Diabetic Lipemia Research Articles

Severe hypertriglyceridemia in an adolescent female with diabetic ketoacidosis: A case report

Abstract Severe hypertriglyceridemia (SHT) is a rare metabolic complication of diabetic ketoacidosis (DKA) and may complicate the course by leading to acute pancreatitis. While intravenous insulin typically treats the dyslipidemia in these cases, the role of lipid-lowering agents to prevent adverse outcomes in patients not responding to insulin warrants further investigation. We report the case of an adolescent girl who presented to us with DKA and SHT (8639 mg/dL), requiring intravenous insulin as well as fibrates. She did not develop any complications that could be attributed to diabetic lipemia; investigations revealed no sequelae of hyperlipidemia or evidence of familial dyslipidemia.

Severe hypertriglyceridemia in the course of ketoacidosis in a patient with newly diagnosed type 1 diabetes mellitus

BACKGROUND: One of the most serious complications in delayed diagnosis of DKA is hypertriglyceridemia (HTG), Prevalence of mild hypertriglyceridemia is found in about 50% of patients with diabetic ketoacidosis (DKA). Prevalence of severe hypertriglyceridemia [TG > 22.4 mmol/L (> 1959 mg/dL)] was found in about 1–8% of adults with DKA, but few data have been reported in children with severity ranging from asymptomatic to severe acute pancreatitis. CASE PRESENTATION: A 2-year-old-girl with a 2 weeks history of generalized weakness, polydipsia, polyuria, and vulvar candidiasis was admitted to the Intensive Care Unit with clinical signs of DKA. Our patient was met the diagnostic criteria for DKA (pH 7.1, HCO3- 8.8 mmol/L, BE -21.1 mmol/L), glucose level of > 22 mmol/L (556 mg/dl). Initial biochemical analysis showed hyperlipidemia [TG 11470 mg/dL (131.1 mmol/L)], amylase 28 U/L. Her blood demonstrated a grossly lipemic appearance and her lipemic condition disturbed the results of other biochemical blood investigations. The objective of this case report is to present and describe the clinical features, laboratory investigations, case management, and natural course of hypertriglyceridemia in a 2-year-old girl with DKA. CONCLUSIONS: Lipemia secondary to severe HTG may exist in new-onset T1DM with DKA. Diabetic lipemia can be caused not only by profound insulin deficiency. An additional factor which should be taken into consideration in very young children is breastfeeding, which is associated with increased mean total cholesterol (TC) and LDL levels. Moreover, severe hypertriglyceridemia may result in mutations of genes encoding lipoprotein lipase (LPL).

Strawberry milk-like blood in a subject with diabetic lipemia: dramatic change to transparent color after insulin therapy.

Introduction It is known that chylomicronemia is caused by several pathologies and is classified as primary and secondary chylomicronemia. Since hypertriglycemia is associated with an increased risk of cardiovascular disease and severe pancreatitis, it is very important to make a proper diagnosis of the cause of hypertriglycemia.Case description We herein present the case of a 40-year-old male who developed severe hypertriglycemia accompanied with acute exacerbation of type 2 diabetes mellitus. On admission, his blood glucose level was 306 mg/dl and HbA1c was 12.5 %. Moreover, serum triglyceride level was elevated up to 5661 mg/dl. When blood was drawn, it presented strawberry milk-like color. After receiving insulin treatment, he obtained good glycemic control and the serum became back to normal transparent color.Discussion and EvaluationInsulin resistance reduces triglyceride clearance and also increases triglyceride release from adipocyte. It is known that glucose toxicity and strong insulin resistance induce inactivation of LPL, which results in chylomicronemia.ConclusionThis case report suggests that when serum triglyceride level is markedly elevated due to diabetic lipemia, it is extremely important to obtain good glycemic control.

