Studies of fat absorption in patients with hypercholesteremia and in patients with coronary artery disease.

ABNORMAL lipid metabolism has been implicated as one of the causes of atheroselerosis and coronary artery disease.'-3 Measurements of serum levels of cholesterol, triglycerides, lipoproteins, phospholipids, and total fats, as well as the ul1tracentrifugation of serum, have all demonstrated statistically significant differences between groups of normal subjects and groups of patients with proved coronary artery atheroselerosis.1-6 With all of these tests, however, there is considerable overlap between the values found in normal subjects and in patients with coronary artery atherosclerosis. For example, some normal subjects may have elevated serum cholesterol levels while some patients with proved coronary artery disease may have serum cholesterol levels within the normal range. These tests, therefore, are of very limited clinical use in differentiating an individual with significant coronary heart disease from a normal subject. Nevertheless, there is sufficient evidence in these studies to implicate abnormal lipid metabolism. The absorption of I131-labeled triglycerides following oral administration has been well established as a method of study in the diagnosis of disorders of intestinal fat absorption.7-9 Differences in the degree of absorption of fats and fatty acids can be used in the differential diagnosis of steatorrhea of various eauses, such as sprue and pancreatic insufficiency. In 1949 Thannhauser and Stanley'0 showed that patients with idiopathic