[Polymorphous aspects of alcohol-induced hyperlipemia].
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Adult↗
Biomedical subjects
C Breier
Publications and source records attributed to C Breier.
[Reduction of post-heparin lipoprotein lipase activity by acidotic blood pH].
Diseases associated with acidotic blood-pH, such as chronic renal disease, diabetes mellitus or chronic alcoholism, show a marked impairment of lipoprotein lipase. Therefore we influenced blood-pH in 3 healthy subjects by infusions to get alkalotic, neutral and acidotic blood-pH on three days in series. On each day blood-pH from capillary blood and post-heparin lipoprotein lipase from fasting plasma was determined. In comparison to neutral blood-pH in vivo, alkalosis did not influence lipoprotein lipase. In contrast, during artificial acidosis, lipoprotein lipase was impaired significantly (p less than 0.01). Therefore, it seems, that acidosis inhibits lipoprotein lipase in vivo.
Acetazolamide↗
[Atherosclerosis in familial hypercholesteremia possibly induced by defective HDL].
The distinct increase in the highly atherogenic plasma low-density lipoproteins (LDL) caused by the wellknown LDL-receptor defect is considered to be responsible for the development of atherosclerosis in familial hypercholesterolemia (FH). In contrast to the atherogenic LDL, the high-density lipoproteins (HDL) are considered to have a protective effect against the development of atherosclerosis and have hitherto been insufficiently investigated in association with FH. HDL2 are assumed to be important in the removal of free cholesterol from the peripheral tissue to the liver, but this hypothesis needs to be supported by further experimental investigations. In this study 18 patients (7 men/11 women) with familial hypercholesterolemia (FH) were compared with 18 healthy controls (8 men/10 women). From fasting plasma the following parameters were determined: cholesterol, triglycerides, phospholipids, HDL-cholesterol, by rate zonal ultracentrifugation the lipoproteins VLDL (very low-density lipoproteins), IDL (intermediate-density lipoproteins), LDL (low-density lipoproteins), HDL2 and HDL3, as well as the activities of lipoprotein lipase (LPL) and hepatic lipase (HTGL). In addition, the percentage composition of the major apolipoproteins (apo) of HDL2 and HDL3 were determined by polyacrylamide disc-gel electrophoresis. In LDL of patients with FH the percentage amount of protein was significantly (p less than 0.01) smaller than in controls. Furthermore, in HDL2 of patients with FH, the percentage content of apo-A II and apo-D was significantly (both p less than 0.01) higher than in controls. In HDL3 of patients with FH a significantly smaller (p less than 0.02) amount of apo-E was revealed than in controls.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Post-heparin lipolytic activities and alterations of the chemical composition of high density lipoproteins in alcohol-induced type V hyperlipidemia.
In order to study the effects of chronic alcoholism, 3 groups of patients were investigated and compared to 10 healthy controls. Group I consisted of 9 heavy drinkers, who exhibited type V hyperlipidemia (HLP) under alcohol intake. Group II consisted of 7 patients, who previously had type V HLP under the influence of alcohol. At the time of the investigation, however, they had ceased alcohol drinking for at least 6 months and were normolipidemic. Group III consisted of 7 heavy drinkers without hyperlipidemia. Compared to controls, group I had significantly decreased plasma concentrations of high density lipoproteins2 (HDL2) and HDL3 (both P less than 0.01); activities of post-heparin lipoprotein lipase (LPL) and hepatic lipase (HTGL) as well were excessively decreased (both P less than 0.01). In group III LPL was also decreased (P less than 0.01), but HTGL was distinctly (P less than 0.01) higher than in controls. No such differences could be demonstrated for the patients of group II. Acute alcohol withdrawal from a patient suffering from alcoholism with HLP led to a sharp increase of LPL with a simultaneous decrease of VLDL within 2 days and a more delayed increase of LDL, HDL2 and HTGL, all reaching normal values within 12 days after cessation of alcohol drinking. With respect to the apolipoprotein (apo) composition of HDL2, patients of group I and group III exhibited a significantly lower percentual content of apo C-I at the expense of a significantly higher content of apo A-II as compared to controls and patients of group II. In group I and II, the percentual content of apo D in HDL2 was significantly higher than in controls and in group III. It is concluded that severe alcohol intake strongly impairs LPL in patients with HLP. The pronounced increase of HTGL in some patients (group III) may protect these individuals from HLP. The increased content of apo D in HDL2 may be a possible primary trait for alcohol-inducible HLP.