A Case of Diabetic Lipemia at the Onset of Type 1 Diabetes Mellitus in 4-Year-Old Girl

A Case of Diabetic Lipemia at the Onset of Type 1 Diabetes Mellitus in 4-Year-Old Girl

Diabetic lipemia associated with acute pancreatitis in a patient with type 2 diabetes

We report a 59-year-old man with diabetic lipemia associated with acute pancreatitis. The patient was being treated for type 2 diabetes, but his glycemic control was poor. Although his insulin secretory activity was preserved, acute pancreatitis developed because of hypertriglyceridemia and the patient had type V hyperlipidemia. After hospitalization, his hyperlipidemia and hyperglycemia improved in response to insulin infusion and hydration. It is well known that diabetic lipemia is caused by type 1 diabetes, but is rare in type 2 diabetes. Insulin resistance, as well as insulin deficiency, might play a role in the development of diabetic lipemia.

A Case of Type 2 Diabetes Mellitus with Diabetic Lipemia

A Case of Type 2 Diabetes Mellitus with Diabetic Lipemia

Diabetic lipemia with eruptive xanthomatosis in a lean young female with apolipoprotein E4/4

Eruptive xanthomas in adults are usually indicative of chylomicronemia. Although diabetes mellitus is the most common secondary cause of chylomicronemia, which is designated as diabetic lipemia, the clinical characteristics of diabetes with regard to development of xanthomas are not well defined. In this paper, we describe a young female who displayed eruptive xanthomas as an initial manifestation of diabetic lipemia. The patient was a 20-year-old female with a body mass index of 18.9 kg/m 2 and Marfanoid appearance. Her past history was unremarkable, except for patent ductus arteriosus and mild mental retardation. She was admitted to our division for eruptive xanthomas on the extremities and marked hyperglycemia (random glucose, 520 mg/dl) and hypertriglyceridemia (6880 mg/dl). She was diagnosed with Type 2 diabetes based on the positive family history of diabetes, residual secretory capacity of insulin, and absence of autoantibodies related to Type 1 diabetes. Based on the increase in the concentrations of both chylomicrons and very low density lipoproteins, type V hyperlipoproteinemia was diagnosed. After the initiation of insulin therapy, both hypertriglyceridemia and eruptive xanthomas subsided, without administering any hypolipidemic agents. Minimal model analysis of a frequently sampled intravenous glucose tolerance test revealed severe insulin resistance, despite the absence of obesity. Post-heparin lipoprotein lipase (LPL) activity was moderately decreased, and common mutations in the LPL gene were not demonstrated by genetic screening. The apolipoprotein E phenotype was E4/4, which is known to be associated with type V hyperlipoproteinemia. Hypoadiponectinemia of 1.7 μg/ml was also revealed, which may, in part, account for the insulin resistance and decreased LPL activity. In conclusion, the clustering of apolipoprotein E4/4 and hypoadiponectinemia, in addition to insulin resistance and poor glycemic control, might have resulted in hypertriglyceridemia with eruptive xanthomatosis in this subject.

Diabetic hyperlipemia with or without acute pancreatitis in patients with chronic alcoholism. A study of 4 cases

Diabetic lipemia with and without acute pancreatitis in chronic alcoholism. A report of 4 cases. Diabetic lipemia was observed in 4 chronic alcoholic men after ingestion of high doses of alcohol and/or sugar-rich beverages, including one patient who was treated for insulin-dependent diabetes. None had a previous history of serum lipid disturbances. All had marked hyperglycemia, hyperosmolality and hypertriglyceridemia (mean: 60.8 mmol/l), 2 of undetermined type and 2 of type IV with eruptive xanthomas. Factitious hyponatremia was present in 3 cases, but true serum sodium was normal (138 mmol/l) or elevated (154, 156, 182 mmol/l) after correction. Three patients developed acute pancreatitis ascribed to high serum triglyceride levels and/or to alcohol ingestion. Serum and urine amylase activity was inhibited by hypertriglyceridemia. The diagnosis of pancreatitis was assessed twice by echography and computed tomographic scan, and once by tomographic scan and an elevation of the amylase on creatinine clearance ratio. It is likely that hypertriglyceridemia predisposed these patients to develop pancreatitis, alcoholism being a precipitating factor. We suggest that the diagnosis of acute pancreatitis should be systematically considered in any case of diabetic lipemia without true hyponatremia.

