Lipoprotein(a) as a Predictor of Nonalcoholic Fatty Liver After Pancreatectomy

Abstract

Background/aim: Lipoprotein(a) (Lp(a)) is a complex protein involved in the transport of insoluble lipids in plasma. Its expression is predominantly genetically determined, with 70% to over 90% influenced by the number of Kringle IV type 2 domains. This study investigated the association between preoperative serum Lp(a) level and development of post-pancreatectomy nonalcoholic fatty liver disease (NAFLD) in patients who underwent pancreatectomy.

Patients and methods: Serum Lp(a) level was measured preoperatively and retrospectively evaluated together with other known risk factors for NAFLD, which was defined using a computed tomography-based Hounsfield unit (HU) value for liver parenchyma below 40 HU at the anteroposterior midpoint.

Results: NAFLD developed after pancreatectomy in 40 patients (17.5%) in the high Lp(a)-group, which was significantly lower compared to the 30 patients (53%) in the low Lp(a)-group (p=0.01). There were no other significant background factors related to preoperative Lp (a) level. Multivariate analysis indicated that low Lp(a) level is an independent risk factor for postoperative NAFLD, as well as pancreatic head resection, a small residual pancreatic volume, poor intake of pancrelipase, and postoperative diarrhea.

Conclusion: NAFLD after pancreatectomy could be predicted preoperatively to a certain extent by examining serum Lp(a) level.

Keywords: Lipoprotein (a); nonalcoholic fatty liver; pancreatectomy.