Various investigations have been per- formed about the pathogenesis of atherosclerosis, and the view has recently become dominant that the disease is caused by disturbance of lipid metabolism. The author studied the serum lipid values of normal subjects of various ages and then of subjects with coronary diseases, diabetes, cerebrovascular diseases and hypertension. Each of the individuals was tested, as far as possible for all the items, cholesterol, lipoprotein index, free fatty acid, total fatty acid, neutral fat and phospholipid, and an attempt was made to determine which of them might serve as the best pointers of atherosclerosis. Experimental Methods The subjects consisted of 106 normotensive persons those whose blood pressure was consistently below 140/90 mmHg by repeated measurement--32 cases of diabetes mellitus. 22 of angina pectoris, 30 of myocardial infarction, 30 of cerebrovascular lesions and 101 of hypertension. The measurement of serum lipid fractions was carried out by the methods show below. 1) Cholesterol : Costello's method. 2) Lipoprotein index : paper electrophoresis. 3) Total fatty acid : extraction by Bloor and Katsura-Hatakeyama's method and measurement by alkali titration. S) Neutral fat : extraction by the same method and measurement by Bragdon's method. 6) Phospholipid : modified Zilversmit's method. Results 1) Serum lipid levels of normotensive subjects. In normotensive subjects under 50 years, the serum total cholesterol level was 167±35 mg/dl, free cholesterol level 52±15 mg/dl, average lipoprotein index 2.9±1.2, nonesterified fatty acid 0.25±0.12 mEq/l, serum total fatty acid level 268± mEq/l, serum neutral fat level 187±50 mg/dl, serum phospholipid level 155±36 mg/dl, and serum CIP ratio 0.97±0.26 ; and those levels above 50 years 185±40 mg/dl (total cholesterol), 59±15 mg/dl (free cholesterol), 3.5±1.9 (lipoprotein index), 0.32±0.10 mEq/l (nonesterified fatty acid), 376±85 mg/dl (total fatty acid). 224±80 mg/dl (neutral fat), 186±81 mg/dl (phospholipid), 1.13±0.35 (C/P ratio). Between the two age groups of normotensive subjects there is statistically significant difference in the total cholesterol, free cholesterol and phospholipid. The lipoprotein index, phospholipid, neutral fat, free fatty acid and total fatty acid have a tendency to increase with age. But there were two or three of the serum lipid fractions which showed a tendency of decreasing after 70 years of age.
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