Increased mucosal antioxidant enzyme activities in chronic gastritis and benign gastric polyps.

Gastroscopy with gastric biopsy was performed in 109 individuals aged 25-71 years. Activities of three antioxidant enzymes were assayed in biopsy specimens: Cu/Zn superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px). Patients were classified according to the endoscopic and histological findings in the following groups: normal findings (N), superficial gastritis (SG), mild (MAG) and severe (SAG) atrophic gastritis, gastritis after partial gastrectomy (PGG), hyperplastic polyp (HP), and gastric adenoma (A). Compared with the N group, increased activity of SOD was found in groups SG (+37%), PGG (+67%) and A (+35%), increased CAT activity in PGG (+40%), and increased GSH-Px activity in groups SG (+57%), SAG (+46%), PGG (+185%), HP (+50%) and A (+50%). Increased activity of antioxidant enzymes could be induced by higher concentrations of superoxide anion radicals, hydrogen peroxide and lipid peroxides, produced by phagocytic leucocytes or by polyunsaturated fatty acid in cellular membranes of gastric mucosa. The relation of reactive oxygen species to the induction of precancerous conditions and to carcinogenesis of the stomach requires further study.

Albumin metabolism and gastric surgery.

Albumin metabolism was followed in 7 patients suffering from benign gastric diseases. The study was performed using human serum albumin-125 I before gastric surgery and after operation. The total albumin pool decreased after the operation by about 15%. The decrease in extravascular albumin pool was stronger (by about 19%) than the decrease in intravascular albumin pool (at about 11%). The causes of changes in albumin metabolism after surgery are discussed.

Gastric mucosal antioxidant activity in patients at increased risk of gastric cancer.

In 68 subjects the activities of Cu/Zn-superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) were investigated in gastric mucosa. The patients were classified according to the histological finding into following groups: 12 with normal finding (N), 16 with superficial gastritis (SG), 13 with mild atrophic gastritis (MAG), 19 with severe atrophic gastritis (SAG) and 8 with gastritis after partial gastrectomy (PGG). The comparison of groups SG, MAG, SAG and PGG with the group N revealed the following changes: in SG increased SOD and GSH-Px, in MAG and SAG no significant changes, and in PGG increase in SOD, CAT and GSH-Px were observed. It was supposed that increased enzymatic activities were caused by higher concentration of active oxygen species produced by phagocytizing leukocytes in inflamed gastric mucosa. Administration of vitamin E resulted in significant reduction of SOD and CAT activities, on the other hand GSH-Px activity significantly increased. The explanation of this effect of vitamin E requires further studies. A prolonged interaction of active oxygen species with chemical carcinogens (N-nitroso- or diazonium compounds, PAH) can exhibit a significant promoting effect on the development of intestinal type of gastric cancer from its precancerous conditions, above all after partial gastrectomy.

Increased antioxidant enzyme activities in the colorectal adenoma and carcinoma.

Most colon carcinomas are preceded by an adenomatous polyp--adenoma-carcinoma sequence. Active oxygen species (AOS) can play a role in the pathogenesis of this process. Antioxidant enzymes (AE) are the primary defense against the deleterious effect of AOS. Activities of AE in 56 individuals with colorectal adenoma (CA), 29 individuals with colorectal carcinoma (CC) and in 24 control subjects were examined. Biopsy specimens from the non-neoplastic colonic mucosa and from the CA and CC were taken during colonoscopy for histological and enzymological analysis. Activities of following AE were estimated: CuZn-superoxide dismutase (CuZn-SOD), catalase (CAT) and glutathione peroxidase (GPx). It was found that individuals with CA and CC were characterized by: (1) increased activities of CAT and GPx in non-neoplastic mucosa, that persisted in some of the patients even after removal of tumors; (2) increased activities of CuZn-SOD, CAT and PGx in CA and CC tissues. It can be inferred that the accumulation of peroxides in the non-neoplastic colonic mucosa induced higher activities of CAT and GPx. The reasons of high activities of all AE in the tissues of CA and CC and their relation to carcinogenesis are not clear and require further studies.

Blood levels of natural antioxidants in gastric and colorectal precancerous lesions and cancers in Slovakia.

