LIPOPROTEIN ALTERATIONS IN LIVER-CIRRHOSIS - A POSSIBLE CONTRIBUTION TO CHANGES IN PLASMA ONCOTIC PRESSURE AND VISCOSITY

Background/Aims: To investigate whether physicochemical alterations in plasma lipoproteins are associated with changes in plasma oncotic pre ssure and viscosity in liver cirrhosis. Methods: The study included 66 patients with cirrhosis (confirmed by liver biopsy) and 58 healthy vo lunteers, The constituents measured were: the concentration, density a nd composition of plasma lipoproteins; plasma oncotic pressure and vis cosity; and the concentrations of albumin, total protein, haptoglobin, transferrin, immunoglobulin M and alpha(2)-macroglobulin. Results: St ep-wise multiple regression analysis indicated that, in the patients w ith cirrhosis, plasma oncotic pressure was significantly correlated wi th plasma albumin+viscosity (r=+0.85; p<0.001) and with plasma total p rotein+the density of low density lipoprotein (r=+0.74; p<0.001), The inclusion of viscosity and the density of low density lipoprotein in t he regression equations significantly improved the observed correlatio n between albumin and plasma oncotic pressure (r=+0.70; p<0.001). Simi larly, plasma viscosity was significantly correlated with the sum of p lasma total protein and cholesterol (r=+0.68; p<0.001), The inclusion of cholesterol in the regression equation significantly increased the observed correlation between total protein and plasma viscosity (r=+0. 59; p<0.001). Conclusions: These results suggest that lipoprotein alte rations associated with liver cirrhosis may play a role in determining plasma oncotic pressure and viscosity, and thus could influence the p rogression of the disease.