STUDIES ON HORMONAL CONTROL OF SERUM LIPID PARTITION IN MAN*†

Abstract

The serum lipid partition was studied in a group of 18 patients who were treated with cortisone acetate over a period of 6-31 days, with a total dose varying from 0.6-3.2 g. per person. These patients had a variety of clinical conditions including lupus erythematosus disseminatus, scleroderma, rheumatoid arthritis, leukemia, polyarteritis nodosa, nephrosis, Hodgkin''s disease, generalized dermatitis, dermatomyositis, and acute rheumatic fever. The majority of the patients were severely ill, and there was a fatal termination in 3. Under cortisone admn. a gradual increase of total and esterified cholesterol was observed which averaged +19% for total cholesterol and +23% for the esters. A similar trend was observed in the serum phospholipids; the total change for the group was +24%. The rise in serum cholesterol and phospholipid occurred in 2 instances on a salt-free, cholesterol-free diet. In contrast there was a marked decrease in serum neutral fat, which averaged -43% for the entire group. In 16 patients the effect of ACTH (Armour) admn. was studied. This hormone was given over a period of 9-70 days, in a total dose varying from 0.8-3.8 g. per patient. The serum lipids showed less conspicuous changes than with cortisone. Serum cholesterol usually decreased slightly during the first 6-15 days by an avg. of -7%; a moderate elevation of this fraction then followed, the rise in total cholesterol averaged +11%, and that of the esters +13%. The serum phospholipid showed no uniform change under ACTH, the average being a slight increase +7%. The neutral fat of the serum showed a maximum drop during the 6th to the 20th day which averaged -46%, and showed later a tendency to return toward control values. The overall change in neutral fat was -25%. A group of normal individuals was studied to establish normal values for our laboratory. A total of 119 cholesterol and 121 phospholipid detns. revealed an average of 211 mg./100 ml. for serum cholesterol and 249 mg. for serum phospholipid.