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Xanthoma is a common complication of familial hypercholesterolemia and has been considered to be associated with atherosclerotic state, especially coronary heart disease. (CAD)Although the patients with xanthoma investigated in this study had also high frequency of occurence of coronary artery disease in general agreement with the previous reports, some patients were not associated with coronary artery disease even if their xanthoma were quite severe. The purpose of this study is to define the relationship between the type of xanthoma or lipoprotein abnormalities and prevalence of coronary artery disease, and further to clarify the major factor of the development of atherosclerosis.42 patients with xanthoma in our clinic were devided into 4 groups according to patterns of xanthoma:Group (1): Xanthelasma aloneGroup (2): Achilles tendon xanthoma aloneGroup (3): Achilles tendon xanthoma with xanthelasmaGroup (4): Tuberous xanthoma and/or cutaneous xanthomaThe levels of lipids and lipoproteins in serum of each groups were detected and comparired between each other.Patients in group (1) had lower levels of cholesterol (chol.) and lower frequency of CAD than those of group (2), (3) and (4). Group (2), (3) and (4) had similar frequencies of CAD which was more than 50%.HDL-chol. was significantly lower levels in patients with CAD than in those without CAD, but there were no significant differences in levels of chol, and triglyceride between those with CAD and without CAD.The lower the HDL-chol, levels, the higher the frequencies of CAD, on the contrary, there were no CAD patients with HDL-chol. level for more than 50mg/dl. The higher Atherogenic Index (VLDL+LDL/HDL), the higher frequency of CAD.Achilles tendon was significantly thicker in patients with CAD than in those without CAD, and the thicker Achilles tendon the patients had, the higher freequency of CAD they had.
- 社団法人 日本老年医学会の論文