Alcoholism↗
Lipoproteins, HDL-apolipoproteins, activities of hepatic lipase and lecithin-cholesterol acyltransferase in the plasma of patients with post-alcoholic end-stage liver cirrhosis.
12 patients with unequivocal post-alcoholic end-stage liver cirrhosis were compared with 12 healthy controls with regard to the plasma concentrations of lipids, lipoproteins (by rate zonal ultra-centrifugation) and apolipoproteins of high-density-lipoproteins (HDL) (by disc electrophoresis), as well as to the activities of lecithin-cholesterol acyltransferase (LCAT) in plasma and of hepatic lipase (HL) in post-heparin plasma. The cirrhotic group showed the following differences (all significant at the p less than 0.01 level) from the control group: Total cholesterol, HDL-cholesterol, very-low-density-lipoproteins (VLDL), HDL, and HL were decreased. Intermediate-density-lipoproteins (IDL) were not detectable in the cirrhotic group. Low-density-lipoproteins (LDL) did not differ significantly from controls. However, LDL from cirrhotic patients contained more triglycerides but less esterified and free cholesterol (all p less than 0.01). The percentage apolipoprotein composition of HDL did not differ significantly between controls and cirrhotics. Surprisingly, LCAT activity in plasma as well as the ratios between esterified and free cholesterol in plasma, LDL, and HDL were nearly identical in both groups. It seems likely that LCAT activity decreases only in the states of acute or subacute liver injury or of biliary obstruction. Severe chronic liver injury or of biliary obstruction. Severe chronic liver damage as in our cases of end-stage liver cirrhosis without any signs of acute liver injury exhibits apparently no defect in cholesterol esterification.
Adult↗
[Lipoproteins, apolipoproteins, lipoprotein lipase, hepatic triglyceride lipase and lecithin cholesterol acyltransferase in patients with nephrotic syndrome].
Chronic renal disease with secondary hyperlipidemia is highly atherogenic. In uremia and patients on chronic hemodialysis there is a high incidence of atherosclerotic complications whereas the incidence of atherosclerotic disease is relatively low in the nephrotic syndrome. This is surprising, as nephrosis produces type-II hyperlipidemia, which is usually highly atherogenic. In this study 10 patients (5 male, 5 female) with a newly diagnosed nephrotic syndrome were compared to 10 controls (5 male, 5 female). As laboratory parameters, lipids, lipoproteins (VLDL, IDL, LDL, HDL2 and HDL3 by rate zonal centrifugation) and the percentage composition of the major apolipoproteins in VLDL, HDL2 and HDL3, as well as lipoprotein lipase (LPL), hepatic lipase (HTGL) and lecithin-cholesterol-acyl-transferase (LCAT) were measured. In nephrotic patients significantly higher plasma levels of cholesterol, triglycerides, phospholipids, VLDL, IDL and LDL were found, whereas HDL-chol, HDL2 and HDL3 were unchanged. LPL and HTGL were both significantly impaired, whereas LCAT was distinctly increased. The percentage composition of apolipoproteins in HDL2 and HDL3 was normal. In nephrotic VLDL, apo-AI was distinctly increased at the expense of a decrease in apo-CII, and increased LCAT was explained by the relative rise of apo-AI in nephrotic VLDL. The increase in apo-AI in VLDL is discussed as a possible reason for the low atherogenic risk of secondary hyperlipidemia in nephrotic syndrome.
Adolescent↗
[Glibenclamide in type II diabetes as compared with placebo].
60 non-insulin-dependent diabetics (type II) were controlled in our outpatient clinic from the 1st February to the 31st May 1981 for investigation of the effect of glibenclamide on blood glucose. They had been treated with glibenclamide during the preceding 12 months at least. Satisfactory control of blood glucose [1, 9] was obtained in only 22 patients (37%) although primary failure of sulphonylurea therapy had been excluded in all patients. After being changed from glibenclamide to placebo, only 19 patients (32%) exhibited a significant increase in blood glucose. Altogether only six out of all sixty patients (10%) satisfied the criteria of adequate blood glucose control under glibenclamide with a significant increase in blood glucose on substituting placebo in place of glibenclamide. It is concluded that treatment with glibenclamide is indicated only if the fasting blood glucose is under satisfactory control (less than 120 mg%) and the efficacy of glibenclamide is confirmed at least once a year by a comparison with placebo.
