FAT ABSORPTION AND TRANSPORTATION IN PATIENTS WITH LIVER CIRRHOSIS AND IN CCl4-INDUCED CIRRHOTIC RATS

Abstract

In this study, fat malabsorption from small intestine was studied clinically in patients with liver cirrhosis and experimentally in rats with CCl4-induced liver cirrhosis. The presence of abnormalities of fatty acid composition and the inhibition increase in plasma lipids concentration after olive tolerance test as well as the abnormal values of 131I-triolein test were observed in patients with liver cirrhosis. Such abnormalities were found more markedly in patients with ascites, who is supposed to associated with the disorders of intestinal lymphatics. Endoscopically, we can frequently observe the accumulation of lipids in intestinal mucosa in cirrhotic patients with ascites, however there was no evidence of disturbance of apolipoprotein B synthesis in intestinal mucosa of these patients. Experimentally, mucosal uptake of linoleic acid and resynthesis of triglyceride in intestinal mucosa were almost normal, but lymphatic transportation of lipids from intestinal epithelial cells was delayed in rats with liver cirrhosis. In conclusion, the process of mucosal uptake, resynthesis of triglyceride and lipoprotein formation of lipid were supposed to be not so significantly desturbed in liver cirrhosis, but the transportation phase of lipid to intestinal lymphatics was disturbed resulting in mucosal accumulation of lipids. And it is also supposed that fat malabsorption in liver cirrhosis will become marked when the lymphatic disorders were present.