A long-term sufficient intake of fruits and vegetables reduces significantly the risk of gastric and colorectal carcinoma. It is anticipated that natural antioxidants are involved in this effect in addition to other substances. The aim of this study was to determine levels of vitamins A, C and E, as well as beta-carotene, selenium, zinc and copper in blood of 249 patients with precancerous lesions (atrophic gastritis, gastric hyperplastic polyp, gastric, colonic and rectal adenoma, chronic ulcerative colitis) and in 96 individuals with gastric, colonic or rectal carcinoma and to compare these levels with the values of a control group of 130 healthy individuals. We have found that the frequency of average values of analyzed micronutrients in precancerous groups was decreasing in the order vit C > vit E/vit A > Se > beta-car. The average levels of vitamins and beta-carotene were significantly reduced in all carcinoma groups, while selenium level showed a decrease only in the gastric carcinoma group. Copper level was elevated in the ulcerative colitis group and in all groups with carcinoma. The results indicate a frequent insufficient saturation of organism by natural antioxidants in groups with precancerous lesions and carcinomas of stomach and colorectum. Therefore, it is necessary to increase the general consumption of fruits and vegetables in Slovakia as a part of primary prevention of malignant diseases in these organs. Chemoprevention may be recommended in individuals with precancerous lesions.

Copper, zinc and superoxide dismutase in precancerous, benign diseases and gastric, colorectal and breast cancer.

The aim of the present study was to assess serum levels of copper and zinc levels and erythrocytes Cu,Zn-SOD activity and to determine probable changes in gastric and colorectal precancerous diseases, benign breast diseases, gastric, colorectal and breast cancer. The study included 165 subjects with cancer, 348 subjects with precancerous (atrophic gastritis, gastric adenoma, colon adenoma, rectal adenoma) and/or benign diseases (weak dysplasia, severe dysplasia, fibroadenoma, cystic disease) and 161 randomly selected healthy controls. Our results suggest that while in gastric and colorectal cancer there were mostly increased copper levels, in breast cancer they were not changed. Zinc levels were weakly decreased in atrophic gastritis, gastric adenoma and breast cancer. There was a strong positive correlation between zinc levels and SOD activity in fibroadenoma and a weak positive correlation in colorectal adenoma and colorectal cancer without any correlation between SOD activity and copper in these groups. In gastric precancerous disease there was a positive correlation between SOD and copper. The results of this study suggest that serum trace element levels and activity of related enzymes might be different in various neoplastic processes. This variation in neoplastic processes might be influenced by other factors that have to be considered in complex relationships between the whole body and neoplastic cells.

[Ulcerative colitis: activity of antioxidant enzymes of the colonic mucosa]. / Colite ulcéreuse: activité des enzymes antioxydantes de la muqueuse colique.

OBJECTIVES: Reactive oxygen species are regarded as mediators of inflammation in ulcerative colitis. Antioxidant enzymes are the primary defense against reactive oxygen species. We investigated the activities of antioxidant enzymes-superoxide dismutase, catalase and glutathion peroxidase-in colonic mucosa biopsy specimens obtained at different phases of the disease in patients given vitamin E therapy or not and in controls. PATIENTS AND METHODS: Biopsy specimens were obtained from 29 patients with ulcerative colitis and from 18 healthy controls. Ten patients on maintenance drug therapy were also given a 300 mg daily oral dose of vitamin E. RESULTS: Enzyme activities were significantly increased in inflamed non-polypous colonic mucosa in patients with active ulcerative colitis, while they were similar to activities observed in controls during quiescent phases of the disease. Antioxidant enzyme activities in specimens from inflammatory polyps remained high even in patients in clinical remission. Administration of vitamin E resulted in a significant reduction of glutathion peroxidase activity in the colonic mucosa. CONCLUSION: These findings indirectly confirm that important quantities of reactive oxygen species are formed in ulcerative colitis. Further studies are needed to elucidate the relationship of these changes with the pathogenesis of ulcerative colitis.

[Serum lipids in obese persons in a selected population in the Slovak Republic]. / Lipidy v sére obéznych osôb vo vybranej populácii Slovenskej republiky.

