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Lipoprotein composition in young normolipidemic coronary patients
S 120
Poster session abstracts / .4 therosclerosis 115 ( Suppl. ) (1995) $ 4 5 - S129 PI8 Lipoproteins
449
451
LIPOPROTEIN COMPOSITION IN YOUNG NORMOLIP1DEMIC CORONARY PATIENTS P. Pauciullo C. Sapio, C. Lirato, A. Fischetti, M. Ligouri, "M. Galatti, "N. Spampinato, M. Mancini lnst of lnt Med and Dis of Metab; "Chair of Cardiovascular Surgery, University "Federico II", Naples, Italy
THE PREVALENCE OF ASYMPTOMATIC COMPLICATIONS OF DIABETES MELLITUS IN THE UKRAINIAN CARPATHIANS V.I. Pankiv Central Regional Hospital. Kolomyja, Ukraine
Lipoprotein composition was evaluated in 43 normolipidemic asymptomatic males with premature coronary heart disease (onset before age 50) and in 30 control subjects comparable for sex, age, BMI and life style. Plasma was fractionated in VLDL, LDL and HDL. VLDL was subfractionated in large VLDL (Sf 400-100) and small VLDL (Sf 20-100). Post-heparin Lipoprotein Lipase (LPL) activity was also measured. HDL resulted lower (p<0.005) in patients than in controls. Abnormalities were found in large and small VLDL of patients that showed relative and absolute reduction of cholesteryl ester as compared to control subjects' VLDL. In normal subjects VLDL cholesteryl esters should increase due to exchanges with HDL. These data on VLDL composition along with the low HDL levels and the normal LPL activity found in these patients, suggest reduced supply of cholesteryl ester from HDL to VLDL, probably due to impaired lecithin-cholesterol-acyl-transferaseactivity.
In order to evaluate the importance of the screening for the late complications in the routine clinical approach, we analysed the prevalence of asymptomatic coronary heart disease (CHD), arterial hypertension, nephropathy, retinopathy and somatic neuropathy in 212 patients with insulin-dependent diabetes mellitus (IDDM) (duration of diabetes: 6.2 5 : 1 . 9 yr) and 365 patients with non-insulindependent diabetes mellitus (NIDDM) (duration of diabetes 7.4 5: 2.1 yr) without clinical signs of complications, admitted to the ward of the Central Regional Hospital in Kolomyja. The patients were submitted to the examination in search for CHD (electrocardiography and veloergoelectrocardiography), hypertension (sphygmomanometry), nephropathy (microalbuminuria), retinopathy (fundus examination) and neuropathy (electromyography). The data were gathered and analysed by computer program, designed as the data base for the implementation of the St Vincent Declaration program, which allows simultaneous analysis of all the data on diabetic complications. In IDDM and NIDDM patients we found similar prevalence of asymptomatic retinopathy (6l; 28,8% vs 94; 25,8%, p = N S ) and nephropathy (24; 11,3% vs 33; 9%, p=NS). In contrast, we found that IDDM patients exhibited lower prevalence of CHD (19; 8,9% vs 61; 16,7%, p < 0 , 0 5 ) , hypertension (20; 9,4% vs 64; 17,5%, p < 0 , 0 5 ) and neuropathy (60; 28,3% vs 174; 47,7%, p < 0 , 0 5 ) . Our data signify that prevalence of asymptomatic complications is remarkably high which stresses the importance of the routine use of the screening methods.
