THE LIPIDS OF SERUM AND LIVER IN PATIENTS WITH HEPATIC DISEASES 1

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Abstract
The serum lipids have been fractionated on 174 occasions in 70 patients with diseases of the liver and bile ducts. Total cholesterol and lipid P are elevated in the serum of patients with biliary obstruction, returning to normal when the condition is relieved by operation. They are also high in a certain proportion of patients with biliary cirrhosis and with infectious hepatitis. Cholesterol and lipid P are normal or subnormal in most patients with portal cirrhosis, tending to fall as the disease advances. In patients with toxic hepatitis and some with infectious hepatitis, these lipid components are also reduced. Neutral fat in liver disease seldom rises above the upper normal limits. It is, however, usually above the avg. normal, and occasionally greatly elevated, in obstructive icterus and infectious hepatitis. The most frequent disorder of serum lipids in liver diseases is an increase of the ratio of free to total cholesterol. In liver disease, especially in those disorders attended by hyperlipemia, the ratio of lipid P to cholesterol is greater than normal. The 2 ratios, free cholesterol: total cholesterol and lipid phosphorus: total cholesterol, are differently and somewhat characteristically altered in various diseases of the liver. Choline chloride and other lipotrophic agents were given to a small series of patients with diseases of the liver, without definitely beneficial effects. The lipids of the sera of 9 patients have been compared with the lipids of samples of liver obtained at autopsy,.