THE RATIO BETWEEN PHOSPHOLIPID AND THE CHOLESTEROLS IN PLASMA AS AN INDEX OF HUMAN ATHEROSCLEROSIS

Abstract

242 detns. of total cholesterol, free cholesterol and phospholipid from a miscellaneous series of normal and diseased human subjects were analyzed to determine the validity of the suggestion that a relationship may exist between the fixation of lipid in intimal cells and decreased phospholipid-total cholesterol ratios in serum. A true biologic relationship, independent of disease state, can be demonstrated between phospholipid and free cholesterol, but not between phospholipid and total cholesterol. Diseases which are the end result of atherosclerosis or which predispose to this vascular lesion were shown not to deviate from the relationship defined by analysis of the entire series. This relationship was of such a nature that hypercholesterolemic states necessarily have a lower ratio than normocholesterolemic states. In the absence of liver disease, which disturbs the normally constant relationship between total and free cholesterol, it is possible to predict both the phospholipid-total cholesterol ratio and the phospholipid-free cholesterol ratio within narrow limits, if given any one of these 3 values. From this it was concluded that this ratio could be no more reliable as an index of atherosclerosis than the discredited total cholesterol itself.