Background/Aims: In acute liver failure the liver has to regenerate, which
may increase the consumption of essential fatty acids. Nutritional support
consists mainly of infusion of glucose. It is therefore possible that essen
tial fatty acid deficiency may develop in such patients.
Methods: Plasma phospholipid composition was studied in healthy controls (n
=11), in patients with acute liver failure, (n=10), in patients with stable
cirrhosis (n=7), and in patients with acute an chronic liver disease with
hepatic encephalopathy (n=6), The influence of 2 days of fat-free diet foll
owed by infusion of glucose was studied in five healthy controls.
Results: The ratio between the sums of nonessential/essential fatty acids,
(n-7+n-9)/(n-3+n-6), was higher in patients with acute liver failure (0.73/-0.17) compared to healthy controls (0.35+/-0.06, p<0.001). The ratio was
also higher in patients with acute on chronic liver disease (1.11+/-0.39) c
ompared to patients with cirrhosis (0.61+/-0.18, p<0.01). These differences
were mainly due to low levels of linoleic acid and high levels of oleic ac
id in the patients with acute liver failure and acute on chronic liver dise
ase. Two days of fat-free diet followed by infusion of glucose did not chan
ge this ratio (0.40+/-0.04 vs. 0.47+/-0.05, NS) in healthy controls, The es
sential fatty acid deficiency indicator eicosatrienoic acid was detectable
in 2 out of 11 controls, in 5/10 with acute liver failure, in 7/7 with cirr
hosis, and in 6/7 with acute on chronic liver disease.
Conclusion: Acute severe deterioration of liver function was associated wit
h changes in the fatty acid composition of plasma phospholipids suggestive
of essential fatty acid deficiency.