Parameters of flbrlnolysls, Including euglobulln fibrlnolytlc activity, tissue-type plasminogen activator (t-PA) antigen, plasminogen activator Inhibitor (PA-lnhlbltor) activity, and plasmln-aj-antlplasmln complex (PAP) were studied In 62 patients (35 women and 27 men; ages 53 ± 16 years) with either Insulin-dependent (IDDM) or nonlnsulln-dependent (NIDDM) diabetes mellKus. Compared to a control group of similar age (n = 57), the diabetic patients had a significantly lower mean euglobulln fibrlnolytlc activity (1.2 ±0.7 vs. 1.7 ±1.1 ng/ml, p<0.01) but significantly higher mean t-PA antigen (15.7 ± 8.4 vs. 6.6 ± 2.9 ng/ml, p < 0.001) and PA-lnhlbltor activity (2.6 ± 1.3 vs. 1.5 ± 0.7 lU/ml, p<0.001) levels. Significant unlvarlate correlations were observed between PA-lnhlbttor activity and age (r=0.32, p<0.05), dlastollc blood pressure (r = 0.42, p < 0.01) and euglobulin fibrlnolytlc activity (r = -0.40, p < 0.01). In multlvariate analysis, only body mass Index (positively) and euglobulin fibrlnolytlc activity (negatively) remained significantly related to PA-lnhlbltor activity In the total diabetic population as well as In the NIDDM group. The only parameter In the IDDM group significantly related to PA-lnhlbltor activity was dlastollc blood pressure. These results suggest that PA-lnhibltor plays a role In the regulation of flbrlnolysls In diabetes patients and that factors like obesity and hypertension may be related to reduced flbrlnolysls via PA-lnhlbltor levels. (Arteriosclerosis 8:68-72, January/February 1988) D iabetes patients are predisposed to cardiovascular complications, which occur earlier and more frequently than in comparable nondiabetic patients. Abnormalities in both lipid metabolism and hemostasis contribute to the development of vascular damage.1 In diabetes patients, spontaneous fibrinolytic activity is reported to be normal or low, 2 -6 while release of plasminogen activator from the vascular endothelium is abnormal in some cases. 59 recently demonstrated that elevated tissue-type plasminogen activator (t-PA) antigen levels in poorly controlled diabetics could be decreased by insulin administration. These authors argued that a decrease of t-PA antigen in hyperinsulinemic, insulin-treated diabetics could hamper the fibrinolytic capacity and thereby favor the development of atherosclerosis.In the present study we have evaluated t-PA antigen and plasminogen activator inhibitor (PA-inhibitor) activity by both univariate and multtvariate analysis in a well-defined group of moderately controlled diabetic patients, including both insulin-dependent and noninsulin-dependent subjects. MethodsSixty-two diabetic patients (35 women and 27 men) ages 16 to 79 years (53 ± 16 years, mean ± SD) were

Serum cholesterol and HDL cholesterol levels were measured in an urban and a rural population of the People's Republic of China and compared with cholesterol values obtained in Belgium and in the Republic of Korea, with use of the same methodology. Total cholesterol levels were markedly lower In the People's Republic of China than in Belgium and generally lower than in Korea, both in male and female subjects. However, the differences In HDL cholesterol levels among the three populations were small in males and only significantly higher in Belgium in the age classes below 34 years. In women of all age groups, HDL cholesterol values were significantly higher In Belgium than in China and Korea. Total cholesterol levels below 100 mg/dl were found In the People's Republic of China in about 2% of the participants. Apolipoprotein B was significantly lower, and the apolipoprotein A,/B ratio was significantly higher, In China and Korea compared to Belgium. I schemic heart disease remains a major problem in Western countries, whereas Oriental populations are relatively immune to this disease. Since serum lipid values are an indicator of the relative risk for ischemic heart disease in Western countries, it is important to study the distribution of serum lipid values in populations where this disease is rare.The purpose of this article is to present data on the serum lipid distribution obtained in a population sample from the People's Republic of China (PRC) and to compare this distribution with data obtained in another Oriental population (the Republic of Korea) and in a typically Western population (Belgium). Methods Study PopulationsThe Chinese population studied consisted of 495 male and 561 female subjects. All were living in the region of Beijing. Of the participants, 256 male and Laboratory MethodsBlood samples for the measurement of serum lipids were taken from nonfasting subjects, and blood sera were separated by centrifugation after coagulation. All serum samples were stored at -2 0° C for a period of 4 to 8 weeks. They were airmailed to Belgium and arrived frozen. To assure standardization, 427 by guest on May 11, 2018 http://atvb.ahajournals.org/ Downloaded from

SUMMARY Serum cholesterol values are markedly lower in Korea than in Belgium in both males and females. This is attributed to the much lower consumption of saturated fat in Korea. A mean population serum cholesterol value of about 160 mg/dl appears to be compatible with excellent general health and with the absence of ischemic heart disease or other atheromatous diseases. The influence of age, height and weight on cholesterol between Belgium and Korea is qualitatively similar but quantitatively different. High-density lipoprotein cholesterol values are lower in Korea than in Belgium, particularly in females. Differences in the HDL cholesterol level thus cannot explain the low prevalence of ischemic heart disease in Korea.

The trends in mortality from ischaemic heart disease, cerebrovascular stroke, and all cardiovascular diseases were analysed for the province of North Karelia and for the rest of Finland. Linear trends in mortality were computed for the population aged 35 to 64 for the period from 1969 to 1982, and changes in mortality between the three year means of 1969-71 and 1980-2 were calculated. In North Karelia, where a community based preventive programme has been carried out since 1972, the annual decline in mortality from ischaemic heart disease in men was on average 2-9/o, whereas in the rest of Finland it was 2-0%. For

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