Portal hypertension and refractory ascites associated with multicentric Castleman's disease.
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Biomedical subjects
Publications and source records attributed to J L Escolar.
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318 records of male workers, 169 Spanish and 149 Arab were retrospectively studied in 1987 at the "Gabinete de Seguridad e Higiene en el Trabajo" (Council for Safety and Hygiene in the Workplace) in Ceuta in order to prove the hypothesis that 2 different ethnic groups living in the same geographic area have a non-equal distribution of cardiovascular risk factors. The Spanish group showed a higher prevalence in blood hypertension, diabetes, glucose intolerance, obesity and alcohol intake, compared to the Arab group. Smoking and high levels of seric cholesterol were similar in both groups, however, medium levels of seric cholesterol were lower in the Arab group. Family histories of cardiovascular disease were very rare in the latter mentioned group. These observations suggested a major predisposition to ischemic cardiopathy in the Spanish group.
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Alcohol intake is known to increase plasma HDL subfractions and apo A levels. Few data are available, however, with regard to precise apoprotein composition of plasma lipoproteins in alcohol consumers. The aim of the present study was to examine the lipid and apoprotein distribution in plasma lipoproteins of subjects with different levels of alcohol intake. Thirty-six male regular drinkers were classified as social (n = 10, average daily consumption greater than or equal to 5 and less than or equal to 20 g), moderate (n = 11, average daily consumption greater than 20 g and less than 70 g) and heavy drinkers (n = 15, average daily consumption greater than or equal to 70 g). Reference data were obtained from 11 subjects, all lifelong abstainers. Lipoproteins were fractioned by sequential ultracentrifugation and apolipoprotein distribution in VLDL, HDL-2 and HDL-3 was determined by isoelectrofocusing in polyacrylamide-urea gel. HDL-2 cholesterol was significantly higher in heavy drinkers (P less than 0.005). A parallel trend for HDL-3 cholesterol was observed. In alcohol consumers HDL-2 particles were enriched in apos C, in particular apo C-II (P 0.005), displacing apo A-I. These data suggest that apolipoprotein distribution in the HDL-2 subfraction is influenced by alcohol intake even at the lowest level.
The distribution of apoprotein E phenotypes in a randomly chosen population sample of Málaga was compared to other published studies performed in other countries, observing minimal differences in Caucasian populations but significant differences with oriental ethnic groups. Cholesterol and triglyceride plasma levels were not significantly different in the different apo E phenotypes. A high proportion of subjects (26%) with hydrocarbon metabolism abnormalities (diabetic and glucose intolerant) was observed in phenotype E4/3 and very low (4.7%) in phenotype E3/2. The study of plasma triglyceride levels which were higher in the diabetic group, revealed a greater increase in phenotype E4/3 than in E3/3. These results support the idea about the complex relationship that exists between apo E phenotypes and some cardiovascular risk factors.
The levels of plasmatic lipids and the lipo and apoprotein composition of lipoprotein of high density were analysed in 18 patients, diagnosed as having non-insulin dependent diabetes, and compared to a control group of 18 healthy patients. 10 patients showed a moderate hypertriglyceridemia, this sub-group having the main HDL alteration. In this lipoprotein fraction an increase of triglycerides was observed, and a decrease in cholesterol and apoprotein III, probably as result of a lower activity of lipoprotein lipase in plasma.
Changes in lipids and lipoprotein fractions were studied 6 months after a combined heart and liver transplantation in a patient with terminal ischemic heart disease due to homozygous familial hypercholesterolemia. The double transplant was followed by striking decreases in total and low-density-lipoprotein cholesterol levels (-71% and -79%) and content of apolipoprotein B in the low-density-lipoprotein fraction (-74%). There was also an increase in high-density-lipoprotein cholesterol (+7.8%). These changes are greater than those reported with portacaval shunt or plasma exchange. Liver transplantation may be considered in selected patients with homozygous familial hypercholesterolemia.
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