Serum lipid levels were determined in 287 obese subjects and the findings were compared with the mean values recorded in a representative series of the population of the Slovak Republic (n = 3433). Comparison of serum lipid values in age-matched groups from the two series showed the following results: significant increase of triacylglycerols in obese men aged 15-55 y, in obese women aged 15-35 y; significant increase of total cholesterol in obese men aged 26-55 y, in obese women aged 26-35 y; significant reduction of HDL cholesterol in obese men after 25 years of age and in obese women after 35 years of age. Obesity was found to increase significantly serum lipid levels, particularly in men with predominant central-abdominal type of obesity.

[Obesity and osteoarthritic changes in the lower extremities]. / Obezita a osteoartropatické zmeny na dolných koncatinách.

The purpose of the radiologic examination carried out in 124 obese subjects was to determine degenerative changes on the coxae and knees and entesopathy on the calices in relation to the degree and duration of obesity and the age of the subjects examined. The direct correlation established between the degree of obesity and each of the three parameters studied was most marked with respect to the knees of obese women. In a considerable number of subjects, changes of the coxae were found to develop also at a relatively low overweight. The highest rate of pathological changes was recorded in obese subjects with overweight lasting several decades or even throughout life. In the younger age group pathologic changes were observed in 10-30% of subjects, whereas of those in the 6th decade of life up to 96% were affected. The findings clearly show a direct relationship between the degree and duration of obesity as well as the age of the subjects and the extent of pathologic changes on the skeleto-tendinous apparatus of the lower extremities. Overweight appears to be a potential etiological and definitely a contributing factor of osteoarthrosis of the lower extremities and particularly of the knee. (Tab. 3, Fig. 3, Ref. 10).

[Nitrates and nitrites in gastric juice in chronic gastritis]. / Nitráty a nitrity v zalúdocnej st'ave pri chronickej gastritíde.

Atrophic gastritis is precancerous condition of the intestinal type of gastric carcinoma. This process supposes a genotoxic effect of N-nitroso-compounds which are formed in the stomach by nitrosation of nitrites and organic nitrogen compounds. The authors examined 41 patients with chronic superficial and atrophic gastritis. They examined the pH and concentration of nitrates and nitrites in gastric juice taken in the morning before meal. They discovered that in severe atrophic gastritis the amount of nitrates is significantly increased and the amount of nitrites is decreased, all in comparison with superficial gastritis. An exponential relation of the concentration of nitrites towards the pH of gastric juice was found to be NO2- = epH-6.5, CC = 0.935. A significant elevation of nitrite concentration was observed in cases of pH being higher than 5.5. Nitrate concentration altered in dependence of the value of gastric pH. Oral administration of 300 mg of vitamin C or 250 mg of vitamin E did not significantly affect the amount of gastric nitrites. The work discusses the mutual relation of nitrites, ascorbic acid and alpha-tocopherol towards the formation of N-nitroso-compounds in the stomach inflicted by atrophic gastritis. (Tab. 3, Fig. 2, Ref. 25.)

The activity of Cu/Zn-superoxide dismutase and catalase of gastric mucosa in chronic gastritis, and the effect of alpha-tocopherol.

Activity of Cu/Zn superoxide dismutase (SOD) and catalase (CAT) in gastric mucosa was examined in 12 control subjects and 48 patients with various degree of chronic gastritis. Bioptic specimens of mucosa for enzymologic assays were sampled during gastroscopic examination after overnight fasting. Compared to the control group, a significant increase of SOD activity was observed in samples from superficial gastritis and only insignificant changes in samples from atrophic gastritis, while a remarkable and significant increase in the activity of both SOD and CAT was observed in samples from gastritis after partial gastrectomy. Application of vitamin E significantly reduced activities of SOD and CAT in subjects with chronic gastritis. The authors suppose that the increase in the activities of antioxidant enzymes was caused by an increased formation of superoxide anion radical and hydrogen peroxide, both originating from phagocyting leucocytes in inflamed mucosa. The reduced activity of SOD and CAT after application of vitamin E indicates an inhibition of the formation of active oxygen species in gastric mucosa. Relation of chronic gastritis and elevated concentrations of active oxygen species to gastric carcinogenesis is discussed in the report. (Tab. 2, Fig. 1, Ref. 22.)

[Precancerous conditions and carcinomas of the stomach and colorectum--blood levels of selected micronutrients]. / Prekancerózy a karcinómy zalúdka a kolorekta--hladiny vybraných mikronutrientov v krvi.

