APO A1 and Lipid Profile in Cirrhotic Patients and its Correlation with Prognostic Scores: A one Year Cross Sectional Study at KLES Dr. Prabhakar Kore Hospital and MRC, Belagavi

Abstract

BACKGROUND AND OBJECTIVES Liver is considered the primary site for cholesterol and lipoprotein synthesis. In cirrhosis, glycogen reserves are substantially reduced, inducing lipolysis and malnutrition and thereby altering the lipid metabolism. Such modifications evolve along with liver disease progression and can be used as a prognostic indicator for decompensated disease. This study was done to evaluate the lipid profile and levels of Apo A1 in patients with cirrhosis and to determine its association with Child-Pugh and MELD scores. MATERIALS AND METHODS A total of 106 subjects with liver cirrhosis as evidenced by clinical, biochemical or ultrasonographical features of cirrhosis were included and were classified as per different prognostic scores like Child-Pugh score and MELD score. Lipid profile and Apo A1 measurements were done. The correlation between the Child Pugh score and MELD score with levels of Apo A1 and lipid profile was analyzed. RESULTS - All components of the lipid profile were found to be low in patients diagnosed with cirrhosis. Low Apolipoprotein A1 levels (< 1.2 g/L) was seen in 71.64% of the patients. Correlation of MELD score with different components of the lipid profile revealed that there is negative correlation of MELD score with all components of the lipid profile like total cholesterol, LDL, HDL, VLDL, triglycerides and Apo A1. However, statistically significant negative correlation of MELD score was seen only with Apo A1 levels (p< 0.0001) and HDL levels (p< 0.0001). ANOVA test applied to study variation of means of different components of lipid profile in the different classes of Child Pugh classification revealed that there was statistically significant variance in the means of Apo A1, total cholesterol and HDL levels between the 3 classes of Child Pugh scoring classification. INTERPRETATION AND CONCLUSION – A reduction in the lipid profile and Apo A1 in cirrhotics was significantly associated with the severity of liver disease as determined by Child-Pugh and MELD prognostic scores. Evaluation of lipid profile and Apo A1 may be used to determine the synthetic function of liver.