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A more recent version of this article appeared on March 1, 2003

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J. Lipid Res., doi:10.1194/jlr.M200342-JLR200
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Submitted on August 26, 2002
Revised on November 14, 2002
Accepted on November 22, 2002

Fatty liver in familial hypobetalipoproteinemia: triglyceride assembly into VLDL particles is affected by the extent of hepatic steatosis

Gustav Schonfeld, Bruce W Patterson, Dmitriy A Yablonskiy, Tariq S.K. Tanoli, Maurizio Averna, Nizar Elias, Pin Yue, and Joseph Ackerman

Atherosclerosis, Nutrition and Lipid Research, Washington University School of Medicine, St. Louis, MO 63110

Corresponding Author: gschonfe{at}im.wustl.edu

An unknown proportion of subjects with familial hypobetalipoproteinemia [FHBL] develops fatty liver. The fat content of livers was assessed in 21 representative FHBL subjects with truncations of apoB ranging from apoB-4 to apoB-89, and 14 matched controls by magnetic resonance spectroscopy [MRS]. Respective liver fat% were 16.7+/-11.5 and 3.3+/-2.9 [mean+/-SD] (p=0.001). In FHBL subjects, liver fat% was positively correlated with body mass index, and waist circumference, and areas under the insulin curves of 2h glucose tolerance tests. A similar pattern of correlations was present in controls. However, mean values for these variables were similar in FHBL and controls. This suggests that the degree of abdominal obesity may affect the severity of liver fat accumulation, but for any given degree of obesity FHBL subjects have more hepatic fat, probably due to reduced production of VLDL particles. VLDL-triglyceride [TG]-fatty acids arise from plasma and non-plasma sources such as lipids in the liver and other splanchnic tissues. To assess the relative contributions of each, [2H2]-palmitate was infused over 12h in 13 FHBL and 11 controls and the isotopic enrichment of plasma free palmitate and VLDL-TG-palmitate was determined by mass spectrometry, and the fraction of VLDL-TG originating from plasma and non-plasma sources was assessed using a compartmental model. Non-plasma sources contributed 51+/-15% in FHBL subjects versus 37+/-13% in controls (p=0.02). The correlation between liver fat % measured by MRS and the contribution from non-plasma sources was r=0.89 (p=0.0001) for FHBL subjects and r=0.69 (p=0.01) for controls, indicating that hepatic stores comprise a major component of the non-plasma lipid assembled into VLDL-TG. Thus, apoB truncation-producing mutations result in fatty liver and in altered assembly of VLDL-TG.


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