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[Cutaneous cholesterol in the young and aged coronary patient].

Serum cholesterol (ch), its lipoprotein fractions and triglycerides were measured in three populations of proven coronary patients (less than 50 years, n = 56; between 50 and 65 years, n = 56; greater than 65 years, n = 23); the risk factor total ch/HDL ch was calculated. The level of skin cholesterol was also estimated by skin biopsy in each patient and compared to that of three control populations of the same age. The results indicated that 1) there was no significant difference in skin cholesterol of patients with myocardial infarction whatever their age, 2) there was a significant difference (p less than 0,001) with control subjects of the same age except in the over 65 population, 3) the total cholesterol was normal in all three groups, 4) the HDL cholesterol of coronary patients over 50 year old was normal and slightly reduced in younger coronary patients, 5) the ratio total ch/HDL ch was increased in coronary patients under 50, but normal after this age, 6) the triglyceride level was higher in the young coronary patients than in those over 50 years old. Four conclusions are drawn: 1) the total Ch/HDL ch ratio is a good indicator of coronary risk in patients under 50 years old but shows less sensitive variations than the level of skin cholesterol, 2) the ch/HDL ch in coronary patients between 50 and 65 years old is normal; the only laboratory finding which correlates with the coronary event is skin cholesterol; after 65 years of age the skin cholesterol stabilises to the same levels as found in control subjects; 3) from the outset, at whatever age infarction occurs, skin cholesterol is increased (about 0,45 mumol/100 ngr of fresh skin), whilst the risk factor is higher in the younger population; 4) skin cholesterol shows less variation in the three coronary groups than the other blood parameters measured. It would therefore appear to be a very discriminating index of coronary atherosclerosis.