What causes fatty liver in patients with Kwashiorkor?

In patients with Kwashiorkor, a form of protein malnutrition, fatty liver is primarily caused by decreased levels of apolipoproteins. In this condition, the lack of adequate dietary protein impairs the synthesis of key proteins necessary for the transport of lipids from the liver. Apolipoproteins are essential components of lipoproteins, which facilitate the export of triglycerides and other lipids from the liver to peripheral tissues.

When the synthesis of apolipoproteins is compromised, fatty acids accumulate in the liver because they cannot be effectively transported. This leads to the development of hepatic steatosis, or fatty liver. The condition is characterized by an imbalance wherein lipid production outpaces its export, resulting in excess accumulation within the liver.

Other potential causes of fatty liver, such as excessive alcohol consumption or high cholesterol diet, are not the primary mechanisms in the context of Kwashiorkor. Similarly, excess fructose intake relates to non-alcoholic fatty liver disease but is not relevant in this scenario. Thus, decreased apolipoproteins directly due to protein deficiency in Kwashiorkor is the critical factor leading to fatty liver in affected patients.