The clearance rate of retinyl ester from plasma distinguishes patients with idiopathic portal hypertension from those with liver cirrhosis

Abstract A study was conducted to investigate alterations in the clearance rate of chylomicron remnant from plasma in patients with liver cirrhosis and idiopathic portal hypertension. Chylomicron remnant was labeled with retinyl palmitate which was orally administered at a dose of 0.14 mg/kg body weight. Blood samples were drawn serially up to 6 h after the oral administration, and plasma retinyl palmitate levels were determined by high performance liquid chromatography. Kinetics of plasma disappearance curves of retinyl palmitate were analyzed assuming a three compartment model which consists of chylomicron, chylomicron remnant and low density lipoprotein (LDL) pools. Retinyl palmitate was found to be removed from plasma through the latter two compartments, which fractional efflux rate constants were designated as 12 and 13, respectively. 12 was reduced significantly in both liver cirrhosis (1.4 × 10 −2 /min, median, n = 30) and idiopathic portal hypertension (3.1 × 10 −2 , n = 5) as compared with the control (4.0 x 10 −2 , n = 6).13 in idiopathic portal hypertension (6.8 × 10 −3 /min) was significantly elevated, while that in liver cirrhosis (1.9 × 10 −3 ) was decreased when compared to the control (5.0 × 10 −3 ). Such opposite alterations in l 3 may be brought about by the decrease in the number of the responsible receptor (possibly apoB/E receptor) in liver cirrhosis and by the up-regulation of the receptor in idiopathic portal hypertension. The alterations in l 3 are also suggested to help distinguish idiopathic portal hypertension from liver cirrhosis.