Levels of serum lipids, apolipoproteins A-I and B and pseudocholinesterase activity and their discriminative values in patients with coronary by-pass operation.

Serum lipids and apoproteins A-I and B were measured in 115 male patients and serum pseudocholinesterase activity (PChE) was determined in 83 patients with 3 vessel coronary artery disease (CAD). The control subjects were matched according to sex, smoking, relative weight and age and were free from heart disease. The CAD patients had significantly higher serum VLDL cholesterol and triglyceride levels and lower HDL cholesterol and apo A-I levels and lower HDL to total cholesterol ratio than the controls. The concentrations of serum total cholesterol and LDL cholesterol were only slightly (6.4% and 8.8%, on an average) higher in CAD patients than in controls. The apo B levels of CAD patients were also slightly lower in patients than in controls. The CAD patients had slightly higher PChE activities than controls. The ratios of apo A-I to PChE and HDL cholesterol to PChE were significantly (about 30%, P less than 0.001) lower in patients than in controls. In discriminant analysis between the groups HDL cholesterol and apo A-I showed the best (74% success in reclassifying the patients to correct groups), and total cholesterol, triglycerides, LDL cholesterol and apo B remarkably weak discriminating power among the single variables of serum lipids and lipoproteins. In discriminating analysis the apo A-I/PChE and HDL cholesterol/PChE ratios showed relatively high (77.1 and 71.1% success from the patients to correct groups) and serum PChE activity weak discriminating power. These results indicate that low levels of HDL cholesterol and apo A-I and the low ratio of HDL cholesterol to total cholesterol are the most potent metabolic risk factors for 3 vessel coronary artery disease in a population with relatively high serum total cholesterol level. The determinations of apo A-I/PChE and HDL cholesterol/PChE ratios may be an additional, valuable tool in discriminating the risk for CAD.

The effect of acebutolol on plasma apoproteins and HDL cholesterol subfractions.

The effect on plasma apoproteins A-I and B and HDL cholesterol subfractions of acebutolol given orally over a 6-month period to 18 patients with essential hypertension was studied. The concentration of apoprotein A-I decreased during acebutolol treatment: statistical significance was reached at 3 (p less than 0.05) and 6 months (p less than 0.01). The level of apoprotein B increased slightly but not significantly. The ratio of apo A-I to apo B decreased significantly during acebutolol treatment. The concentration of total HDL cholesterol tended to be slightly but not significantly higher during therapy than before it. This increase was due to the increase of HDL3 cholesterol and this increase was significant (p less than 0.05) at 3 months. The level of HDL2 cholesterol did not change significantly during acebutolol therapy.

Double-blind comparison of the effects of long-term treatment with doxazosin or atenolol on serum lipoproteins.

The effects on plasma lipids and apoproteins A-I and B of oral administration of doxazosin and atenolol over a 20-week period were studied in 42 patients with mild to moderate essential hypertension. Total plasma cholesterol decreased by 8.9% (P less than 0.01) and LDL cholesterol by 16.9% (P less than 0.01) after 20 weeks' treatment with doxazosin. Total HDL cholesterol and HDL2 cholesterol concentrations increased slightly during doxazosin treatment and the increase in HDL2 level at 4 weeks was statistically significant (P less than 0.05). At 20 weeks, the levels of total HDL cholesterol and HDL2 were significantly (P less than 0.05) lower with atenolol than with doxazosin. The ratio HDL/total cholesterol increased during doxazosin treatment (P less than 0.05 at 4, 12 and 20 weeks). The HDL/total cholesterol ratio was significantly higher after 20 weeks with doxazosin than with atenolol (P less than 0.05). The levels of VLDL cholesterol and triglycerides increased significantly (P less than 0.01) during atenolol treatment. The concentrations of apoproteins A-I and B did not change significantly during treatment with doxazosin or with atenolol but at 20 weeks the ratio of apo A-I to apo B was significantly (P less than 0.05) lower with atenolol than with doxazosin. On the basis of these results, doxazosin would seem to have significant favourable effects on the serum lipid profile.

Fatty acid composition of serum lipids in patients with a coronary bypass operation.

The fatty acid composition of serum phospholipids and cholesteryl esters was analysed in 71 male patients with angiographically defined three-vessel coronary artery disease (CAD) selected for a coronary bypass operation. Their 71 control subjects were matched according to age, sex, smoking, relative weight, and absence of CAD. The concentrations of fatty acids, 14:0, 16:0 and 16:1 of the serum phospholipids, were significantly (P less than 0.01, P less than 0.05 and P less than 0.01, respectively) higher in CAD patients than in the controls. On the other hand, linoleic (18:2 omega 6), linolenic (18:3 omega 3) and arachidonic (20:4 omega 6) acids were at a significantly lower level in the patients when compared to the controls. The polyunsaturated/saturated fatty acids (P/S) ratio in serum phospholipids was significantly (P less than 0.01) lower in the patients than in the controls. In the cholesteryl ester fraction the results paralleled those of the phospholipids. Significant correlations were obtained between the polyunsaturated fatty acids and the high density lipoprotein cholesterol or apolipoprotein A-I in the control subjects but most of these correlations were absent in the patients. Our present results further support the importance of linoleic acid in the protection against atherosclerosis. However, no unequivocal evidence on the possible beneficial effect of long-chain omega 3-fatty acids in comparison with omega 6-acids was obtained.

Orienteering performance and ingestion of glucose and glucose polymers.

The benefit of glucose polymer ingestion in addition to 2.5 per cent glucose before and during a prolonged orienteering competition was studied. The final time in the competition in the group ingesting 2.5 per cent glucose (group G, n = 10) was 113 min 37 s +/- 8 min 11 s, and in the group which had additionally ingested glucose polymer (group G + GP, n = 8) 107 min 18s +/- 4 min 41 s (NS). One fifth (21 per cent) of the time difference between the two groups was due to difference in orienteering errors. Group G + GP orienteered the last third of the competition faster than group G (p less than 0.05). The time ratio between the last third of the competition and the first third of the competition was lower in group G + GP than in group G (p less than 0.05). After the competition, there was statistically insignificant tendency to higher serum glucose and lower serum free fatty acid concentrations in group G + GP, and serum insulin concentration was higher in group G + GP than in group G (p less than 0.05). Three subjects reported that they exhausted during the competition. These same three subjects had the lowest serum glucose concentrations after the competition (2.9 mmol.1(-1), 2.9 mmol.1(-1), 3.5 mmol.1(-1] and all of them were from group G. It is concluded that glucose polymer syrup ingestion is beneficial for prolonged psychophysical performance.