脂質代謝(遊離脂肪酸代謝)よりみた循環器系心身症(循環器系心身症の発生機序とその臨床5)(第16回日本精神身体医学総会)

抄録

It is well known that exposure of man to various psychological stress leads to an increase of plasma free fatty acid, so we investigated the lipids (free fatty acid) metabolism in psychosomatic diseases of the cardiovascular system. The psychosomatic patients who showed abnormal test results, such as CMI type IV and high MAS points, have higher fasting plasma free fatty acid level (706±63μEq/l n=12) than the normal (CMI type I, low MAS points) control group (473±40μEq/l n=13). Among these patients, especially the cardiac neurosis group, plasma FFA and blood glucose increased more markedly after infusion of low doses of norepinephrine (0.2μg/kg/min for 15 min.) than the noraml control. This difference in response does not seem to be the effect of aging, obesity and hyperlipidemia. In both groups, the increase in plasma FFA and glucose after norepinephrine infusion was not completely suppressed by the pretreatment with propranolol infusion. In animal experiments, during a hemorragic shock, plasma FFA of anesthetized dogs gradually decreased, instead of marked increase of blood lactate and catecholamines. From these results, it is tempting to speculate that a certain group of psychosomatic patients may have metabolic hyperresponse (ex. hyper-free-fatty-acidemia) to distressing stimuli, but the variety, intensity and duration of stress may cause variable metabolic responses.