David Adlersberg

Syndrome of idiopathic hyperlipemia, mild diabetes mellitus, and severe vascular damage.

Idiopathic hyperlipemia is characterized by milky or creamy appearance (lactescence) of the serum in the fasting state. This is caused by a very marked increase of the neutral fat content. Often but not always there is a concomitant considerable increase of serum cholesterol and phospholipids. By definition, primary hypercholesteremia differs from idiopathic hyperlipemia in the clear appearance of the serum and in normal content of neutral fat. Both abnormalities of lipid metabolism may be associated with xanthoma formation. Xanthoma diabeticorum was extensively studied many years ago.-

Adrenal Cortex and Lipid Metabolism Effects of Cortisone and Adreno-corticotropin (ACTH) on Serum Lipids in Man

Summary This investigation indicates that cortisone produced well-characterized changes of serum lipids in man. The effects of ACTH on the serum lipids were less pronounced.

ISOTOPIC STUDIES OF PLASMA CHOLESTEROL OF ENDOGENOUS AND EXOGENOUS ORIGINS

This study was undertaken in order to compare the metabolic behavior of plasma cholesterol derived from the diet with that of cholesterol synthesized in vAvo from acetate (1). Cholesterol labeled with either isotopic carbon or hydrogen was administered orally to human subjects and the incorporation into plasma cholesterol was followed over an extended period. In certain instances, both endogenous and exogenous cholesterol metabolism were studied simultaneously by the use of appropriately labeled acetate and cholesterol. These techniques were also applied to an examination of the behavior of plasma cholesterol in four patients with hypercholesterolemia.

Heredity, Environment, and Serum Cholesterol A Study of 201 Healthy Families

Serum cholesterol levels of 1,236 healthy persons, including 775 members of 201 families, were analyzed in the investigation of the genetic control of serum cholesterol. It was concluded that there is an important genetic component in the determination of this level in healthy persons, that the gene is probably not sex-linked, and that environmental factors seem to play a lesser role.

Hereditary disturbance of cholesterol metabolism; a factor in the genesis of atherosclerosis.

Abstract Serum cholesterol was found to be elevated over 300 mg. per 100 c.c. in seventy-one members (58 per cent) of a group of 122 patients with proved coronary atherosclerosis whose disease began under the age of 50 years. The average serum cholesterol for the entire group of 122 patients was 316 mg. per 100 c.c. (±7.49 S.D.m). The average serum cholesterol for the seventy-one patients who exhibited hypercholesterolemia was 365 mg. per 100 c.c., and the average among the remaining fifty-one patients was 250 mg. per 100 cubic centimeters. Arcus senilis was exhibited by twenty-two, xanthelasma by twelve, and xanthomatosis by three of the group. The great majority with these stigmata had elevated serum cholesterol levels. Hypercholesterolemia (serum cholesterol of 300 mg. per 100 c.c. or more) was found in all or most of the siblings of one-third of fifty families of patients with coronary acherosclerosis. In nine more families, one-half of the siblings exhibited hypercholesterolemia. This study lends support to previous clinical investigations and indicates that a disturbance in cholesterol metabolism is probably concerned in the genesis of some instances of coronary atherosclerosis. It also suggests that altered cholesterol metabolism may be the common denominator in most patients who have coronary artery disease and arcus senilis, or coronary artery disease and xanthelasma. One of the hereditary factors responsible for arteriosclerotic heart disease may reside in abnormal cholesterol metabolism. Since therapeutic measures for correcting this metabolic disturbance may reasonably be anticipated, further investigations paralleling the present one are desirable.

EFFECT OF HEPARIN ON PLASMA LIPID PARTITION IN MAN: STUDIES IN NORMAL PERSONS AND IN PATIENTS WITH CORONARY ATHEROSCLEROSIS, NEPHROSIS AND PRIMARY HYPERLIPEMIA

Excerpt This study is concerned with the effect of heparin on plasma lipid partition in man under normal and certain pathologic conditions. That heparin reduces the opacity of lipemic blood plasma ...

Management of intractable sprue with cortisone and adrenocorticotropin (ACTH).

Excerpt In a previous communication,1aobservations on the clinical and chemical effects of cortisone and ACTH in the sprue syndrome were reported. Independently, similar observations by other autho...

