In a study of 307 white patients who underwent coronary angiography, the relationship of coronary artery disease (CAD) to plasma levels of lipoprotein Lp(a) No. 4, 758-765, 1986. THE ASSOCIATION between coronary artery disease and a plasma lipoprotein migrating on agarose gel or cellulose acetate electrophoresis as a distinct pre-beta, band was reported independently in 1972-1973 from several laboratories.'-3 The activity of the pre-beta, lipoprotein4 was soon discovered to be identical to Lp(a) plasma antigenic activity, discovered by Berg in 1963,5 and results of qualitative assays for Lp(a) likewise were associated with various manifestations of coronary artery disease.4 6 7 Studies using quantitative assays of plasma Lp(a) have tended to confirm an association with coronary artery disease, but thus far statistically significant associations have been reported from these studies only in the context of retrospective subgroup analysis8' 9 or dichotomization of Lp(a) lev-

Lipoprotein Lp(a) is an atherogenic subfraction of plasma lipoproteins which has been studied predominantly in white populations. We quantified Lp(a) by electroimmunoassay in plasma from 105 black and 134 white healthy men and women. Results were correlated with clinical variables and plasma levels of lipids, other lipoproteins, and apolipoprotein (apo) B determined by radioimmunoassay. Black subjects had levels of Lp(a) that averaged twice those of whites (p < 0.001). Among blacks, Lp(a) levels showed a bell-shaped frequency distribution, while among whites the distribution was strongly skewed, with the highest frequencies at low levels. Contrary to previously published results, the apo B levels in our study correlated significantly, though weakly, with Lp L ipoprotein Lp(a) is a cholesterol-rich lipoprotein that can be identified by its characteristic Lp(a) antigenic activity in human plasma.12 The apoproteins of lipoprotein Lp(a) include apolipoprotein (apo) B and apo (a), the antigenic determinant.2 Lipoprotein Lp(a) migrates as a distinct prebeta, band on agarose gel electrophoresis 1 and shows an apparent hydrated density in the range of 1.05 to 1.12 g/ml on ultracentrifugation.2 It is identical to the "prebeta," or the "sinking-prebeta" lipoprotein. 34 Catabolic rates and pathways of lipoprotein Lp(a) resemble those of iow density iipoprotein (LDL). 56 Other metabolic aspects are obscure but appear to be distinct from those of LDL 7 - Despite the fact that lipoprotein Lp(a) typically carries less than 15% of the cholesterol in plasma, levels of this lipoprotein are strongly and positively associated with coronary heart disease.3 ' A i a " Plasma levels of apo B also are strongly associated with the risk for coronary heart disease, and in certain situations, apo B appears to impart risk independently of total plasma cholesterol or LDL cholesterol.12 " 15However, there are few prevalence data in which both Lp(a) and apo B have been measured in the same group of individuals. 4 Such data are needed to clarify the interactive roles of Lp(a) and apo B in iipid metabolism and atherogenesis.Further understanding may be gained by measuring these putatively atherogenic entities within population groups that differ in their average risk of cardiovascular disease. As measured at autopsy, blacks showed less propensity for atherosclerosis than whites, 16 -17 and black men have relatively low mortality from coronary heart disease.1819 Thus far, the comparison of atherogenic apolipoprotein levels in black versus white individuals is limited to qualitative Lp(a) determinations;

No abstract

We performed a double-blind study in 101 preterm infants who weighed less than or equal to 1500 g at birth, who had respiratory distress, and who survived for at least four weeks, to evaluate the efficacy of oral vitamin E in preventing the development of retrolental fibroplasia. Weekly indirect ophthalmologic examinations begun when the infants were three weeks old revealed a significant decrease in the incidence of retrolental fibroplasia greater than or equal to Grade III (P less than 0.03) and greater than or equal to Grade II (P less than 0.05) (McCormick classification) in the 50 infants given 100 mg of vitamin E per kilogram of body weight per day as compared with 51 given 5 mg per kilogram per day (controls). When multivariate analysis was applied to the controls, five risk factors were identified: gestational age, level and duration of administration oxygen, intraventricular hemorrhage, sepsis, and birth weight. When multivariate analysis was applied to both control and treatment groups, the severity of retrolental fibroplasia was found to be significantly reduced in infants given 100 mg of vitamin E (P = 0.012).

We report a cardiovascular risk factor survey of "native" Hawaiians 20-59 years old (70 percent, or 257), living on the Hawaiian Homestead lands on the island of Molokai, Hawaii. More than 60 percent of both sexes were overweight. Among males, 42 percent were smokers. The percent of the population with systolic blood pressure greater than 140 mm Hg or a diastolic pressure greater than 90 mm Hg or taking hypertensive medications was 14 percent of those ages 20-39 and 36 percent of those ages 40-59. The percent with serum cholesterol greater than or equal to 6.2 mmol/L ranged from 8 percent of those 20-29 years old to 46 percent in those 50-59 years old. Two percent of those ages 20-29 had a history of diabetes, or 2 + or greater glycosuria by dipstick, as did 23 percent of those ages 50-59. The majority of the known diabetics exhibited glycosuria and elevated glycohemoglobin levels, indicating poor control. Hypertension, although usually known to the participant, was frequently uncontrolled. From these data, it appears that among this group of Hawaiians major risk factors for cardiovascular disease were frequent, while at the same time the levels of awareness and/or control for most of these factors were low.