Glucose, insulin, and triglyceride responses to high and low carbohydrate diets in man.

Farquhar, John W.; Frank, Arthur; Gross, R; Reaven, Gerald M.

doi:10.1172/jci105472

Cited by 243 publications

(80 citation statements)

References 21 publications

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“…In this study, multicompartmental analysis of VLDL-TG kinetics following injection of labeled glycerol was employed in an attempt to distinguish between these two mechanisms for hypertriglyceridemia and to determine which is predominant. Farquhar et al (20) introduced the use of radioactive glycerol as a precursor for investigation of VLDL-TG kinetics, and they have employed it in a series of studies on causation of hypertriglyceridemia (1,2,22,23). Their studies were carried out for relatively short periods in fasting patients; specific activities of VLDL-TG were usually estimated for 12 h after injection of [3H]glycerol.…”

Section: Discussionmentioning

confidence: 99%

“…Using single-exponential analysis, Farquhar et al (1,2,20,22,23) have suggested that most instances of hypertriglyceridemia are due to increased influx of VLDL-TG. Specifically, they concluded that concentrations of VLDL-TG are roughly proportional to influx rates up to a relatively fixed point of saturation of TG removal mechanisms.…”

Section: Discussionmentioning

confidence: 99%

“…Second, FFA levels and fluxes are elevated in obesity, ancd these could provide another excess of precursor for VLDL-TG (29,(39)(40)(41)(42). Finally, insulini levels are oftein enhanced in obesity, and this has been proposed to stimulate VLDL-TG synthesis (2,22,(43)(44)(45)(46)(47). Thus, our finding of increased fluxes of VLDL in miiarked obesity could have several bases.…”

Section: Discussionmentioning

confidence: 99%

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Transport of Very Low Density Lipoprotein Triglycerides in Varying Degrees of Obesity and Hypertriglyceridemia

Grundy¹,

Mok²,

Zech³

et al. 1979

J. Clin. Invest.

271

107

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A B S T R A C T Measurements oftransport oftriglycerides (TG) in very low density lipoproteins (VLDL) were carried out in 59 patients by injection of radioactive glycerol, determinations of specific activities of VLDL-TG for 48 h thereafter, and treatment of the data by multicompartmental analysis. The patients were divided into three groups: normal weight (89-120% ideal weight), mildly obese (120-135% ideal weight), and markedly obese (135% ideal weight). They had varying levels of VLDL-TG ranging from normal to markedly elevated. In many subjects, there was a positive correlation between concentrations and transport of VLDL indicating that overproduction of VLDL-TG contributed to hypertriglyceridemia. In others, and particularly in several markedly obese subjects, transport rates were greatly increased without significant hypertriglyceridemia, suggesting that they had enhanced capacity to clear TG. In all groups, however, there were patients whose degree ofhypertriglyceridemia seemed out of proportion to their transport rates. This finding and the fact that many patients have increased secretion ofVLDL-TG without elevated plasma TG suggests that both overproduction of VLDL-TG and insufficient enhancement of clearance contributed to the development of hypertriglyceridemia.The data showed a poor correlation between transport rates determined by our multicompartment analysis and single-exponential analysis used previously by other investigators (r = 0.46); this comparison was not improved by segregating patients according to their degree of obesity. Although two conversion pathways (fast and slow synthetic paths) were required to fit the data, there was no correlation between transport ratesThis work was presented, in part, at the 49th and 50th

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Transport of Very Low Density Lipoprotein Triglycerides in Varying Degrees of Obesity and Hypertriglyceridemia

Grundy¹,

Mok²,

Zech³

et al. 1979

J. Clin. Invest.

271

107

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“…The association of these two risk factors has been stressed in several studies [15,19,20]. However, the relationship between hypertriglyceridaemia and hyper'msulinaemia in diabetic subjects remains to be clarified.…”

Section: Inter-relationship Between Insulin Secretion and Plasma Freementioning

confidence: 99%

Inter-relationship between insulin secretion and plasma free fatty acid and triglyceride transport kinetics in maturity onset diabetes and the effect of phenethylbiguanide (Phenformin)

