Lipid parameters in childhood cirrhosis and chronic liver disease

BACKGROUND: Alterations in lipid metabolism are well defined in liver disease. As there has not been an ample amount of work published regarding this topic in children, especially about apolipoprotein A-I (apo A-I) and apolipoprotein B (apo B), theoretical knowledge depends on adult studies. In this study, we investigated serum lipid parameters of children with chronic liver disease and cirrhosis. METHODS: Serum triglyceride, cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), plasma apo A-I and apo B levels of 82 children with chronic liver disease, 41 of whom had cirrhosis as well, were investigated. Twenty healthy children were selected as controls. RESULTS: While mean serum triglyceride and cholesterol levels were not different in chronic hepatitis, cirrhosis and healthy children, mean apo B level of cirrhotic group was higher than that of the control group (P < 0.05). Mean LDL and HDL values of children with chronic hepatitis were lower and mean apo B value was higher than those of the control group (P < 0.05, P < 0.05 and P < 0.001, respectively). Apolipoprotein A-I level was lower in cholestatic cirrhotic children than non-cholestatic children (P < 0.05). No statistical difference was detected in lipid parameters of children with or without malnutrition (P > 0.05). The mean HDL value of Child-Pugh B group was significantly lower when compared to Child-Pugh A group (P < 0.05). The mean apo A-I value of Child-Pugh A group was higher than those of Child-Pugh B and C groups (P < 0.05 and P < 0.001). CONCLUSION: Consequently, we found that among lipid parameters apo A-I was the most affected parameter in liver injury. Whether apo A-I level can be used as a prognostic criterion in childhood cirrhosis may require further study.