Article révisé par les pairs
Résumé : Three cases of chylous ascites were studied. Patient 1 ingested [14]palmitate and the radioactivity in ascitic fluid was recovered mostly in chylomicron triglyceride as early as the first hour reaching 56% of the dose after 24 hours. In patient 2, palmitate was administered simultaneously by i.v. injection (3H) and by the oral route (14C). [3H]Palmitate appeared sooner and reached a much higher level in plasma than in ascitic lipoproteins. [14C]Palmitate appearance was delayed compared to [3H]Palmitate in both plasma and ascitic fluid but in contrast was incorporated much more in ascitic lipoproteins. The relative activity of the two tracers in organs demonstrated the major contribution of the intestine in ascitic lipoprotein synthesis whereas plasma lipoproteins originated in both intestine and liver. In patient 3, ascitic fluid lipoproteins differed from their plasma counterparts by a higher triglyceride/protein ratio, a lower cholesteryl ester and sphingomyelin percentage especially in high density and low density lipoproteins, an inverse ratio of apoproteins A-I/A-II and an increase in apoproteins C-III1 and C-III2. The possibilities of distinct but parallel metabolism of lipoproteins in plasma and ascitic fluid and of a unique origin for all ascitic lipoproteins are discussed. A schematic representation of lipoprotein formation in chylous ascites is proposed. © 1977.