Pathophysiological Approach to the Study of Matal Toxicity (Panel Discussion) (Proceedings of the 10th Symposium on Environmental Pollutants and Toxicology)

Environmental toxicology of metals, like that of other chemicals, consists of ecotoxicology and biotoxicology. Among the biotoxicology, pathophysiological approach, along with toxicological approach, is of particular importance for understanding effects of metals on human health and establishing measures to cope with them including biological monitoring and development of exposure parameters and preventive methods. Experiments have been carride out on chemical biology of chromium and clinical biochemistry of organic tin compounds. The aim of these studies is to demonstrate and evaluate the pathophysiological approach in the study of metal toxicity. Recent results in our laboratory are as follows. 1. Chemical toxicology of chromium. Two low-molecular-weight chromium-binding substances, LMCrI and II, were purified from the liver of dogs. Chromium bound to them showed a lower acute toxicity and higher rates of urinary excretion and renal clearance than potassium dichromate (VI) and chromium (III) chloride. The results together with other findings indicate that LMCrs play an important role in the detoxification and excretion of chromium in mammals. They also show that chemical form of metals and binding protein in the body are important factors in metal toxicity. 2. Clinical biochemistry of organic tin compounds Triphenyltin and tributyltin have been shown to inhibit insulin release from pancreatic islets, subsequently inducing diabetic lipemia due to insulin deficiency. The organic tins also inhibited collagen-induced aggregation and ATP secretion of platelets. Furthermore, they showed a dosedependent inhibition of O2- production, O2 consumption and degranulation of leukocytes. These results indicate that organic tins affect a common mechanism of the stumulus-response coupling in the cell membrane.

Recent progress in the study of analytical methods, toxicity, metabolism and health effects of organotin compounds

Over the years, a variety of uses has been found of organic tin compounds as fungicides, as stabilizers in plastics and for other industrial uses. The purpose of this article is to summarize and review the results so far obtained as to the analytical method for organotins in biological samples, the toxicity, metabolism, and biochemical and health effects of organotin compounds. 1) Many methods have been developed for analysis of organotin compounds by spectrophotometry, polarography, gas- or liquid-chromatography, etc. These methods, however, are mainly for analysis of organotins in standard solutions or in water, and are not suitable for organotin compounds in biological samples. Recently, we have developed several methods for analysis of various kinds of organotin compounds in biological samples. These methods are able simultaneously to separate and determine trace amounts (at nanogram order) of organotin compounds and their metabolites in the same biological samples. 2) Acute toxicity of organotin compounds which appeared on the literature are summarized. Trialkyl and triaryl compounds seem to be more toxic than the tetra-, di-, or mono-compounds of the same chain length. With an increase in the number of C atoms the toxicity of alkyl compounds decreases. Aryltin compounds are less toxic than alkyltin compounds. 3) Intestinal absorption sites for tetra-alkyltins are jejunum and duodenum, and those for trialkyltins are ileum and jejunum. A considerable amount of orally administered tetra- and trialkyltins of low molecular weights are absorbed, but only very little of the other organotin compounds seems to be absorbed from the gastrointestinal tract. Absorbed organotin compounds rapidly undergo dealkylation by the microsomal mono-oxygenase system dependent on cytochrome P-450 in the liver, brain or other organs, and the compounds and their metabolites distribute to the whole body, ultimately being excreted into urine, bile and faeces. The biological half life of organotin compounds in mammals is usually short, a half of the amount of tributyl- and triphenyl-tins deposited in the body disappearing in several days. A part of organotin compounds excreted into bile is demonstrated to have been absorbed from the intestine and to circulate in the body via enterohepatic circulation. 4) Specific effects of organotin compounds on the biological systems and health include disturbance of the structure and function of the central nervous system (interstitial edema of white matter), inhibited oxidative phosphorylation in mitochondria of cells, atrophy of the thymus and thymus dependent lymphoid tissues resulting in the dysfunction of T cells for immunity, inhibited enzyme activity, lesions in the liver and bile ducts etc., although some specificity is observed among species of animals and organotin compounds. Recently we found that a single oral administration of triphenyltin fluoride to rabbits induces transient diabetes and diabetic lipemia by inhibiting insulin secretion from morphologically normal pancreatic B-cells...

