Dilute blood clot lysis time and electrophoretic lipoprotein fractions in a population sample of healthy Romanians.

Serum total lipids and cholesterol, electrophoretically determined lipoprotein concentrations, serum pseudocholinesterase and dilute blood clot lysis time were determined in 630 healthy subjects (287 men and 343 women) aged 20-60, working in the food industry. A high incidence of over-weight was noted ranging from 22.4% in women aged 20-40 to 58.7% in men aged 41-60. Over-weight subjects presenting higher levels of serum cholesterol, total lipids and of the pre-beta electrophoretic fraction also had a higher pseudo-cholinesterase activity and a more delayed clot lysis time than normal-weight subjects matched as to age and sex. When the material was divided into quintiles for pre-beta- and beta-lipoproteins, a highly significant delay of fibrinolysis was noted in the fourth and fifth quintiles for pre-beta-lipoproteins, but no significant changes of lysis time occurred with increasing concentrations of beta-lipoproteins. Possible explanations of the abovementioned findings are briefly discussed.

Serum pseudocholinesterase and ceruloplasmin in various types of hyperlipoproteinemia.

Starting from previous observations emphasizing an increased pseudocholinesterase (PCE) activity in obese and hyperlipemic subjects, the behaviour of this enzyme and of ceruloplasmin was studied in connection with changes of serum lipids and lipoproteins in various types of hyperlipoproteinemia. When compared to values detected in 67 middle-aged normal weight normolipemic subjects, PCE activity was found to be significantly greater (smaller than 0.001) in the 49 overweight subjects without obvious hyperlipemia but presenting a moderate increase of the prebeta electrophoretic fraction. PCE activity was much higher in lean or overweight subjects with endogenous hypertriglyceridemia (68 patients with type IV and 86 patients with mixed hyperlipemia). The slight increase of mean values of PCE activity in the 53 subjects with type II-a was due mainly to overweight subjects, while this enzyme's activity was not significantly changed in lean subjects with pure hypercholesterolemia. PCE activity was positively correlated with serum triglyceride (r equals 0.540; p smaller than 0.001) and the prebeta electrophoretic fraction (r equals 610; p smaller than 0.001). The correlation with beta-lipoproteins was not significant. Ceruloplasmin levels were not significantly changed. It is suggested that elevation of PCE activity could be connected to mechanisms leading to an increased secretion rate of lipoproteins.

Serum electrophoretic lipoprotein factors and pseudocholinesterase activity in thyroid disease.

Decreased levels of serum cholesterol and beta-lipoproteins occurring in hyperthyroidism were found to be accompanied by an enchanced activity of pseudocholinesterase, while in patients with myxedema, the pathologically increased levels of serum cholesterol and beta-lipoproteins were associated with diminished serum pseudocholinesterase activity. The percentage of the pre-beta fraction was found to be increased in both hypo- and hyperthyroid patients, but mechanisms leading to this change are probably different in the two pathological conditions. The behaviour of cholesterol and pseudocholinesterase activity and especially the ratio between these paramameters might be used for the diagnosis of thyroid disease and for the control of therapeutic efficiency.

Long-term study of the risk factors in atherosclerosis.

A study of the risk factors in atherosclerosis carried out in 595 subjects over a period of 10 years showed an increased prevalence of arterial hypertension, of high serum cholesterol values and of overweight in 1970 as compared to 1960. This rise was significant for all the parameters studied and was particularly evident in serum cholesterol values and overweight, beginning with the 21 to 30 age decade. The frequency of subjects with risk factors increased with age. During the period of study there occurred certain changes within the population such as an increase in the total consumption of calories and in the lipid contents of the food, as well as of the cultural level of the population. The authors show that the increase in the number of subjects with risk factors and the natural history of the various diseases or disturbances depend on the changes of living conditions and of environment.

Serum pseudocholinesterase activity during experimental fattening.

The exact role of serum pseudocholinesterase (PSCE) is not known. Its main role probably consists in the degradation of butyril-choline, an intermediate of lipid metabolism. Decreased values have been described in liver cirrhosis as an index of diminished proteosynthetic function. An increased activity of this enzyme was reported in obesity, diabetes mellitus, nephrosis, hyperthyroidism and in hyperlipemic subjects without obesity. A significant correlation was found between serum cholesterol, triglycerides and PSCE, as an expression of lipid metabolism. In view of assessing the possible change of this enzyme during fattening, the authors investigated PSCE activity during fattening in pigs (the same breed). The results indicate a statistically significant increase of PSCE during fattening, from 30.4 +/- 1.7 to 43.6 +/- 1.7 (p less than 0.001). These results together with those reported in a previous paper concerning blood lipids and cholesterol, show a positive correlation between these parameters and PSCE during fattening in pigs, which might be due to an adaptative increase of the hepatic synthesis of this enzyme in response to the increased lipid metabolism.

Increased plasma level of clotting factors VII and X in hyperlipoproteinemia.

When compared to values obtained in healthy normal-weight normolipidemic controls, the combined activities of clotting factors VII and XI, as well as serum cholinesterase were found to be significantly higher in hyperlipidemic and especially in hypertriglyceridemic subjects. The levels of the vitamin K-dependent clotting factors are positively correlated with the concentration of serum cholesterol, the logarithm of serum triacylglycerol level and serum cholinesterase activity. Based on these data as well as on previous observations concerning an increased plasma level of other liver secretion enzymes in endogenous hypertriglyceridemia, a possible interrelationship between accelerated turnover of lipoproteins, enhanced hepatic protein synthesis and thromboatherosclerosis is suggested.

Behaviour of gamma-glutamyltransferase in chronic consumers of alcohol.

Results obtained in three successive investigations involving various groups of population are presented. In a first study gamma-glutamyltransferase (gammaGT) activity was found to exceed the upper limit of the normal in 70% of the 36 subjects from a rural community in Northern Transylvania who were known by the local physician as being addicted to alcohol since at least five years. In a subsequent study gammaGT activity was determined in 86 patients seeking psychiatric help for a drinking problem. Only 55% of these patients were presenting increased gammaGT values and this finding could be explained by the fact that some of the psychiatric patients were admitted to the clinic for pathological bouts of dipsomania and not because of longstanding chronic intake of alcohol. When studied in connexion with the behaviour of serum triglyceride and alanineaminotransferase (GPT) levels, gammaGT activity was found to be particularly high in hypertriglyceridemic alcoholics and in those presenting a moderate increase of serum transaminases. Population studies emphasized that gammaGT activity exceeded the upper normal limit in 49.2% of the men and in 21.6% of the women working for more than five years in the industry of alcoholic beverages, while an increased activity of this enzyme was detected only in 19% of the men and in 1.7% of the women in a random population.