Effect of medium-chain triglycerides on liver fatty acid composition in alcoholics with or without cirrhosis

Dietary fatty acids are known to be deposited in liver lipids of alcoholic patients, but their ce:role in the pathogenesis of alcoholic cirrhosis is uncertain. In the present study, the fatty acid composition of liver biopsies obtained from seven patients with alcoholic cirrhosis on an essentially normal hospital diet (100-g fat diet for 2 weeks) was compared with those of noncirrhotic alcoholics (six patients) on the same diet. No significant difference was found in the relative amounts of any of 14 fatty acids ranging from C12:0 to C22:6. Substitution of MCT for LCT in similarly selected alcoholics with and without cirrhosis for 2 weeks changed the liver lipid composition of the cirrhotic patients (6 patients), but not in alcoholics without cirrhosis (10 patients). The shorter chain fatty acids (C14:0 and C15:0) increased and the long-chain fatty acids (C18:0 and C18:1) decreased. It is most likely that the persistently elevated serum levels of the medium-chain fatty acids in the cirrhotic patients was responsible for the shift towards the shorter chain fatty acids. Twenty-two of the twenty-nine alcoholic patients (13 had cirrhosis) selected for the study had serum albumin levels below 3.5 mg/100 ml. No change was observed in the two groups on the LCT diet. However, a significant increase of serum albumin levels was observed in the patients fed MCT for a 2-week period. This is usually considered to correlate with recovery of parenchymal function. The data presented suggest a potential value of MCT in the treatment of cirrhosis.