A statistical comparison between different tests for the diagnosis of latent diabetes and their clinical relevance.
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Biomedical subjects
Publications and source records attributed to H Kaffarnik.
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Three of our regularly controlled patients suffering from Type IV hyperlipoproteinemia and treated with clofibrate complained of impotence within one year after commencement of treatment with this drug. Two of the patients had previously suffered from myocardial infarction. Two patients observed improvement of the symptom 3 and 4 weeks after interruption of clofibrate therapy; one patient again complained of impotence when clofibrate therapy was resumed. The third patient continued intake of the drug up to the present day, and still complains of impotence.
The polymorphism of apolipoprotein E (apo E) accounts for a substantial amount of the genetic variance of cholesterol levels in man. The epsilon-2 allele and the epsilon-4 allele raises plasma and low density lipoprotein cholesterol levels as compared to the epsilon-3 allele. Whereas the lower cholesterol levels in carriers of the epsilon-2 allele can, at least in part, be attributed to the grossly deficient binding of apo E-2 to the apo B,E receptor, apo E-3 and E-4 bind to the same degree. We used gel filtration and ultracentrifugation to separate lipoproteins and subsequent immunoblotting analysis to study the apo E isoform distribution. We always found lipoproteins of lower density relatively enriched in apo E-4 and high density lipoproteins relatively depleted of apo E-4 as compared to apo E-3. This was also seen in plasma of heterozygous subjects that simultaneously express two apo E isoforms. Also, the apo E-A-II complex was directly shown by immunoblotting. Furthermore, when purified iodinated apo E was incubated with plasma in vitro, apo E-4 also reassociated more with lipoproteins of lower density than apo E-3. We conclude that apo E-3 and apo E-4 have a different lipoprotein particle distribution in vivo. This differential lipoprotein distribution may account for differences in the metabolism between apo E-3 and E-4.
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