45O
452
LIPOPROTEIN LIPIDS AND THE PREVALENCE OF HYPERL1PIDAEMIA AMONG INDIAN MALES S. Guptha ~, R. Gupta2, S. Jain 3, A.K. Josh: Merck Sharp & Dohme Ltd. UK ~, Departments of Medicine, Monilek Hospital and Research Centre. Jawahar Nagar, Jaipur, India2 and Department of Nutrition, University of Rajasthan, Jaipur, India 3
EFFECT OF A LOWER BIRTH WEIGHT IN POLYGENOUS HYPERCHOLESTEROLEMIA R Poledne, H Pistulkov& 1 Hub~i~ek, Z Pfsa. Z Valenta Institute tor Clinical and Experimental Medicine Prague
Objectives: The objective of this study was to determine the lipoprotein lipids. Methods: 401 blood samples were obtained from a larger population survey of 3397 Indian men between 20 and 73 years of age, (202 - rural, 199 - urban). Results: The mean 5: SD serum levels were for total cholesterol 171 + 39 mg/dl, LDL cholesterol 102+36mg/dl, HDL cholesterol 44+12mg/dl and triglycerides 124+50mg/dl. The mean levels in rural vs urban population were for total cholesterol 1655:37 vs 1765:41mg/dl (p=.004), LDL cholesterol 975:33 vs 108_+39 mg/dl {p=.002), HDL cholesterol 445:13 vs 43_+llmg/dl (p=ns) and triglycerides 1225:45 vs 127 + 54mg/dl (p = ns). There was a significant positive correlation of age and body-mass index with total cholesterol levels (r=0.13, 0.23), LDL cholesterol (r=0.07, 0.18) and triglycerides (r=0.22, 0.16) but not with HDL cholesterol levels (r=0.02, 0.06). When classified according to the US National Cholesterol Education Program recommendations high total cholesterol >239mg/dl and LDL cholesterol > 159mg/dl was seen in 33 (8.3%) and low HDL cholesterol <35mg/dl was seen in 95 (23.7%) males. High triglyceride > 400mg/dl was seen in none. Conclusions: The total cholesterol and LDL cholesterol levels are lower than developed countries. The levels of total and LDL cholesterol are significantly higher in urban men. Age and body-mass index are significant correlates of total and LDL cholesterol and triglycerides but not of HDL cholesterol. The most important type of dyslipoproteinaemia in Indian males is low HDL cholesterol
Four groups (100 individuals each) of 11 to 12-year old children were selected from diflerent parts of the distribution curve of cholesmrolemia ol 2000 Prague children - low cholesterol group (LCG) between tile 5th and lOth percentiles a high cholesterol group (HCG) exceeding 95th percentile, a control group for HCG between the 90th and 95th percentiles and a central group as a random sample between the 10th and 90th percentiles. Analysis using a model of linear regression displayed a highly significant negative relationship between LDL cholesterol and births weight in boys. with an increase in O I mlnol/I for each decrease in birth weight for 200 grams. No such relationship was dei'uonstrated in girls. When analysing the frequencies of different geuotypes in apoE and apoB(Xbal), groups of individuals with a birth weight lower or higher to median of HCG did not dii:fer. It is suggested that besides the earlier proved differences m genotype frequencies ill apoE and apoB(Xbal) gene loci between LCG and HCG, a lower'birth weight is an additional factor involved m polygenous hypercholesterolemia.
Poster session abstracts / .4 therosclerosis 115 ( Suppl. ) (1995) $ 4 5 - S129 PI8 Lipoproteins
449
451
LIPOPROTEIN COMPOSITION IN YOUNG NORMOLIP1DEMIC CORONARY PATIENTS P. Pauciullo C. Sapio, C. Lirato, A. Fischetti, M. Ligouri, "M. Galatti, "N. Spampinato, M. Mancini lnst of lnt Med and Dis of Metab; "Chair of Cardiovascular Surgery, University "Federico II", Naples, Italy
THE PREVALENCE OF ASYMPTOMATIC COMPLICATIONS OF DIABETES MELLITUS IN THE UKRAINIAN CARPATHIANS V.I. Pankiv Central Regional Hospital. Kolomyja, Ukraine
Lipoprotein composition was evaluated in 43 normolipidemic asymptomatic males with premature coronary heart disease (onset before age 50) and in 30 control subjects comparable for sex, age, BMI and life style. Plasma was fractionated in VLDL, LDL and HDL. VLDL was subfractionated in large VLDL (Sf 400-100) and small VLDL (Sf 20-100). Post-heparin Lipoprotein Lipase (LPL) activity was also measured. HDL resulted lower (p<0.005) in patients than in controls. Abnormalities were found in large and small VLDL of patients that showed relative and absolute reduction of cholesteryl ester as compared to control subjects' VLDL. In normal subjects VLDL cholesteryl esters should increase due to exchanges with HDL. These data on VLDL composition along with the low HDL levels and the normal LPL activity found in these patients, suggest reduced supply of cholesteryl ester from HDL to VLDL, probably due to impaired lecithin-cholesterol-acyl-transferaseactivity.
