Lipid and lipoprotein abnormalities in liver disease: the possible role of lecithin: cholesterol acyltransferase deficiency.

Abnormalities of plasma lipids are common in patients with diseases of the liver. Plasma cholesterol levels are usually high with obstructive jaundice and low with severe parenchymal liver disease. In both situations free cholesterol tends to be elevated; the ester: free ratio is low. Lecithin levels may be high and lysolecithin low. These changes are similar to those found in patients suffering from a familial deficiency of the plasma enzyme lecithin: cholesterol acyltransferase (LCAT). Detailed examination of plasma lipoproteins reveals other similarities between the effects of liver disease and those of familial LCAT deficiency. Decreased activity of LCAT would explain many of the lipid changes of liver disease but it is unlikely that it could account for all of them.

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