The effect of hepatitis B on plasma cholesterol and sterol balance

  • Christopher D. Saudek
    Requests for reprints should be addressed to Dr. Christopher D. Saudek, Room F-263, The New York Hospital-Cornell Medical Center, 1300 York Avenue, New York, New York 10021.
    New York, New York, USA
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  • Author Footnotes
    1 From The New York Hospital-Cornell University Medical College, Department of Medicine, Laboratory of Metabolism, New York, New York.
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      A patient with hepatitis B was studied by cholesterol balance technics throughout 29 days of the incubation period, the entire preicteric phase (49 days) and 15 days into the icteric phase. As hepatic inflammation developed, the plasma cholesterol concentration declined, reaching 56 per cent of its base line level before the onset of jaundice. Fecal bile acids diminished slightly whereas fecal neutral steroids were unchanged. As jaundice developed, the plasma cholesterol level rose abruptly and fecal bile acid excretion decreased markedly. This report suggests that plasma cholesterol is diminished by hepatitis prior to the development of icterus. Cholesterol synthesis is probably decreased.
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        • Flint A
        Experimental researches into a new excretory function of the liver: consisting in the removal of cholesterine from the blood, and its discharge from the body in the form of stercorine.
        Am J Med Sci. 1862; 44: 305
        • Sherlock S
        Diseases of the Liver.
        in: 4th ed. F.A. Davis Co, Philadelphia1968: 29
        • Cohn EM
        Diagnostic procedures in the evaluation of hepatic disease.
        in: 6th ed. Gastroenterology. vol III. W.B. Saunders Co, Philadelphia1965: 149
        • Bogoch A
        in: McGraw-Hill Book Co, New York1973: 748
        • Alpers DH
        • Isselbacher KJ
        Derangements of hepatic metabolism.
        in: Harrison's Principles of Internal Medicine. 6th ed. McGraw-Hill Book Co, New York1970: 1524
        • Eder HA
        • Russ EM
        • Pritchett RAR
        • et al.
        Protein-lipid relationships in human plasma, in biliary cirrhosis, obstructive jaundice, and acute hepatitis.
        J Clin Invest. 1955; 34: 1147
        • Tamir I
        • Heldenberg D
        • Levtow O
        Behavior of serum lipids in children with hepatitis A.
        Clin Chim Acta. 1974; 56: 113
      1. Sunderman FW Sunderman Jr, FW Laboratory Diagnosis of Liver Diseases. Warren H. Green Inc, St. Louis, Missouri1968: 291
        • Schmitz J
        • Kahlke W
        Serum lipoproteins and lipids in patients with hepatitis.
        Dtsch Med Wochenschr. 1973; 98: 2436
        • Gerna G
        • Barbi M
        • Manara G
        • et al.
        Evaluation of several clinical and laboratory parameters in 142 patients with acute viral hepatitis in relation to the positive or non-positive tests for Australia antigen (HBsAg).
        Ann Sclavo. 1973; 15: 48
        • Davignon J
        • Simmonds WJ
        • Ahrens Jr, E.H.
        Usefulness of chromic oxide as an internal standard for balance studies in formula-fed patients and for assessment of colonic function.
        J Clin Invest. 1968; 47: 127
        • Grundy SM
        • Ahrens Jr, E.H.
        • Miettinen TA
        Quantitative isolation and gas-liquid chromatographic analysis of total fecal bile acids.
        J Lipid Res. 1965; 6: 397
        • Miettinen TA
        • Ahrens Jr, E.H.
        • Grundy SM
        Quantitative isolation and gas-liquid chromatographic analysis of total dietary and fecal neutral steroids.
        J Lipid Res. 1965; 6: 411
        • Grundy SM
        • Ahrens Jr, E.H.
        • Sälen G
        Dietary β-sitosterol as an internal standard to correct for cholesterol losses in sterol balance studies.
        J Lipid Res. 1968; 9: 374
        • Quintao E
        • Grundy SM
        • Ahrens Jr, E.H.
        An evaluation of four methods for measuring cholesterol absorption by the intestine in man.
        J Lipid Res. 1971; 12: 221
        • Goodman DS
        • Noble RP
        • Dell RB
        Three-pool model of the long-term turnover of plasma cholesterol in man.
        J Lipid Res. 1973; 14: 178
        • Goodman DS
        • Noble RP
        Turnover of plasma cholesterol in man.
        J Clin Invest. 1968; 47: 231
        • Modai M
        • Theodor E
        Intestinal contents in patients with viral hepatitis after a lipid meal.
        Gastroenterology. 1970; 58: 379
        • Miettinen TA
        Clinical implications of bile acid metabolism in man.
        in: 2nd ed. The Bile Acids. vol 2. Plenum Press, New York1973: 227
        • Gross JB
        • Comfort MW
        • Wallaeger EE
        Total solids, fat and nitrogen in the feces. V. A study of patients with primary parenchymatous hepatic disease.
        Gastroenterology. 1950; 16: 140
        • Colwell AR
        Fecal fat excretion in patients with jaundice due to viral hepatitis.
        Gastroenterology. 1957; 33: 591
        • Erb W
        • Krohl R
        • Schreiber J
        • et al.
        Fecal excretion of lipids and bile acids in obstructive icterus and acute virus hepatitis.
        Gastroenterology. 1972; 10: 85
        • Miettinen TA
        Detection of changes in human cholesterol metabolism.
        Ann Clin Res. 1970; 2: 300
        • Scidel D
        • Alaupovic P
        • Furman RH
        A lipoprotein characterizing obstructive jaundice. I. Method for quantitative separation and identification of lipoproteins in jaundiced subjects.
        J Clin Invest. 1969; 48: 1211
        • Scidel D
        Plasma lipids and lipoproteins in patients with liver disease.
        Scand J Gastroenterol. 1972; 7: 105
        • Fredrickson DS
        • Loud AV
        • Hinkelman BT
        • et al.
        The effect of ligation of the common bile duct on cholesterol synthesis in the rat.
        J Exp Med. 1954; 99: 43
        • Widal F
        • Weill A
        • Laudat M
        La lipemie des brightiques: rapports de la retinite des brightiques avec l'azotemie and la cholesterinemie.
        Sema Med. 1912; 32: 529
        • Simon JB
        • Scheig R
        Serum cholesterol esterification in liver disease The importance of lecithin-cholesterol acyltransferase.
        N Engl J med. 1970; 283: 841
        • Jones DP
        • Sosa FR
        • Shartsis J
        • et al.
        Serum cholesterol esterifying and cholesterol ester hydrolyzing activities in liver diseases: relationships to cholesterol, bilirubin and bile salt concentrations.
        J Clin Invest. 1971; 50: 259
        • Gardner HT
        • Swift WE
        • Modica M
        • et al.
        Serum cholesterol and cholesterol esters in viral hepatitis.
        Am J Med. 1950; 8: 584