A malabsorption of lipids frequently occurs in patients with liver disease, not only in those with cholestasis but also in those with parenchymal liver disease. Moreover, lipid synthesis and transfer rates are impaired in cirrhotic patients. They have both impaired FFA synthesis and impaired VLDL production. In cirrhosis, plasma triglycerides are elevated and are carried by LDL rather than VLDL. In advanced liver disease, however, both plasma triglycerides and VLDL levels are reduced. In 1862 Austin Flint had suggested that the blood cholesterol level was affected by diseases of the liver. He found that blood cholesterol was raised in three patients with parenchymal liver diseases. Lipid synthesis is decreased in cirrhotics. In cirrhotics, triglycerides are increased and are carried by LDL rather than VLDL. However in advanced cirrhosis of liver, both plasma triglycerides and VLDL are found to be reduced. In patients with cirrhosis, the total serum cholesterol level was decreased. There was a significant decrease in serum HDL and LDL cholesterol. The serum triglyceride levels were significantly increased in alcoholic cirrhotic patients, the amount of decrements measured in the levels of serum total cholesterol; LDL and HDL in patients with cirrhosis are related to the progress in cirrhosis. Further studies are needed to assess the predictive values of measuring lipid profiles as a mean to estimate the extent of liver damage in cirrhotic patients. A total of 50 patients of age group >18 years, diagnosed as Cirrhosis with regards to both history and clinical examination were studied for 12 months in down town hospital, Guwahati, Assam. Lipid profiles of cases were compared with age and sex matched 50 controls patients. The age of the patients ranged from 18 to 60 years, with a mean age of 48.09 ± 9.3 years. Male patients predominated in this study. Maximum numbers of cases were in the age group 41 to 60 years. The commonest cause of cirrhosis in this study was alcoholism, followed by viral hepatitis C. Abdominal distension, fever, yellowish discoloration of eyes/urine & leg were the commonest presenting symptoms in this group of patients. The commonest signs were pallor, pedal edema, icterus and ascitis. Most of the patients in this study showing moderate to severe ascites. Maximum number of patients belonged to Child Pugh Class C. Total cholesterol levels showed highly significant reduction in cirrhosis when compared to controls (p<0.001) and showed positive correlation with the stage of Cirrhosis. Triglycerides level showed very significant reduction in cirrhosis when compared to controls (p<0.01) and was found to have significant correlation with the severity of Liver Disease. HDL cholesterol levels showed highly significant reduction in cirrhosis when compared to controls (p<0.001) and showed positive correlation with the severity of Liver disease. LDL cholesterol levels showed highly significant reduction in cirrhosis when compared to controls (p<0.001) and showed positive correlation with the severity of Liver disease. VLDL levels were decreased very significantly when compared to control & showed positive correlation with the severity of Liver disease. There is a graded response of the lipid profile depending on the Grade of Cirrhosis.
