The Lipid Composition of Serum in Patients With Liver Disease*

The association of a serum lipid abnormality and liver disease has been known since 1862, when Flint (1) described the accumulation of cholesterine in the blood of patients with liver disease as the result of decreased excretion of this substance into the bile. Subsequent observations disclosed that this increase in serum cholesterol concentration was largely in the unesterified (free) fraction, so that the ratio of free/total cholesterol was elevated (2-4). Man, Kartin, Durlacher and Peters (5), in 1945, showed that the lipid phos-phorus concentration and the ratio of lipid phos-phorus/cholesterol were also elevated in certain patients with liver disease. The elevation in se-rum lipid phosphorus concentration appeared to be attributable largely to an increase in the serum lecithin concentration (6-9). The hyperlipemia and the increase in the ratio of free/total choles-terol, moreover, showed some correlation with the degree of jaundice, whether due to biliary obstruc-tion or to parenchymal damage (5, 10-12). Abnormalities in the serum lipoprotein compo-sition have also been described in patients with liver disease and jaundice. Marked increases in the Sf6 and Sf8 with varying increases in the Sf10-17 ultracentrifugal classes of lipoproteins have been reported in patients with biliary cir-rhosis (13). In patients with hepatitis, increases in the SA12, 12-20, and 20-100 classes, which correlated positively with the icteric index, and decreases in the Sf00-400 class, which correlated negatively with the icteric index, have been found (14). Increased concentrations of /3-lipoprotein and decreased-to-absent concentrations of a-lipo-protein have been observed with zone electro-phoresis of serum from patients with jaundice (15). Similar findings have been reported with