降低,但相对于载脂蛋白A-II的主要降低,载脂蛋白A-I/载脂蛋白A-II比值升高。肝脏酶学指标无鉴别意义,即使是γ-谷氨酰转移酶(γGT)也是如此,它在所有3组中均升高。载脂蛋白B、总胆固醇和低密度脂蛋白胆固醇(LDL-C)对肝脏受累程度不敏感,但低载脂蛋白A-I/B比值可能提示心血管风险。建议将载脂蛋白及其比值用作酒精中毒程度和心血管并发症风险的新标志物。