In order to evaluate the importance of the screening for the late complications in the routine clinical approach, we analysed the prevalence of asymptomatic coronary heart disease (CHD), arterial hypertension, nephropathy, retinopathy and somatic neuropathy in 212 patients with insulin-dependent diabetes mellitus (IDDM) (duration of diabetes: 6.2 5 : 1 . 9 yr) and 365 patients with non-insulindependent diabetes mellitus (NIDDM) (duration of diabetes 7.4 5: 2.1 yr) without clinical signs of complications, admitted to the ward of the Central Regional Hospital in Kolomyja. The patients were submitted to the examination in search for CHD (electrocardiography and veloergoelectrocardiography), hypertension (sphygmomanometry), nephropathy (microalbuminuria), retinopathy (fundus examination) and neuropathy (electromyography). The data were gathered and analysed by computer program, designed as the data base for the implementation of the St Vincent Declaration program, which allows simultaneous analysis of all the data on diabetic complications. In IDDM and NIDDM patients we found similar prevalence of asymptomatic retinopathy (6l; 28,8% vs 94; 25,8%, p = N S ) and nephropathy (24; 11,3% vs 33; 9%, p=NS). In contrast, we found that IDDM patients exhibited lower prevalence of CHD (19; 8,9% vs 61; 16,7%, p < 0 , 0 5 ) , hypertension (20; 9,4% vs 64; 17,5%, p < 0 , 0 5 ) and neuropathy (60; 28,3% vs 174; 47,7%, p < 0 , 0 5 ) . Our data signify that prevalence of asymptomatic complications is remarkably high which stresses the importance of the routine use of the screening methods.
45O
452
LIPOPROTEIN LIPIDS AND THE PREVALENCE OF HYPERL1PIDAEMIA AMONG INDIAN MALES S. Guptha ~, R. Gupta2, S. Jain 3, A.K. Josh: Merck Sharp & Dohme Ltd. UK ~, Departments of Medicine, Monilek Hospital and Research Centre. Jawahar Nagar, Jaipur, India2 and Department of Nutrition, University of Rajasthan, Jaipur, India 3
EFFECT OF A LOWER BIRTH WEIGHT IN POLYGENOUS HYPERCHOLESTEROLEMIA R Poledne, H Pistulkov& 1 Hub~i~ek, Z Pfsa. Z Valenta Institute tor Clinical and Experimental Medicine Prague
Objectives: The objective of this study was to determine the lipoprotein lipids. Methods: 401 blood samples were obtained from a larger population survey of 3397 Indian men between 20 and 73 years of age, (202 - rural, 199 - urban). Results: The mean 5: SD serum levels were for total cholesterol 171 + 39 mg/dl, LDL cholesterol 102+36mg/dl, HDL cholesterol 44+12mg/dl and triglycerides 124+50mg/dl. The mean levels in rural vs urban population were for total cholesterol 1655:37 vs 1765:41mg/dl (p=.004), LDL cholesterol 975:33 vs 108_+39 mg/dl {p=.002), HDL cholesterol 445:13 vs 43_+llmg/dl (p=ns) and triglycerides 1225:45 vs 127 + 54mg/dl (p = ns). There was a significant positive correlation of age and body-mass index with total cholesterol levels (r=0.13, 0.23), LDL cholesterol (r=0.07, 0.18) and triglycerides (r=0.22, 0.16) but not with HDL cholesterol levels (r=0.02, 0.06). When classified according to the US National Cholesterol Education Program recommendations high total cholesterol >239mg/dl and LDL cholesterol > 159mg/dl was seen in 33 (8.3%) and low HDL cholesterol <35mg/dl was seen in 95 (23.7%) males. High triglyceride > 400mg/dl was seen in none. Conclusions: The total cholesterol and LDL cholesterol levels are lower than developed countries. The levels of total and LDL cholesterol are significantly higher in urban men. Age and body-mass index are significant correlates of total and LDL cholesterol and triglycerides but not of HDL cholesterol. The most important type of dyslipoproteinaemia in Indian males is low HDL cholesterol
Four groups (100 individuals each) of 11 to 12-year old children were selected from diflerent parts of the distribution curve of cholesmrolemia ol 2000 Prague children - low cholesterol group (LCG) between tile 5th and lOth percentiles a high cholesterol group (HCG) exceeding 95th percentile, a control group for HCG between the 90th and 95th percentiles and a central group as a random sample between the 10th and 90th percentiles. Analysis using a model of linear regression displayed a highly significant negative relationship between LDL cholesterol and births weight in boys. with an increase in O I mlnol/I for each decrease in birth weight for 200 grams. No such relationship was dei'uonstrated in girls. When analysing the frequencies of different geuotypes in apoE and apoB(Xbal), groups of individuals with a birth weight lower or higher to median of HCG did not dii:fer. It is suggested that besides the earlier proved differences m genotype frequencies ill apoE and apoB(Xbal) gene loci between LCG and HCG, a lower'birth weight is an additional factor involved m polygenous hypercholesterolemia.