BACKGROUND: Optimal saturation of organism by micronutrients--vitamins and trace elements--has a significant inhibitory effect on the origin and development of malign diseases. OBJECTIVES: The aim of the study was to investigate the blood levels of A, C and E vitamins, Beta-carotene, zinc, and selenium in 249 patients with precanceroses (atrophic gastritis, hyperplastic polyp of the stomach, adenomas of the stomach and colorectum, ulcerative colitis), 96 patients with carcinoma of the stomach or colorectum, and to compare them with a control group of 130 people. RESULTS: We have discovered the frequency of decreased average levels of micronutrients in patients with precanceroses as follows: vitamin C > vitamins E and A > selenium > beta carotene. In all groups of patients with carcinoma the average levels of vitamins and Beta-carotene were significantly decreased, the level of selenium has decreased only in the group of gastric carcinoma. The copper level was increased in the group of ulcerative colitis and in all groups with carcinoma. CONCLUSION: The results indicate that in the primary prevention of these malign diseases it is necessary to improve the levels of the presented micronutrients in the population of the Slovak Republic by increasing the intake of fruit, vegetables and other sources of nutrition, the secondary prevention in persons with precanceroses requires an appropriate intermittent supplementation of micronutrients (chemoprevention). (Tab. 3, Ref. 24.)

[Levels of erythrocyte glutathione and ceruloplasmin and transferrin in the serum and their role in antioxidant protection]. / Koncentrácia glutatiónu v erytrocytoch, ceruloplazmínu a transferínu v sére a ich úloha pri antioxidacnej obrane.

All organisms are protected from harmful reactive oxygen which is produced also under physiological conditions by a complex antioxidative system. Our work was aimed at the ascertainment of the level of reduced and oxidated glutathione in erythrocytes of healthy people, the concentrations of ceruloplasmin (GSH) and transferrin (GSSG) in the serum, as well as the investigation of the relationship to antioxidative enzymes ---Cu, Zn-superoxide dismutase (SOD), catalase (CAT) and Se-glutathione-peroxidase (GPx) in erythrocytes. We discovered a mutual direct linear correlation between the levels of GSH, GSSG, CPL and TRF, indirect linear relation between the concentrations of TRF, GSH, GSSG and activities of SOD and GPx, between the concentrations of CPL and GPx activities, and a direct linear relation between concentrations of GSH and TRF with CAT activity. The results indicate to a mutual dependence of investigated nonenzymatic antioxidative factors and antioxidative enzymes. (Tab2, Fig. 4, Ref.13.).

[Activity of the antioxidant system in patients with idiopathic proctocolitis and the effect of 5-aminosalicylic acid (Salofalk)]. / Aktivita antioxidacného systému pacientov s idiopatickou proktokolitídou a vplyv kyseliny 5-aminosalicylovej (Salofalk).

There is a close relationship between inflammation and reactive oxygen species (ROS). Primary source of ROS are activated leucocytes. Antioxidant system protects organism against the deleterious effect of ROS. The aim of the present study was to follow the activity of antioxidant system in blood and colonic mucosa of 17 patients with idiopathic proctocolitis. All patients were treated with 5-aminosalicylic acid (Salofalk), 7 patients with a combination of prednison. The following biochemical parameters were ascertained: malondialdehyde (MDA) and ceruloplasmin in serum, glutathione (GSH) and activities of superoxide dismutase, catalase and glutathione peroxidase in erythrocytes and colonic mucosa. Before treatment there was found: an increase of MDA and all antioxidant enzyme activities, an a decrease of GSH. After 3 weeks of therapy in 59% of patients, initial clinical remission was observed without serious improvement of biochemical parameters. After 10 weeks of therapy the clinical course improved in all patients, a significant decrease of MDA and activities of all antioxidant enzymes as well as an increase of GSH were stated. The authors assume that IP was positively affected by 5-ASA, and in some patients by its combination with prednisom. The effect of 5-ASA is based on its known antiinflammatory impact and its functioning as a "scavanger" of free radicals (or ROS). (Tab. 1, Fig. 3, Ref. 23.)

[Relation between fatty acid composition, vitamin e and malondialdehyde levels, and activity of antioxidant enzymes in the blood]. / Vzájomný vztah zlozenia mastných kyselín ku koncentrácii vitamínu E, k hladine malóndialdehydu a k aktivitám antioxidacných enzýmov v krvi.

