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. 1967 Nov;46(11):1756–1767. doi: 10.1172/JCI105666

Role of Insulin in Endogenous Hypertriglyceridemia*

Gerald M Reaven 1, Roger L Lerner 1,‡, Michael P Stern 1,§, John W Farquhar 1
PMCID: PMC292926  PMID: 6061748

Abstract

Dietary carbohydrate accentuation of endogenous triglyceride production has been studied in 33 patients. A broad and relatively continuous spectrum of steady-state plasma triglyceride concentrations was produced in 31 of the 33 subjects during 3 wk of a high carbohydrate (fat-free) liquid formula diet. Two patients developed plasma triglyceride concentrations in excess of 2000 mg/100 ml, and these were the only patients we have studied in which carbohydrate induction of hypertriglyceridemia seemed to be associated with a defect in endogenous plasma triglyceride removal mechanisms. In the remaining 31 patients the degree of hypertriglyceridemia was highly correlated with the insulin response elicited by the ingestion of the high carbohydrate formula (P < 0.005). No significant correlation existed between fasting plasma triglyceride concentration and either plasma glucose or free fatty acid concentrations after the high carbohydrate diet, nor was the degree of hypertriglyceridemia related to degree of obesity. It is suggested that hypertriglyceridemia in most subjects results from an increase in hepatic triglyceride secretion rate secondary to exaggerated postprandial increases in plasma insulin concentration.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. AHRENS E. H., Jr, HIRSCH J., OETTE K., FARQUHAR J. W., STEIN Y. Carbohydrate-induced and fat-induced lipemia. Trans Assoc Am Physicians. 1961;74:134–146. [PubMed] [Google Scholar]
  2. ANTONIS A. SEMIAUTOMATED METHOD FOR THE COLORIMETRIC DETERMINATION OF PLASMA FREE FATTY ACIDS. J Lipid Res. 1965 Apr;6:307–312. [PubMed] [Google Scholar]
  3. Albrink M. J., Meigs J. W. The relationship between serum triglycerides and skinfold thickness in obese subjects. Ann N Y Acad Sci. 1965 Oct 8;131(1):673–683. doi: 10.1111/j.1749-6632.1965.tb34830.x. [DOI] [PubMed] [Google Scholar]
  4. Bagdade J. D., Porte D., Jr, Bierman E. L. Diabetic lipemia. A form of acquired fat-induced lipemia. N Engl J Med. 1967 Feb 23;276(8):427–433. doi: 10.1056/NEJM196702232760802. [DOI] [PubMed] [Google Scholar]
  5. Berson S. A., Yalow R. S. Some current controversies in diabetes research. Diabetes. 1965 Sep;14(9):549–572. doi: 10.2337/diab.14.9.549. [DOI] [PubMed] [Google Scholar]
  6. FOLCH J., LEES M., SLOANE STANLEY G. H. A simple method for the isolation and purification of total lipides from animal tissues. J Biol Chem. 1957 May;226(1):497–509. [PubMed] [Google Scholar]
  7. Farquhar J. W., Frank A., Gross R. C., Reaven G. M. Glucose, insulin, and triglyceride responses to high and low carbohydrate diets in man. J Clin Invest. 1966 Oct;45(10):1648–1656. doi: 10.1172/JCI105472. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Fredrickson D. S., Levy R. I., Lees R. S. Fat transport in lipoproteins--an integrated approach to mechanisms and disorders. N Engl J Med. 1967 Jan 19;276(3):148–contd. doi: 10.1056/NEJM196701192760305. [DOI] [PubMed] [Google Scholar]
  9. Gross R. C., Eigenbrodt E. H., Farquhar J. W. Endogenous triglyceride turnover in liver and plasma of the dog. J Lipid Res. 1967 Mar;8(2):114–125. [PubMed] [Google Scholar]
