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Nineteen patients with familial hypercholesterolemia, 5 patients with hyperlipidaemia secondary to nephrotic syndrome and 14 normal individuals were given a mean containing lg saturated fat/Kg body weight. The plasma total functional antithrombin (AT) activity was measured in the normal before the meal and 2,4 and 6 hours after the meal by both a clotting assay system and the chromogenic substrate S2160. Only the clotting assay system could be employed in the hyperlipidaemia situation. The functional plasma AT-III activity was compared with AT protein levels measured by quantitative radial immunodiffusion. Functional AT activity was depressed maximally at 2 hours after the meal in 13 of the normal and all of the nephrotic individuals studied. The immunologically measured AT-III levels remained constant throughout the experiment. Only 9 of the 19 familial hypercholesterolemic patients showed a similar phenomenon. The functional depression in AT activity failed to correlate with the rise in serum triglyceride level. Basal functional AT activity was similar in the normal and hypercholesterolemia patients but considerably increased in the nephrotic patients studied. When similar studies with an unsaturated fatty meal were carried out in normal volunteers no significant alteration in functional AT activity was observed. In addition, 11 volunteer normal individuals were fasted for 24 hours. Considerable increases in functional AT activity were present in 9 of the 11 subjects. These studies indicate that functional AT activity may be modified by various physiological and pathological factors.

Antithrombin Functional Activity in Normal Individuals and in Patients with Familial Hypercholesterolemia and Nephrotic Syndrome