The aim of our study was to determine the composition of saturated fatty acids (SFA), monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA) in erythrocytes and to investigate their relation to the concentration of vitamin E (Vit E) in the plasma, level of malondialdehyde (MDA) in the serum and activities of antioxidant enzymes (AE) in erythrocytes. We examined 128 healthy volunteers (57 men and 71 women) at the ages ranging between 20 and 72. Fatty acids were assessed by gas chromatography, vitamin E by the HPLC method, MDA by the spectrophotometric method, GSH-Px by the kinetic method, CU, Zn-SOD by the Randox test. We have detected the following order in the proportion of fatty acids: SFA > PUFA > MUFA. The increase in PUFA and MUFA was in direct correlation with the concentration of MDA and AE activity, however in reverse correlation with Vit E. A reverse correlation was observed in the increase in SFA. We have found an increase in lipoperoxidation due to the increase in PUFA in erythrocytes in the group of healthy people. This state is concommited by an increase in the activity of antioxidant protection for the maintenance of the balance state. The authors assume that a decrease in Vit E can be caused by its increased "consumption" as the most effective antioxidant in lipid environment. (Tab. 2, Fig. 1, Ref. 27.)

[Relation between levels of vitamins C, E, A and beta-carotene and activity of antioxidant enzymes in the blood]. / Vztah hladín vitamínov C, E, A a beta-karoténu k aktivite antioxidacných enzýmov v krvi.

UNLABELLED: Antioxidant protection is procured by many enzymatic and non-enzymatic factors which maintain the physiological level of reactive forms of oxygen. The aim of this study was to determine the levels and relationship between concentrations of the selected non-enzymatic antioxidants in healthy people (vitamin C--Vit C, vitamin E--Vit E, beta-carotene-beta-Car and vitamin A--Vit A) in the serum, antioxidant enzymes, CuZn-superoxide dismutase--SOD, catalase CAT, glutathione peroxidase--GPx) in erythrocytes and malondialdehyde (MDA) in the serum. We have examined 128 volunteers (57 men and 71 women) at the age ranging between 20 and 72. The average levels of vitamins and beta-Carotene were detected near the lower level of normal values or below it, whilst the highest interindividual differences were detected in Vit C and Vit E. The level of Vit E indirectly correlated with SOD, GPx, MDA, but directly with CAT. On the contrary, the levels of Vit A directly correlated with SOD, GPx, MDA and indirectly with CAT. The levels of Vit C and beta-Carotene had no relation with the activities of antioxidant enzymes and the level of MDA. The direct correlation was between the levels of Vit C and Vit E, and Vit C and beta-Carotene. CONCLUSIONS: 1. A decrease in average levels of Vit A, C, E and beta-Carotene in the blood of the investigated group of healthy persons indicates their lower antioxidant protection. 2. The relation between Vit E, MDA, activities of GPx and SOD indicates the presumed mutually supplementing effect of these antioxidants in liquidation of products of lipoperoxidations. (Tab. 2, Fig. 3, Ref. 17.)

[Antioxidative enzyme activity in the blood of healthy persons]. / Aktivita antioxidacných enzýmov v krvi zdrav ch osôb.

BACKGROUND: Under physiological conditions the dynamic balance between the reactive oxygen production and detoxication is maintained. OBJECTIVES: The study was aimed at the detection of the activity of antioxidant enzymes: superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) in erythrocytes and the level of malondialdehyde (MDA) in the serum of healthy subjects, their relation to age, body weight, sex, smoking, and the possible correlation between individual parameters. METHODS: The authors have examined 128 healthy volunteers (57 men and 71 women) from 20 to 72 years of age. The results were statistically evaluated by means of the ANOVA programme. RESULTS: The group of healthy people had a large dispersion of interindividual activities of antioxidant enzymes and MDA levels. Age and weight were reversely correlated to the CAT activity in erythrocytes. The CAT activity was significantly higher in women than in men, and the GPx activity was lower in smokers than in non-smokers. The rest of investigated parameters were not significantly influenced by sex of examined people and smoking. Mutual correlation between individual enzymes were highly significant. CONCLUSIONS: A large dispersion of activities of the investigated enzymes and MDA levels in healthy individuals do not allow to make a standard use of these parameters in clinical practice. (Tab. 5, Fig. 2, Ref. 20.).

