title: Decreases in the serum VLDL-TG/non-VLDL-TG ratio from early stages of chronic hepatitis C: alterations in TG-rich lipoprotein levels.
abstract: BACKGROUND
  The liver secretes very-low-density lipoproteins (VLDLs) and plays a key role in lipid metabolism. Plasma total triglyceride (TG) level variations have been studied in patients with hepatitis C virus (HCV)-related chronic hepatitis (CH-C). However, the results of these studies are variable. A homogenous assay protocol was recently proposed to directly measure the TG content in VLDL (VLDL-TG) and VLDL remnants.
  
  
  RESULTS
  Using the assay protocol, we determined serum VLDL-TG levels in 69 fasting patients with biopsy-proven HCV-related chronic liver disease and 50 healthy subjects. Patients were classified into stages F0-F4 using the 5-point Desmet scale. Serum total TG levels in patients with non-cirrhotic (F1-F3) CH-C did not demonstrate significant differences compared with healthy subjects, but serum VLDL-TG levels did demonstrate significant differences. Mean serum VLDL-TG levels tended to decrease with disease progression from F1 to F4 (cirrhosis). Compared with healthy subjects, serum non-VLDL-TG levels significantly increased in patients with stages F2 and F3 CH-C; however, we observed no significant difference in patients with liver cirrhosis. Furthermore, the serum VLDL-TG/non-VLDL-TG ratio, when taken, demonstrated a significant decrease in patients with CH-C from the mildest stage F1 onward.
  
  
  CONCLUSIONS
  The decrease in serum VLDL-TG levels was attenuated by increase in non-VLDL-TG levels in patients with non-cirrhotic CH-C, resulting in comparable total TG levels. Results of previous studies though variable, were confirmed to have a logical basis. The decrease in the serum VLDL-TG/non-VLDL-TG ratio as early as stage F1 demonstrated TG metabolic alterations in early stages of CH-C for the first time. The involvement of TG metabolism in CH-C pathogenesis has been established in experimental animals, while conventional TG measurements are generally considered as poor indicators of CH-C progression in clinical practice. The serum VLDL-TG/non-VLDL-TG ratio, which focuses on TG metabolic alterations, may be an early indicator of CH-C.
authors.affiliation: Department of Molecular Diagnosis, Graduate School of Medicine, Chiba University, Chiba City, Japan. ZXA03460@nifty.ne.jp
authors.forename: Motoi
authors.initials: M
authors.lastname: Nishimura
authors.forename: Haruna
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Yoshida
authors.forename: Masanori
authors.initials: M
authors.lastname: Seimiya
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sawabe
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Matsushita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Umemura
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Sogawa
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Takizawa
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
authors.forename: Fumio
authors.initials: F
authors.lastname: Nomura
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D018450:Disease Progression; D015536:Down-Regulation; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000150:complications / Q000378:metabolism; D006801:Humans; D052439:Lipid Metabolism Disorders / Q000097:blood / Q000150:complications; D008074:Lipoproteins / Q000097:blood*; D008079:Lipoproteins, VLDL / Q000032:analysis / Q000097:blood*; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014280:Triglycerides / Q000032:analysis / Q000097:blood*
chemical_list: D008074:Lipoproteins; D008079:Lipoproteins, VLDL; D014280:Triglycerides; C030087:lipoprotein triglyceride; C030106:very low density lipoprotein triglyceride