  10. HALES C. N., RANDLE P. J. Immunoassay of insulin with insulin-antibody precipitate. Biochem J. 1963 Jul;88:137–146. doi: 10.1042/bj0880137. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Harlan W. R., Jr, Winesett P. S., Wasserman A. J. Tissue lipoprotein lipase in normal individuals and in individuals with exogenous hypertriglyceridemia and the relationship of this enzyme to assimilation of fat. J Clin Invest. 1967 Feb;46(2):239–247. doi: 10.1172/JCI105526. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. KANE J. P., LONGCOPE C., PAVLATOS F. C., GRODSKY G. M. STUDIES OF CARBOHYDRATE METABOLISM IN IDIOPATHIC HYPERTRIGLYCERIDEMIA. Metabolism. 1965 Apr;14:471–486. doi: 10.1016/0026-0495(65)90038-7. [DOI] [PubMed] [Google Scholar]
  13. KARAM J. H., GRODSKY G. M., PAVLATOS F. C., FORSHAM P. H. CRITICAL FACTORS IN EXCESSIVE SERUM-INSULIN RESPONSE TO GLUCOSE. OBESITY IN MATURITY-ONSET DIABETES AND GROWTH HORMONE IN ACROMEGALY. Lancet. 1965 Feb 6;1(7380):286–289. doi: 10.1016/s0140-6736(65)91026-3. [DOI] [PubMed] [Google Scholar]
  14. LOFLAND H. B., Jr A SEMIAUTOMATED PROCEDURE FOR THE DETERMINATION OF TRIGLYCERIDES IN SERUM. Anal Biochem. 1964 Dec;9:393–400. doi: 10.1016/0003-2697(64)90199-x. [DOI] [PubMed] [Google Scholar]
  15. NESTEL P. J., STEINBERG D. FATE OF PALMITATE AND OF LINOLEATE PERFUSED THROUGH THE ISOLATED RAT LIVER AT HIGH CONCENTRATIONS. J Lipid Res. 1963 Oct;4:461–469. [PubMed] [Google Scholar]
  16. Nestel P. J. Triglyceride turnover in coronary heart disease and the effect of dietary carbohydrate. Clin Sci. 1966 Aug;31(1):31–38. [PubMed] [Google Scholar]
  17. Porte D., Jr, O'Hara D. D., Williams R. H. The relation between postheparin lipolytic activity and plasma triglyceride in myxedema. Metabolism. 1966 Feb;15(2):107–113. doi: 10.1016/0026-0495(66)90031-x. [DOI] [PubMed] [Google Scholar]
  18. ROSE H., VAUGHAN M., STEINBERG D. UTILIZATION OF FATTY ACIDS BY RAT LIVER SLICES AS A FUNCTION OF MEDIUM CONCENTRATION. Am J Physiol. 1964 Feb;206:345–350. doi: 10.1152/ajplegacy.1964.206.2.345. [DOI] [PubMed] [Google Scholar]
  19. Reaven G. M., Hill D. B., Gross R. C., Farquhar J. W. Kinetics of triglyceride turnover of very low density lipoproteins of human plasma. J Clin Invest. 1965 Nov;44(11):1826–1833. doi: 10.1172/JCI105290. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. SHOEMAKER W. C., CARRUTHERS P. J., ELWYN D. H., ASHMORE J. Effect of insulin on fatty acid transport and regional metabolism. Am J Physiol. 1962 Nov;203:919–925. doi: 10.1152/ajplegacy.1962.203.5.919. [DOI] [PubMed] [Google Scholar]
  21. Salans L. B., Reaven G. M. Effect of insulin pretreatment on glucose and lipid metabolism of liver slices from normal rats. Proc Soc Exp Biol Med. 1966 Aug-Sep;122(4):1208–1213. doi: 10.3181/00379727-122-31362. [DOI] [PubMed] [Google Scholar]
  22. Steinkamp R. C., Cohen N. L., Gaffey W. R., McKey T., Bron G., Siri W. E., Sargent T. W., Isaacs E. Measures of body fat and related factors in normal adults. II. A simple clinical method to estimate body fat and lean body mass. J Chronic Dis. 1965 Dec;18(12):1291–1307. doi: 10.1016/0021-9681(65)90162-1. [DOI] [PubMed] [Google Scholar]

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