Mini Review
Lipoprotein X in Cholestasis and Questionable Atherogenic Risk
Ana Paula Marte Chacra1, Anita LR Saldanha2, Raul D Santos Filho1 and Tania Leme da Rocha Martínez1,2*
1Department of Medicine, University of São Paulo, Brazil
2Department of Nephrology, BP – The Portuguese Beneficence of São Paulo, Brazil
Tania Leme da Rocha Martinez, Department of Nephrology, BP – The Portuguese Beneficence of São Paulo, Brazil.
Received Date: May 21, 2020; Published Date: June 08, 2020
Abstract
Lipoprotein X is still an enigma for its lack of evidence as a risk association with atherosclerosis. Primary biliary cirrhosis is a chronic, autoimmune cholestatic liver disease characterized by the presence of T cells that destroy the biliary epithelium. In patients with primary biliary cirrhosis, total cholesterol levels may reach values between 500 and 1000 mg/dL, with cutaneous xanthomas similar to those observed in genetic hypercholesterolemias. The rise in cholesterol is largely due to increased serum levels of lipoprotein-X. It has a small amount of albumin, apoprotein AI, apoprotein Cs and apoprotein E and has no apoprotein B. The formation of lipoprotein-X results from regurgitation of bile lipids in plasma, as well as the accumulation of plasma phospholipids and free cholesterol, resulting from the lower activity of lecithin: acyltransferase cholesterol. Multicenter randomized trials are needed to assess the impact of lipid-lowering patients on lipid reduction and cardiovascular risk, as well as the effect on hepatic cholestasis. Treatment with statins is not indicated for lowering cholesterol in patients with primary biliary cirrhosis and dyslipidemia, as there is no evidence that these patients have high cardiovascular risk.
Keywords: Atherosclerosis; Cholesterol; Lecithin cholesterol acyl transferase; Lipoprotein X; Primary Biliary cirrhosis
Abbreviations: LCAT: Lecithin Cholesterol Acyl Transferase; LDL: Low Density Lipoprotein; LDL-c: Low Density Lipoprotein Cholesterol; LP-X: Lipoprotein X; PBC: Primary Biliary Cirrhosis
-
Ana Paula Marte Chacra, Anita LR Saldanha, Raul D Santos Filho, Tania Leme da Rocha Martínez. Lipoprotein X in Cholestasis and Questionable Atherogenic Risk. On J Cardio Res & Rep. 4(2): 2020. OJCRR.MS.ID.000581.