Current Metabolic-Genetic Interrelationship in Human Atherosclerosis

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Abstract
A few simple laboratory methods were suggested for phenotyping of clinical hyperlipidemias. Proper classification of plasma lipid abnormalities would provide the physician with an insight into the basic metabolic disorder in hyperlipidemia and atherosclerosis. Increased sensitivity to dietary carbohydrate as manifested in hyper-pre-[beta]-lipoproteinemia (rich in both cholesterol and triglycerides) may be quite widespread among the apparently healthy persons while the process is exaggerated in the majority of atherosclerotic patients. Disorder in carbohydrate metabolism may be the major etiological factor in human atherosclerosis. Although hyperlipidemia is frequently encountered in diabetes mellitus, patients with abnormal sensitivity to carbohydrate are characterized primarily by increased endogenous lipogenesis. This disorder may be initiated and sustained by an abnormal insulin mechanism with high plasma insulin and insulin-like activities but normal blood sugar response to carbohydrate meals. The current status of several promising chemotherapeutic agents is reviewed. Their effects upon the control of this special form of disorder in carbohydrate metabolism are being actively investigated. Tentatively, a sugar restrictive 125 gm carbohydrate diet seems to be useful for the control of the metabolic disorder.