[Profile of cardiovascular risk factors in females with a definitive myocardial infarct up to 49 years of age]. / Zum kardiovaskulären Risikofaktorenprofil bei Frauen mit einem definitiven Myokardinfarkt bis zum 49. Lebensjahr.

The appearance of myocardial infarctions in fertile women is to agree upon the concept of cardiovascular risk factors. Women without diabetes showed in 3 age groups up to 49 years 2.5-3.1 factors and with diabetes 4.4-4.8 factors, such as smoking, hyperlipoproteinaemia, hypertension, obesity, oral contraceptives, hyperuricaemia and diabetes mellitus, respectively. No female patient with infarction was free of risk factors. The obesity can be regarded as indicator for the presence of further risk factors. A critical indication for oral contraceptives is recommended, if already one of the factors, such as smoking, hyperlipoproteinaemia, hypertension, obesity or diabetes mellitus is present, or, if possible, its removal before ordination. Also low-dose oral contraceptives must be regarded as a potential risk factor up to further clarification.

PIP: The fertile woman is generally protected by her hormone status from myocardial infarct. Since the introduction of oral contraceptives, however, isolated cases of myocardial infarct have been observed in young women. Although some authors have assigned a causal effect to oral contraceptives, other studies have indicated a simultaneous occurrence of such risk factors as smoking, high blood pressure and hyperlipoproteinemia (HLP). In this study 68 women who had undergone definite myocardial infarct and who had not reached 49 years of age or menopause were studied for the occurrence of these risk factors. None of the patients were found to be without other risk factors. Oral contraceptives, carbohydrate intolerance, hyperuricemia and obesity were never observed as single risk factors. High blood pressure and obesity affected 2 out of 5 under 40 years old, 4 out of 5 between 40-44 years, and 17 out of 18 between 45-49 years. The combination of carbohydrate intolerance and obesity rose in the 3 age groups from 1 in 5 to 2 in 5 to 10 in 18. 86% of the patients with body weight 120% of normal also had high blood pressure. Obesity was always associated with other risk factors among these patients. With a prevalence of 38%, diabetes was an important factor in the 45-49 year group. Before prescribing oral contraceptives, the physician should always determine the presence of other factors such as smoking, HLP, diabetes and obesity and attempt to remove these factors before proceeding with oral contraception.

[Urinary alanine aminopeptidase and lysozyme excretion in patients with diabetes]. / Alaninaminopeptidase- und Lysozymausscheidung im Urin von Diabetikern

The excretion of alanine aminopeptidase in the urine is changed by several factors influencing the tubuli. The diabetics increasedly excrete alanine aminopeptidase in the urine, apparantly as an expression of an increased cell moulting of the tubuli. Whether the increased alanine aminopeptidase activity of the urine may indicate a diabetic nephropathy, is to be clarified only by means of bioptic investigations of the kidneys. Streptomycin can also like a nephrostasis as a sequel of a decompensated cor pulmonale increase the activity of alanine aminopeptidase of the urine.