Abstract
Free fatty acids (FFA) in blood are carried by serum albumin. A hypothesis is offered that conditions giving a high molar ratio of FFA to albumin may lead to dysfunction of the cells which are directly exposed to the high FFA/albumin ratio, i.e. the red and white blood cells, and endothelial cells. The hypothesis is supported by observations of (1) hemolytic effect of FFA, and protection by albumin in vitro, (2) inhibition of white blood cells by FFA, (3) increased FFA/albumin ratio and erythrocyte susceptibility to hemolysis in pre-eclampsia, (4) increased incidence of eclampsia in undernutrition, (5) the paradox that famine suppresses and refeeding activates malaria, and (6) an inverse relationship between serum albumin level and mortality.
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