Triphenyltin Fluoride (TPTF) as a Diabetogenic Agent: TPTF Induces Diabetic Lipemia by Inhibiting Insulin Secretion from Morphologically Intact Rabbit B-Cell

Recent work in our laboratory has shown that oral administration of triphenyltin fluoride (TPTF) evokes hypertriglyceridemia in rabbits. The present experiments were conducted to elucidate the mechanism of TPTF-induced hypertriglyceridemia in rabbits by a combined biochemical and ultrastructural approach. After a single TPTF administration, fasting blood glucose and plasma triglyceride levels increased significantly (P less than 0.02) for about 20 days. On the other hand, both plasma and adipose tissue lipoprotein lipase (LPL) activity was markedly decreased (P less than 0.001) during this period, and triglyceride production rates on day 2 after TPTF administration was significantly decreased (P less than 0.01). Density-gradient ultracentrifugation showed a remarkable accumulation of chylomicron and VLDL in the composition of plasma lipoproteins. Insulin injection to the hypertriglyceridemic rabbits induced a significant recovery of the decreased plasma LPL activity with a concomitant decrease of plasma triglyceride levels, while abeyance of insulin injection resulted in a decrease of LPL activity again. A significant inhibition of insulin release in response to the loading of glucose, glucagon, or arginine was observed in the TPTF rabbits (P less than 0.02). Inhibition of glucagon release was also observed in the arginine-loading test (P less than 0.01). Electron microscopic studies showed small abnormalities in the pancreatic islets of TPTF-treated rabbits. These findings suggest that TPTF inhibits insulin release from rabbit islets, subsequently inducing diabetic lipemia due to the insulin deficiency. Furthermore, it is possible to provide a new animal model for diabetes and diabetic lipemia by administration of TPTF to rabbits.

Triphenyltin fluoride (TPTF) as a diabetogenic agent. TPTF induces diabetic lipemia by inhibiting insulin secretion from morphologically intact rabbit B-cell

Triphenyltin fluoride (TPTF) as a diabetogenic agent. TPTF induces diabetic lipemia by inhibiting insulin secretion from morphologically intact rabbit B-cell

Transient Diabetic Lipemia and Reversible Glucose Intolerance in Rabbits after a Single Dose of Triphenyltin Fluoride

Transient Diabetic Lipemia and Reversible Glucose Intolerance in Rabbits after a Single Dose of Triphenyltin Fluoride

Carbohydrate Induction of Diabetic Lipemia.

s1 May 1968Carbohydrate Induction of Diabetic Lipemia.William H. R. Nye, M.D., F.A.C.P., Christine Waterhouse, M.D., F.A.C.P.William H. R. Nye, M.D., F.A.C.P.Search for more papers by this author, Christine Waterhouse, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-68-5-1188_4 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptLipemia is frequently seen during the course of diabetes mellitus. It usually occurs transiently as part of the syndrome of acute insulin deficiency, disappearing rapidly with insulin therapy. Less commonly, chronic lipemia is encountered that is not always abolished by insulin administration. A role for carbohydrate (CHO) induction in these cases was suggested by the finding of endogenous as well as exogenous particulate fat in the plasma of 3 insulin-requiring patients with chronic diabetic lipemia, and was evaluated in 2 of them in a Clinical Research Center as follows: Each was given [1] a high-CHO, no-, or low-fat diet and... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Albuquerque, New Mexico, and Rochester, New York PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1968Volume 68, Issue 5Page: 1188-1189KeywordsBlood plasmaCarbohydratesDiabetes mellitusDietFatsHyperlipidemiaInsulinParticulates Issue Published: 1 May 1968 PDF DownloadLoading ...

Persistent hyperlipemia and hepatosplenomegaly in a patient with controlled diabetes mellitus.