Genetic studies on hypercholesteremia: Frequency in a hospital population and in families of hypercholesteremic index patients☆

Abstract Hypercholesteremia appears to be a common denominator for most patients with early coronary atherosclerosis. The frequency of the occurrence of this disorder and its possible genetic relationship become, therefore, important points in any studies designed to further our knowledge of coronary artery disease, particularly that occurring in the younger age groups. This report summarizes studies of hypercholesteremia in 250 men and 250 women, consecutive admissions to the Mount Sinai Hospital, New York, and an analysis of families of fifty-nine of the seventy-five probands who were found to have idiopathic hypercholesteremia. Serum cholesterol determinations were performed by the method of Schoenheimer and Sperry on blood drawn from patients who had fasted 12 hours. Hypercholesteremia was considered to be present if the serum cholesterol was 280 mg. per 100 ml. or greater. The age of the 250 men in the index group averaged 50.9 years, and their serum cholesterol averaged 215 mg. per 100 ml. The 250 women averaged 48.1 years, and their cholesterol 230 mg. per 100 ml. Ninetyseven of these 500 probands (41 men and 56 women) were hypercholesteremic. This group averaged 52.8 years of age, and 348 mg. per 100 ml. of serum cholesterol. Twenty-two of these ninety-seven patients were suffering from diseases associated with hypercholesteremia and were excluded from further consideration. Of the remaining 478 probands thirty-two of the 242 men (13.2 per cent) and forty-three of the 236 women (18.2 per cent) were hypercholesteremic. The frequency of hypercholesteremia was not significantly different between the two sexes. A thorough attempt was then made to examine the immediate relatives of the seventy-five hypercholesteremic probands. No relatives of sixteen of these patients could be examined. This was usually due to the fact that there was no living family member, or that those living were scattered throughout the world and therefore unavailable. Ninety-seven siblings and 110 children of the remaining fifty-nine hypercholesteremic probands were examined. The frequency of hypercholesteremia among the siblings was 51.5 per cent and among the children 29.4 per cent. Both these frequencies are significantly higher than those found among the 478 patients. Since the definition of hypercholesteremia used in the preceding calculations did not take into account the fact that serum cholesterol varies with age, the analyses were repeated using data of Keys and associates 11a in which age is taken into consideration; in these two age groups women have significantly higher cholesterol levels than men. Again it was found that the values for men and women are fairly close, differing at the 5 per cent level for only two age groups, 58 to 62 and 63 to 67. Keys and associates published serum cholesterol values which are expected to be exceeded by only 5 per cent of the population in each age group. The frequency of hypercholesteremia for the total usable sample, according to this method of analysis, was 12.0 per cent; the frequency among the siblings of the hypercholesteremic probands was 36.2 per cent and among the children 34.0 per cent. These frequencies, again, are significantly greater than those found for the index patients; but are not significantly different from the corresponding values obtained when levels of cholesterol above 279 mg. per 100 ml. were considered to represent hypercholesteremia. Of the 478 probands 266 were Jewish and 212 were non-Jewish. Hypercholesteremia was significantly more frequent among the Jewish probands (21 per cent versus 9 per cent), but the frequency among siblings and children was not different when Jewish hypercholesteremic probands and families were compared with non-Jewish. The mode of inheritance of idiopathic hypercholesteremia remains to be worked out. The finding that hypercholesteremia is as frequent among the siblings and children of the non-Jewish hypercholesteremic probands as compared with the Jewish may indicate that environmental factors are not of too great importance in determining the presence of hypercholesteremia. The validity of these tentative conclusions awaits the completion of a study now being done in a more representative and complete population group. However, even these preliminary observations shed some light on the complicated error of metabolism involved in hypercholesteremia and predisposition to early atherosclerosis.

Steroid Diabetes In Man: The Development of Diabetes During Treatment with Cortisone and Corticotropin

Observations on the development of diabetes have been made in five cases in which corticotropin (ACTH) and/or cortisone were used for the treatment of the basic disease. A detailed analysis of the diabetes, observed with a follow up on its subsequent course lasting up to iVz years, is presented. Special attention is devoted to a comparison of the features of the diabetes with those previously described as steroid diabetes in animals 1-4 and man.-

Tissue Permeability--a Factor in Atherogenesis: Studies with Cortisone and Hyaluronidase

Cortisone has a retarding effect on atherogenesis in cholesterol-fed rabbits, despite higher plasma cholesterol levels. This effect of cortisone is prevented by administration of hyaluronidase. The latter intensifies atherosclerosis and deposition of cholesterol in the liver.