[Levels of Cu, Zn, Se and their relation to levels of ceruloplasmin and the activity of antioxidative enzymes]. / Koncentrácia Cu, Zn, Se a ich vztah k hladine ceruloplazmínu a aktivite antioxidacných enzýmov.

BACKGROUND: Essential trace elements copper, zinc and selenium are important parts of antioxidant enzymes as superoxide dismutase, glutathione peroxidase as well as of transport protein with antioxidant properties-ceruloplasmin. Mentioned trace elements may affect antioxidant defence system. AIM OF STUDY: The aim of our study was to estimate serum levels of copper, zinc, and selenium in a group of healthy subjects and to correlate them with erythrocyte activity of Cu,Zn-SOD, GSH-Px and serum levels of ceruloplasmin. METHODS: We examined a group of 128 healthy volunteers (57 men and 71 women) aged 20 to 74 years. The analyses of trace elements we performed by atomic absorption spectrophotometry, Cu,Zn-SOD were detected by Randox test, GSH-Px by kinetic method and ceruloplasmin was measured immunoelectrophoretically. RESULTS: We have not found any correlations between investigated trace elements, age and sex. Average serum levels were as follows: copper (17.26 +/- 2.71 mumol/L), zinc (15.30 +/- 1.92 mumol/L), and selenium (0.79 +/- 0.19 mumol/L). There was a weak linear correlation between serum levels of copper and ceruloplasmin. CONCLUSION: There was no relationship between serum copper and zinc levels and Cu,Zn-SOD activity, and serum concentration of selenium and GSH-Px activity in the group of healthy subjects. A moderate linear correlation was estimated between serum values of copper and ceruloplasmin. (Tab. 2, Fig. 4, Ref. 29.)

[Pain and osteoarticular changes in obese persons]. / Bolest a osteoartikulárne zmeny u obézních osôb.

Obesity was confirmed as a possible aetiological and certainly promoting factor in the development of osteoarthritis (OA). One of the first clinical symptoms of OA is pain which does not always correspond with the X-ray picture of the damaged joint. The authors examined 11,124 obese subjects where they investigated X-ray changes of the hip joints, knees and heels and selected clinical symptoms. They correlated them with the degree of obesity, the duration of obesity and the subjects age. They revealed a direct correlation between the development of OA and all the investigated parameters. An alarming finding was that arthritis changes developed in the hip joints also in half the subjects with minor overweight and in particular that in one third of the obese subjects in the second and third decade pathological changes of the joints are present without causing subjects complaints. During a prolonged reducing regime attention must be paid to the possible development of osteopenia which may be also the source of pain. Obese subjects suffer pain also from nodes of non-inflammatory proliferated subcutaneous adipose tissue, venous insufficiency and trophic skin changes.

[Obesity and hyperlipoproteinemia. I. Changes in lipid levels in obese persons]. / Obezita a hyperlipoproteinémia. I. Zmeny hladín lipidov v krvi obéznych osôb.

The authors investigated changes in serum lipid levels in 115 obese men and 172 obese women. The body mass index (BMI) of the subjects was 29-50 kg/m2. The group was subdivided by sex and age as follows: 15-18 years, 19-25 years, 26-35 years, 36-55 years. It was revealed that with advancing age and increasing body weight the mean tiacylglycerol levels in men increased from 1.74 mmol/l to 4.40 mmol/l, in women from 1.37 mmol/l to 1.84 mmol/l. The mean levels of total serum cholesterol increased in men from 4.58 mmol/l to 6.82 mmol/l, in women from 5.09 mmol/l to 5.96 mmol/l. In the rise of serum cholesterol in men the LDL and VLDL fractions participated, in women mainly the LDL fraction. Conversely the HDL fraction declined in men from 1.60 mmol/l to 1.20 mmol/l, in women from 1.71 mmol/l to 1.26 mmol/l. The mean value of the atherogenic index in men increased from 2.88 to 5.68, in women from 2.99 to 4.73. The results indicate the adverse changes of serum lipid levels in obese subjects which appear in men already after the age of 25 years, in women 10-20 years later. The authors discuss the causes of hyperlipoproteinaemia and the risk of atherosclerosis in obesity.