LOW VITAMIN-E CONTENT IN PLASMA OF PATIENTS WITH ALCOHOLIC LIVER-DISEASE, HEMOCHROMATOSIS AND WILSONS-DISEASE

The RRR-alpha-tocopherol (vitamin E) content in plasma from 46 patient s with liver diseases and 23 healthy controls was determined by high p erformance liquid chromatography and electrochemical detection. Patien ts were divided into three groups: alcoholic liver diseases (n=17; gro up A), hemochromatosis (n=17; group B) and Wilson's disease (n=12; gro up C). Lipid-standardized alpha-tocopherol levels were determined to n eutralize differences due to hyperlipemia. The ratio of serum vitamin E to serum lipids (cholesterol, triglycerides, phospholipids) was high est in healthy controls and in patients in group A with cirrhosis and normal transaminases and bilirubin. Patients in group A with acute or chronic ethanol intoxication and high bilirubin levels had a 37% lower lipid-standardized vitamin E level than controls. Patients in group B with hemochromatosis, showing high serum iron (>180 mu g/dl), a low f ree iron binding capacity (<8 mu mol/l) and high ferritin-levels (<450 mu g/l), had a 34% lower vitamin E/lipid ratio than healthy controls. No significant lowering of the vitamin E/lipid ratio was observed in the other patients in group B. A significant decrease (37%) in the vit amin E/lipid ratio was only detectable in patients with Wilson's disea se (group C) showing high free serum copper (>10 mu g/dl). The data su pport a role for free radicals in the pathogenesis of active liver dis eases. (C) Journal of Hepatology.