1974

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Summary. The plasma free fatty acid and triglyceride transport kinetics in 16 non-obese and 7 obese maturity onset diabetics with hypertriglyceridaemia have been compared with results obtained in 27 control subjects. Changes in glucose and insulin responses were evaluated in relation to the lipid parameters. All the diabetics showed elevated plasma FFA levels and turnover rates. In the non-obese diabetics the plasma triglyceride turnover rate was within the normal range and their hypertriglyceridaemia was due to impaired trigleeride clearance. In the obese diabetics the plasma trig]yceride turnover rate was increased and they also had some impairment of triglyceride clearance, so that in them a double mechanism was observed to account for their hypertriglyceridaemia. The insulin levels in the diabetics were similar to, or greater than, those found in the controls. Our results suggested that the enhanced lipolysis and impaired triglyceride clearance observed in the diabetic patients were a manifestation of insulin unresponsiveness in adipose tissue and that the changes in insulin and glucose relationship could be secondary to elevated FFA and triglyceride levels. Further confirmation was obtained by the finding of an exaggerated insulin response to a glucose challenge in normal subjects infused with Intralipid.Treatment with phenethylbiguanide (Phenformin) significantly lowered the plasma FFA and triglyceride concentration in both diabetic groups. This was associated with normalisation of both plasma FFA turnover and triglyceride clearance. It also reduced the triglyceride turnover rate to the normal range in the obese diabetics. These changes were associated with a fall of plasma glucose and insulin levels to within the normal range. These results suggested an effect of Phenformin in reducing the rate of lipolysis leading to improved glucose tolerance.

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“…4 Furthermore, elevated insulin concentrations are associated with raised blood pressure 5 and serum triglyceride concentrations 6 and with reduced serum high density lipoprotein (HDL) cholesterol concentrations, 7 factors that in themselves may increase coronary heart disease risk.…”

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confidence: 99%

Influence of insulin resistance, secretion, and clearance on serum cholesterol, triglycerides, lipoprotein cholesterol, and blood pressure in healthy men.

Godsland¹,

Crook²,

Walton³

et al. 1992

Arterioscler Thromb

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Relations between serum lipids, lipoproteins, blood pressure, and insulin metabolism were investigated in 158 healthy men aged 19-77 years and with body mass indexes (BMIs) of 19-41 kg • m" 2 . Mathematical modeling analysis of glucose, insulin, and C-peptide concentrations during an intravenous glucose tolerance test was used to measure parameters of insulin metabolism. In univariate analysis, both fasting and postglucose insulin concentrations showed significant positive associations with fasting serum triglyceride levels (r=0-33 and 0.38, respectively) and systolic (r=022 and 0.26) and diastollc (r=0.21 and 0.24) blood pressure and negative associations with high density lipoprotein subtraction 2 cholesterol (HDL 2 ; r=-0.21 and -0.25). In multivariate analysis, the associations between insulin and HDL 2 cholesterol concentrations were found to depend on triglyceride levels. Insulin resistance and basal pancreatic insulin secretion showed significant positive associations with serum triglycerides, which were independent of the effects of age, BMI, and fat distribution. Hepatic insulin throughput was independently associated with HDL 2 cholesterol. Associations of insulin-related variables with blood pressure were generally dependent on age and BMI. These results underline the importance of insulin sensitivity and insulin concentrations as determinants of triglyceride metabolism. They also indicate a close relation between hepatic insulin handling and HDL] concentration that is independent of triglyceride metabolism. has lent support to the possibility that elevated insulin concentrations may have a direct role in atherogenesis. 4 Furthermore, elevated insulin concentrations are associated with raised blood pressure 5 and serum triglyceride concentrations 6 and with reduced serum high density lipoprotein (HDL) cholesterol concentrations, 7 factors that in themselves may increase coronary heart disease risk.Resistance of glucose elimination to insulin action (insulin resistance) is a major determinant of the plasma insulin concentration 8 and may have a stronger relation with cardiovascular disease risk factors than does plasma insulin concentration.9 -11 Determinants of insulin concentrations, such as insulin resistance, may therefore be more directly involved in the relations between insulin and cardiovascular disease risk than are the insulin concentrations themselves. Computer modeling of plasma glucose, insulin, and C-peptide concentrations during an intravenous glucose tolerance test (FVGTT) allows quantification of the determinants of plasma insulin concentrations, which may be otherwise difficult to measure. We have used this technique in a large group of healthy men to investigate the associations of serum lipid and lipoprotein concentrations and blood pressure with insulinrelated variables. A wide range of variation in age and adiposity in this group provided the necessary variation in insulin metabolism against which these associations could be examined. Methods SubjectsWe studied 158 apparently heal...

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Glucose, insulin, and triglyceride responses to high and low carbohydrate diets in man.

Cited by 243 publications

References 21 publications

Transport of Very Low Density Lipoprotein Triglycerides in Varying Degrees of Obesity and Hypertriglyceridemia

Transport of Very Low Density Lipoprotein Triglycerides in Varying Degrees of Obesity and Hypertriglyceridemia

Inter-relationship between insulin secretion and plasma free fatty acid and triglyceride transport kinetics in maturity onset diabetes and the effect of phenethylbiguanide (Phenformin)

Influence of insulin resistance, secretion, and clearance on serum cholesterol, triglycerides, lipoprotein cholesterol, and blood pressure in healthy men.

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