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8 fatty liver and lipotropic factors

The document discusses fatty liver and the biochemical basis and clinical conditions that can cause fatty liver. It notes that accumulation of abnormal quantities of lipids (>25-30% as triglycerides) in the liver is called fatty liver infiltration. Conditions that can cause fatty liver include starvation, diabetes, obesity from excess calorie intake, alcohol abuse, toxins, drugs, protein-energy malnutrition, and certain hormones. It also discusses lipotropic factors, which are substances that help mobilize fat and prevent its accumulation in the liver, such as choline, betaine, methionine, essential fatty acids, inositol, and some vitamins and minerals. Lipotropic factors can prevent fatty liver but cannot reverse an existing condition

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Fatty liver and Lipotropic factor
Dietary lipids Synthesis of FA from carbohydrates and amino acids Mobilisation of FFA from adipose tissue Mobilisation of TAG Into blood as VLDL Degradation of FA for energy need in liver Influx / increases liver fat Exflux / Decreases liver fat 4 – 5 % total lipids as TAG Normal liver contains
Fatty infiltration of liver • Accumulation of abnormal quantity more than 25-30% of lipid as TAG in liver is called fatty infiltration of liver Normal liver cell Chronic accumulation of fat Fatty changes in hepatocytes Fibrotic changes Cirrhosis
Biochemical basis of fatty liver • Increased mobilisation of fat to liver • High fat Diet • Increased Lipolysis as in DM, Starvation • Decreased esterification of FFA in adipose tissue • Decreased activity of lipoprotein lipase in extra hepatic tissue • Reduced removal of Fat from liver • Block in Apo-protein synthesis • Block in lipoprotein synthesis • Decreased VLDL synthesis • Deficiency of Phospholipids • Deficiency of Lipotropic factors
Clinical conditions / causes of Fatty Liver 1. Starvation 2. Diabetes mellitus 3. Obesity, Excess calories intake 4. Alcohol abuse 5. Hepato toxins-- CCl4, CHCl3, Pb, Arsenic, Ethionine, Orotic acid 6. Drugs – Puromycin 7. PEM – deficiency of protein, Essential FA, Lipotropic factors 8. Hormones – Epinephrine, Ant. Pituitary hormone
Lipotropic factors • Substances which facilitate mobilisation of fat and prevent accumulation of fat in liver are called LIPO TROPIC FACTORS / AGENTS / LIPOTROPINS
Lipotropic factors • Choline – ↓ oxidation of FA ↓phospholipid synthesis, – Impair lipoprotein syntheisis • Betain-- ↓ choline synthesis, methyl gr. Donor for choline • Methionine-- ↓ choline synthesis • Essential Fatty acids– required for VLDL and lipoprotein synthesis • Inositol -- ↓phospholipid synthesis
Lipotropic factors • Casein • Heparin • Vit. E, Selenium, Pantothenic acid • ω3 Fatty acids have protective role • Lipotropic factors prevents fatty liver but cannot reverse the condition