Aged↗
[Diagnosis of diabetes in pregnancy. Accuracy and prognostic value].
Pregnancy can impair glucose tolerance severely enough to increase the perinatal mortality rate. In the presence of easily recognizable signs pointing to diabetes mellitus we have performed an oral glucose tolerance test. Among 634 patients who were investigated, 151 or 23.8% had impaired glucose tolerance. As there were 11,017 pregnancies in the observation period from January 1976 to May 1981, the detection rate of impaired glucose tolerance was 1.37%. The patients were treated by diet or by diet plus insulin (105 patients). The observed favourable fetal outcome justifies and promotes the proposed diagnostic procedures.
Adult↗
The variance of forearm blood flow as an indicator of emotional stress.
Forearm blood flow was measured four times per minute by venous occlusion plethysmography during rest and during a brief emotionally stressful mental task. During emotional stress not only was the mean forearm blood flow increased, but the single blood flow values fluctuated more than at rest. The greater fluctuation, expressed statistically as the variance, was an indicator of emotional stress, at least as sensitive as the mean increase in the blood flow. Both a tranquillizer (thioridazine) and a beta-blocker (toliprolol) reduced the greater variance during the emotionally stressful situation in doses insufficient to diminish the mean increase in forearm blood flow.
Adult↗
Defective HDL2 in familial hypercholesterolemia.
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Apolipoprotein A-II↗
[Livedo reticularis: dermatologic alarm signal in cold agglutinin disease].
A hitherto healthy adult man developed paroxysmal cold agglutinin disease following an infection of the upper respiratory tract with mycoplasma pneumoniae. Despite continuous blood exchange he died of massive intravascular hemolysis and uremia after 5 days. A presenting striking symptom of this rapidly fatal disease was the acute onset of generalized livedo reticularis. The disease was caused by the rare anti Pr-cold agglutinins which are capable of eliciting hemolysis even in low titers and, in the present case, at body temperature.
Adult↗
Effect of treatment of the concentration of lipoproteins and the postheparin-lipolytic activity in the plasma of noninsulin-dependent diabetics.
To study the effect of treatment on plasma lipid and lipoprotein concentration and on postheparin-lipolytic activity (PHLA) in plasma, 26 noninsulin-dependent diabetics were investigated who were treated with maximally effective doses of glibenclamide. The patients were randomly divided into two groups: In group I, glibenclamide was replaced by a long-acting insulin preparation given once daily at variable doses until satisfactory metabolic control was achieved. In group II, glibenclamide was replaced by placebo. At weeks 0, 1, 3, 7, and 12 after change of treatment, the following parameters were determined: Blood glucose, plasma concentrations of cholesterol, triglycerides, phospholipids, HDL cholesterol, very-low-density lipoproteins, intermediate-density lipoproteins, low density lipoproteins, high-density lipoproteins2 (HDL2), HDL3 and PHLA. At week 0, no statistically significant differences existed between group I and group II with respect to all parameters mentioned above. The replacement of glibenclamide by insulin resulted in a continuous decrease of blood glucose (p less than 0.01) with a concomitant increase in HDL2 (p less than 0.01) and in PHLA (p less than 0.01) during the period of investigation. In contrast, replacement of glibenclamide by placebo exerted no significant influence on all determined parameters during 12 weeks. These data suggest that in noninsulin-dependent diabetics, who are inadequately controlled by sulfonylureas, an adequate insulin substitution is necessary to correct, apart from glucose metabolism, the impaired lipoprotein metabolism of diabetes mellitus. Sulfonylureas per se seem not to decrease the HDL2 fraction nor the PHLA.
Aged↗
[Concentrations of the main lipoprotein density classes in disturbances of thyroid function in man (author's transl)].
