The abnormal serum lipid pattern in patients with coronary arteriosclerosis.

Studies in experimental arteriosclerosis have indicated that the relative level of serum lipid phosphorus may be as significant a factor as the absolute level of serum cholesterol in the production of arterial lesions. For this reason, the serum lipid pattern of 82 patients with coronary arteriosclerosis has been compared with that of 112 healthy adults. An elevation of the serum cholesterol, serum lipid phosphorus and the serum cholesterol-lipid phosphorus molar ratio has been found in most of the patients with coronary arteriosclerosis. P REVIOUS studies1' 2 from this laboratory have demonstrated that the serum cholesterol pattern of patients with coronary arteriosclerosis differs from that of normal individuals in that the serum cholesterol levels are higher and more inconstant than those in control subjects. Recent experimental data have indicated that the ratio between serum cholesterol and serum phos-pholipids may be as significant as the absolute level of serum cholesterol in the production of arteriosclerosis in animals. A report from this laboratory3 revealed that in the production of experimental arteriosclerosis in rabbits fed cholesterol or dogs fed cholesterol plus thioura-cil, the serum cholesterol levels increased disproportionately to the increase in serum phospholipid. This resulted in an abnormal cholesterol-phospholipid ratio. Kellner and his co-workers4 have recently shown that the intravenous injection of synthetic detergents in rabbits resulted in an elevation of the serum cholesterol and serum phospholipids. The injection of detergents in cholesterol fed rabbits partially inhibited the development of experimental arteriosclerosis. The protective effect was evident in those animals in which the 605 elevation of serum cholesterol was accompanied by a parallel or disproportionate increase in serum phospholipids. Duff and Payne5 have reported that the inhibition of experimental cholesterol arteriosclerosis in rabbits with alloxan diabetes is related to a marked increase in serum neutral fat and lipid phosphorus. It was therefore thought to be of interest to study the serum cholesterol, serum lipid phosphorus and the serum cholesterol-lipid phosphorus ratio in a group of patients with coronary arteriosclerosis to determine if further abnormal patterns of serum lipids existed in this condition. While this project was under way, a report by Gertler and his co-workers6 presented data and postulated that the levels of serum cholesterol and serum phospholipid are less important in coronary artery disease than is the ratio of cholesterol to phospholipids. METHODS Two groups of individuals were studied. The first was composed of 82 patients in whom bouts of well documented …