SEVERAL MECHANISMS CONTRIBUTE TO THE ABNORMAL FATTY-ACID COMPOSITION OF SERUM PHOSPHOLIPIDS AND CHOLESTEROL ESTERS IN CHOLESTATIC CHILDREN WITH EXTRAHEPATIC BILIARY ATRESIA

The fatty acid compositions of serum phospholipids and cholesterol est ers and direct bilirubinemia were determined in 11 children with chole stasis due to extrahepatic biliary atresia, The levels of the differen t fatty acids in these lipid classes were compared with those of 22 ap propriate controls and correlations with conjugated bilirubinemia were calculated. Significant differences were found in the levels of sever al fatty acids in these lipid classes, some of which were related to c onjugated bilirubinemia. Relationships between fatty acids in phosphol ipids and cholesterol esters which exist in the control group were eit her absent or different in the patient group. The results found are co mpatible with the concept that malabsorption, overflow in blood of pho spholipids, which are excreted in bile in healthy individuals, and liv er disease per se contribute to the deviating fatty acid compositions. They suggest that administation in the diet may be required of prefor med long chain polyunsaturated fatty acids in an easily absorbable for m.