The concentrations of the main lipoprotein density classes and the postheparin lipolytic activity (PHLA) were determined in the plasma of 12 hyperthyroid and eight hypothroid patients in comparison with 12 euthyroid, metabolically healthy individuals. Low-density lipoproteins (LDL) and high-density lipoproteins2 (HDL2) were decreased in hyperthyreosis (p less than 0.01) and increased in hypothyreosis (p less than 0.01). No significant differences could be detected with respect to the concentrations of very low-density lipoproteins (VLDL) as well as for HDL3, whereas intermediate-density lipoproteins (IDL) were higher in hypothyreotics than in controls (p less than 0.05). PHLA was increased in hyperthyreosis (p less than 0.01) and decreased in hypothyreosis (p less than 0.01). The chemical composition of LDL and HDL2 as well as the apolipoprotein composition of the protein moiety of HDL2 in hyperthyreosis and in hypothyreosis did not significantly differ from those in the control group. When data from all individuals studied were analyzed, no significant relationship could be detected between the concentrations of VLDL and HDL2, whereas HDL2 and PHLA correlated in a negative manner (p less than 0.05). It is suggested that HDL2, in addition to LDL, acts as carrier protein for the cholesterol increasingly yielded in hypothyreosis.
Adult↗
Lowering plasma cholesterol with beta-sitosterol and diet.
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Adolescent↗
Size and position of the plethysmograph in relation to forearm blood flow values obtained by venous occlusion plethysmography.
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Adolescent↗
[Glucosuria of pregnancy: frequency of diabetes mellitus and renal glucosuria (author's transl)].
From 1974 to 1979 352 pregnant women were referred to our diabetic outpatient clinic because of glycosuria during pregnancy. In 118 women (34%) oral glucose tolerance tests revealed a pathologic glucose tolerance. In 234 pregnant women (66%) a "renal glycosuria of pregnancy" was found to be the cause for the observed glycosuria. A pathologic glucose tolerance was relatively more frequent in the 3rd trimenon, whereas renal glycosuria was observed to be more frequent in the second trimenon.
Blood Glucose↗
Personality dependent effects of the ACTH 4--10 fragment on test performances and on concomitant autonomic reactions.
The effect of the ACTH-fragment 4--10 (30 mg SC) on a mental performance test and on some concomitant cardiovascular changes was investigated in comparison with a placebo in a double blind cross-over study. The subjects were either mainly extraverted or mainly introverted according to Eysenck's 'Maudsley Personality Inventory'. Under the influence of the heptapeptide extraverted subjects achieved a higher total score in the mental task performance with a smaller increase of forearm blood flow and of heart rate than under the influence of the placebo. In contrast, under the influence of the placebo introverted subjects achieved a higher total score in the mental task performance with a smaller increase of forearm blood flow and of heart rate than under the influence of the ACTH-fragment. Personality, therefore, determines to some degree how this centrally acting heptapeptide influences efficiency in the mental task performance and the concomitant cardiovascular changes.
Adrenocorticotropic Hormone↗
Prevention of perinatal morbidity by tight metabolic control in gestational diabetes mellitus.
In a prospective controlled trial, we studied the effect of tight metabolic control on the outcomes of 102 gestational diabetes mellitus (GDM) pregnancies compared with outcomes of 102 matched nondiabetic control pregnancies. Women with GDM were treated to achieve and maintain a blood glucose concentration of less than 130 mg/dl at 1 h after breakfast. Treatment consisted of a diet low in oligosaccharides and fat and, if necessary, once daily insulin. By the end of gestation, 88 of the 102 women with GDM received insulin at a mean dose of 18 U/day. Duration of insulin therapy ranged from 3 to 32 wk with a median of 11 wk. Perinatal outcome of GDM pregnancies under this management equaled that of control pregnancies. The full spectrum of excess morbidity from GDM was prevented, and normal distribution of birth weight and normal rates of macrosomia, dystrophy, hypoglycemia, hypocalcemia, hyperbilirubinemia, fetal acidosis, and low Apgar scores were achieved. No mortality was observed. In addition to the two main study groups, we also studied a third group of 24 women with GDM whose treatment lasted less than or equal to 5 wk due to late diagnosis. This suboptimally treated group demonstrated a significant (P less than .05) increase of macrosomia and umbilical artery acidosis compared with the well-treated GDM group. The study reported herein demonstrates that excess mortality and morbidity typically observed in GDM can be prevented by early institution of tight metabolic control, which required insulin in 86% of our patients.
Birth Weight↗