Case Reports1 September 1954PERSISTENT HYPERLIPEMIA AND HEPATOSPLENOMEGALY IN A PATIENT WITH CONTROLLED DIABETES MELLITUSTHOMAS A. HAYMOND, M.D., KEEHN BERRY JR., M.D.THOMAS A. HAYMOND, M.D.Search for more papers by this author, KEEHN BERRY JR., M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-41-3-609 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptHyperlipemia has been shown to occur in association with a number of disease states.1a Movitt et al.2 and Thannhauser1a, b have listed the conditions, and Thannhauser has written an excellent monograph on the lipidoses.1aOne of the disease states with which hyperlipemia is associated is diabetes mellitus.1a, b, 3, 4, 5Thannhauser states,1ahowever, that the hyperlipemia of diabetes "is controlled completely by insulin." Carfagno and Steiger,3in reviewing 63 cases of lipemia retinalis in the literature, to which they added one of their own, state that lipemia retinalis was seen in the diabetic patients only when they were in...Bibliography1. Thannhauser SJ (a) : Lipidoses, 1950, Oxford University Press, New York. (b) Thannhauser, S. J.: Serum lipids, their value in diagnosis, New England J. Med. 237: 515, 1948. Google Scholar2. MovittGerstlSherwoodEpstein ERBFCC: Essential hyperlipemia, Arch. Int. Med. 87: 78, 1951. CrossrefGoogle Scholar3. CarfagnoSteiger SCWA: The serum lipids in lipemia retinalis, Am. J. M. Sc. 221: 379, 1951. Google Scholar4. Blix G: Diabetic lipemia, Acta med. Scandinav. 64: 142, 1926. CrossrefGoogle Scholar5. WarrenRoot SF: Lipoid containing cells in the spleen in diabetics with lipemia, Am. J. Path. 2: 69, 1926. MedlineGoogle Scholar6. Lawrence RD: Lipodystrophy and hepatomegaly with diabetes, lipemia and other metabolic disturbances, Lancet 1: 724, 773, 1946. CrossrefMedlineGoogle Scholar7. ChapmanKinney FDTD: Hyperlipemia; idiopathic lipemia, Am. J. Dis. Child. 62: 1014, 1941. CrossrefGoogle Scholar8. Hopgood WC: Idiopathic hyperlipemia, New England J. Med. 238: 429, 1948. CrossrefMedlineGoogle Scholar9. KoszalkLevin MFJJ: Idiopathic hyperlipemia, Ann. Int. Med. 33: 473, 1950. LinkGoogle Scholar10. MaimonKirsnerPalmer SNJBWL: Chronic recurrent pancreatitis; a clinic study of 20 cases, Arch. Int. Med. 81: 56, 1948. CrossrefGoogle Scholar11. MentherKnight ROWA: Chronic recurrent pancreatitis, Gastroenterology 12: 24, 1949. CrossrefMedlineGoogle Scholar12. King SE: The syndrome of chronic relapsing pancreatitis, M. Clin. North America 33: 883 (May) 1949. CrossrefMedlineGoogle Scholar13. KlatskinGordon GM: Relationship between relapsing pancreatitis and essential hyperlipemia, Am. J. Med. 12: 3, 1952. CrossrefMedlineGoogle Scholar14. SteinbrockerSpitzerFriedman ONHH: The shoulder-hand syndrome in reflex dystrophy of the upper extremity, Ann. Int. Med. 29: 22, 1948. LinkGoogle Scholar15. Poulsen HM: Familial lipemia: a new form of lipoidosis showing increase in neutral fats combined with attacks of acute pancreatitis, Acta. med. Scandinav. 138: 413, 1950. CrossrefMedlineGoogle Scholar16. SchwarzWoldowDunsmore LARA: Determination of fat tolerance in patients with myocardial infarction: method utilizing serum turbidity changes following a fat meal, J. A. M. A. 149: 364 (May 24) 1952. CrossrefMedlineGoogle Scholar17. ThannhauserReinstein SJH: Fatty changes in the liver from different causes: comparative studies of lipid partition, Arch. Path. 33: 646, 1942. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Received for publication November 3, 1953. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDiabetes mellitus und HyperlipoproteinämieDiabetes mellitus und HyperlipämiePathophysiologie der primären HypertriglyceridämienHYPERLIPEMIA ASSOCIATED WITH DIABETES MELLITUS AND PANCREATITIS: A CASE REPORT WITH AUTOPSY*CHARLES R. TOURTELLOTTE, M.D., RUSSELL D. TYLER, M.D. 1 September 1954Volume 41, Issue 3Page: 609-616KeywordsDiabetes mellitusFatsHeparinHepatosplenomegalyHyperlipidemiaInsulinLipidsResearch laboratories ePublished: 1 December 2008 Issue Published: 1 September 1954 PDF downloadLoading ...

