Determination of serum apolipoprotein (apo) A-IV concentration in patients with various hepatobiliary disorders and its clinical significance.

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We determined serum apo A-IV concentrations in healthy controls and in patients with hepatobiliary disorders. Serum apo A-IV level was 115.6±28.8U/dl in healthy controls (n=34) and there was no significant correlation between apo A-IV and TG, TC or other apolipoproteins (apo A-I, A-II, B, C-II, C-III and E). Apo A-IV level was significantly decreased in patients with acute hepatitis (acute phase), fulminant hepatitis and cholestasis compared with healthy controls (p<0.001). Time course of changes in a patient with acute hepatitis showed decrease of apo A-IV level according to the degree of his oral food reduction. On the other hand, apo A-IV level was considerably low even when he was able to take a full oral diet. In contrast, apo A-IV level was not significantly decreased in patients with chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. These findings suggest that serum apo A-IV level depends on the extents of lipid absorption from the small intestine and the liver does not participate in the synthesis of apo A-IV at least in humans. In addition, apo A-IV is considered to be a new parameter for nutritional assessment with respect to oral alimentation.
社団法人日本肝臓学会の論文