FACTORS ALTERING CONCENTRATION OF BLOOD LIPIDS 447 



are completely exhausted, and the body is forced to rely upon protein and 

 fat as a source of calories, the injection of insulin will cause an increased 

 ketonemia. 682 ' 684 



b'. The Blood Lipids in Diabetes Mellitus: (a') The Presence of 

 Hyperlipemia. — Very high values for blood lipids in men have been reported 

 in cases of diabetes mellitus, as compared with other pathological condi- 

 tions. 685-697 The maximum value for total lipids in diabetes reported in 

 the literature is one of 48% cited by Chase. 594 The ordinary Babcock 

 centrifugation method for butterfat was employed in the determination 

 of this value. Other high values reported are 22%, 596 19.7%, 688 and 

 15%. 693 In the case of children suffering from diabetes, the figures are 

 much lower. Boyd 595 reported that the values for total lipid were higher in 

 the case of diabetic children than for normal subjects; in acidosis, the total 

 blood lipids approximated 1% while, in coma, figures as high as 2% were 

 found. 



Although it was recognized for a long period that a large proportion of 

 fatty material occurred in the blood of diabetics, Fischer 587 and Klemperer 

 and Umber 589 - 590 were the first to emphasize the fact that constituents other 

 than the neutral fats were likewise present in increased quantities. Thus, 

 cholesterol has been reported in amounts of 1.5% (14.1% total lipid), 691 

 and 1.41% (22% total lipid). 596 Feigl 692 found a maximum of 0.92% of 

 lecithin in diabetic blood containing a total of 15% of total lipid, 693 while 

 Herbert 596 reported a value of 0.95% for phospholipids (total lipid, 22%). 

 However, in spite of the marked percentage increase which may occur in 

 the total cholesterol and phospholipid, it is evident that the bulk of the 

 fatty material present, in the above cases of extreme hyperlipemia, must 

 consist of neutral fat. 



According to Blix, 255 the instances of the high degree of lipemia noted 

 above are rare, and a moderate lipemia obtains in the largest proportion of 



684 A. Gottschalk and A. Springborn, Klin. Wochschr., 8, 1660-1661 (1929). 



685 M. Bonninger, Z. klin. Med., 42, 65-71 (1901). 



686 L. Schwarz, Deut. Arch. klin. Med., 76, 233-289 (1903). 



687 B. Fischer, Arch. path. Anat. Physiol. (Virchow's), 172, 30-71 (1903). 



688 E. Neisser and L. Derlin, Z. klin. Med., 51, 428-438 (1904). 



689 G. Klemperer and H. Umber, Z. klin. Med., 61, 145-152 (1907). 



890 G. Klemperer and H. Umber, Z. klin. Med., 65, 340-351 (1908). 



891 C. G. Imrie, /. Biol. Chem., 20, 87-90 (1915). 



892 J. Feigl, Biochem. Z., 92, 1-83 (1918). 



893 J. Feigl, Biochem. Z., 90, 173-214 (1918). 



894 L. A. Chase, Can. Med. Assoc. J., 17, 197-204 (1927). 



898 G. L. Boyd, Am. J. Diseases Children, 36, 298-309 (1928). 



899 F. K. Herbert, Biochem. J., 29, 1887-1893 (1935). 

 597 S. H. Rubin, /. Biol. Chem., 131, 691-702 (1939). 