XANTHOMA DIABETICORUM

Case Reports1 September 1953XANTHOMA DIABETICORUMESAR GORDON MARGOLINESAR GORDON MARGOLINSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-39-3-629 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn recent years cholesterol and its esters have been singled out of the lipid constituents of the body for special consideration, largely because of their relationship to atheromatous changes and partly because of their chemical similarities to adrenal and sexual hormones. Clinicians have been impressed with the importance of the cholesterol levels in certain disease states, and the measurement of cholesterol is now a standard test in most clinical laboratories. A recent case of xanthoma diabeticorum, manifesting striking alterations in cholesterol metabolism occurring in the course of uncontrolled diabetes mellitus, is presented.CASE REPORTPresent Illness:A 21 year old...Bibliography1. AddisonGull TW: On a certain affection of the skin, vitiligoidea—(a) plana; (b) tuberosa, with remarks, Guy's Hosp. Rep. 7: 265, 1851. Cited by Thannhauser.8 Google Scholar2. McGavackShepardson THHC, cited by Buchanan, J. A., and Indelicato, J. C.: A case of xanthoma diabeticorum associated with diabetes mellitus and acromegaly, Am. J. M. Sc. 195: 50-53, 1938. CrossrefGoogle Scholar3. JoslinRootWhiteMarbleBailey EPHFPACC: The treatment of diabetes mellitus, 1946, Lea and Febiger, Philadelphia, pp. 593-595. Google Scholar4. Diamond , cited by Joslin.3 Google Scholar5. Major , cited by Sutton and Sutton.7 Google Scholar6. Beerman H: Lipid diseases as manifested in the skin, M. Clin. North America 35: 433-456, 1951. CrossrefMedlineGoogle Scholar7. SuttonSutton RLRL: Diseases of the skin, 1939, The C. V. Mosby Co., St. Louis, pp. 391-393, 866-871. Google Scholar8. Thannhauser SJ: Lipidoses, diseases of the cellular lipid metabolism, 1950, Oxford University Press, New York. Google Scholar9. CarfagnoSteiger SCWA: The serum lipids in lipemia retinalis, Am. J. M. Sc. 221: 379-383, 1951. CrossrefMedlineGoogle Scholar10. NadbathFauteux RPLZ: Diabetic lipemia retinalis, U. S. Armed Forces M. J. 3: 319-322, 1952. MedlineGoogle Scholar11. CurtisSheldonEckstein ACJMHC: Experimental reproduction of lipemia, Am. J. M. Sc. 186: 548-556, 1933. CrossrefGoogle Scholar12. ParkerCuller WRAM, cited by Curtis and Sheldon.11 Google Scholar13. Allen FM, cited by Curtis and Sheldon.11 Google Scholar14. Garb J: Lipid metabolism in relation to xanthoma diabeticorum with a recommendation for a new nomenclature, Ann. Int. Med. 19: 241-252, 1943. LinkGoogle Scholar15. Duncan GG: Diseases of metabolism, 1947, W. B. Saunders Co., Philadelphia. Google Scholar16. Spencer MC: Xanthoma diabeticorum, Arch. Dermat. and Syph. 64: 92-93, 1951. Google Scholar17. FrankLevitt LLM: Idiopathic hyperlipemia with secondary xanthomatosis, Arch. Dermat. and Syph. 64: 434-436, 1951. CrossrefGoogle Scholar18. DelevettBruger AFM: Plasma lipids in primary (xanthomatosis) and secondary hypercholesterolemia, Arch. Int. Med. 81: 859-867, 1948. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: MC Omaha, Nebraska*Received for publication March 18, 1953.From the Medical Service, 382d General Hospital, APO 54, c/o PM, San Francisco.Present address: 116 So. 50 St., Omaha. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDiabetes and Diseases of the SkinThe diet and the development of coronary heart disease 1 September 1953Volume 39, Issue 3Page: 629-635KeywordsApolipoproteinsCholesterolClinical laboratoriesDiabetes mellitusHormonesLipidsMedical services ePublished: 1 December 2008 Issue Published: 1 September 1953 PDF downloadLoading ...

