HYPOLIPIDÆMIA IN ANÆMIA: Implications for the Epidemiology of Ischaemic Heart-disease

Hypocholesterolæmia and hypophospholipidæmia are present in most subjects with chronic anaemia due to a variety of causes. Ultracentrifugal analysis showed a proportionate decrease of cholesterol and phospholipid in all three main plasmalipoprotein fractions. 2 siblings with congenital microspherocytosis, in whom hæmolysis was compensated, were also hypocholesterolæmic and hypophospholipidæmic. 7 patients with congenital microspherocytosis treated 10 months to 32 years ago by splenectomy tended to have low cholesterol and phospholipid levels, but not to the same extent as the anæmic subjects. In a patient with congenital microspherocytosis, splenectomy was associated with doubling of the cholesterol value. Vitamin-B12 therapy produced a rise in the serum-cholesterol level of a patient with pernicious anæmia. Serum-triglyceride levels were not reduced either in 6 anæmic patients studied or in patients with congenital microspherocytosis. The hypolipidæmia of anæmia is probably due to more than one factor. The findings may explain the differences in the incidence of ischæmic heart-disease between the sexes, between premenopausal and postmenopausal women, and between developed and underdeveloped countries.