Serum Lipids in a Case of Diabetic Lipemia Retinalis

Serum Lipids in a Case of Diabetic Lipemia Retinalis

Relation between blood lipids and excretion of choline in diabetic patients.

THE INCREASE of blood lipid fractions, diabetic-hyperlipemia, is a well known sign of the abnormal fat metabolism which takes place in a system affected with diabetes mellitus. The blood lipids can be divided into three groups, composed of (1) neutral fat, (2) phospholipids and (3) cholesterol. Recent studies seem to indicate that practically all phospholipids contain choline, 1 that is to say, they are composed of sphingomyelin and, mainly, of lecithin. Choline is regarded as an important dietary factor, playing an essential role in fat metabolism. 2 In this laboratory the excretion of choline in the urine of persons with diabetes was investigated, and an increased choline output was found in some instances. 3 In continuing these investigations, the relationship between the amount of choline excreted in the urine and the diabetic lipemia has been studied. MATERIAL Twelve patients with diabetes, 5 men and 7 women, ranging in age from

LEUKEMIC RETICULO-ENDOTHELIOSIS (MONOCYTIC LEUKEMIA)

More or less generalized involvement of the reticuloendothelial system is found in various pathologic conditions, which can be fairly well grouped under the following headings: Storage histiocytomatosis — Gaucher's disease, Pick-Niemann disease, xanthomatosis and, sometimes, diabetic lipemia. Granulomatosis—Hodgkin's disease. Hyperplasia—reticulo-endotheliosis. (A) Leukemic reticulo-endotheliosis (monocytic or histiocytic leukemia) with or without blastoma formation. (B) Aleukemic reticulo-endotheliosis with or without blastoma formation—response to infection (?) or true systemic disease (?). 4. Tumors—reticulum cell lymphosarcoma. The conditions classified under 1, 2 and 4 are fairly well defined, but considerable discussion has arisen concerning reticulo-endotheliosis. The pathologic changes in the cases described are nearly uniformly constant and consist chiefly of a diffuse proliferation primarily of the reticulum cells and sometimes of the endothelial cells in the hematopoietic system, chiefly in the spleen and lymph nodes, and in most of the other viscera. Some investigators, notably Sternberg, maintain that the condition is merely an atypical response to

DIABETIC LIPEMIA RETINALIS

Despite the frequency of reports of severe cases of diabetes mellitus, diabetic lipemia retinalis has been reported only thirty-six times. In February, 1927, I 1 reported the thirty-fifth case; in June, 1927, Ferber and Apperman 2 reported the thirty-sixth case. The following is the thirty-seventh case to be reported. It is of interest because of the completeness of the analyses made of the blood fat and blood cholesterol. For these I am indebted to Dr. W. R. Bloor of the University of Rochester School of Medicine, Rochester, N. Y. The work was done by one of his students, H. D. McEwen, M.A., Robinson Fellow in Biochemistry. REPORT OF CASE A. G., a youth, aged 17, from Dubuc, Sask., was admitted to the Regina Grey Nuns' Hospital the evening of Feb. 15, 1928. He was referred to me by Dr. J. V. Connell at noon, February 16. He gave a history