, Volume 14, Issue 4, pp 249–253 | Cite as

Hepatic insulin responsiveness in patients with endogenous hypertriglyceridaemia

  • R. M. Bernstein
  • B. M. Davis
  • J. M. Olefsky
  • G. M. Reaven


Plasma insulin response to oral glucose, insulin resistance, and insulin suppression of hepatic glucose production were studied in 11 normal subjects and 11 hypertriglyceridaemic patients. Patients with hypertriglyceridaemia had a significantly higher insulin response to oral glucose. Insulin resistance was also significantly greater in hypertriglyceridaemic subjects as determined by measuring the steady-state plasma glucose response during a continuous infusion of epinephrine, propranolol, glucose, and exogenous insulin. Insulin suppression of hepatic glucose production was calculated from the results of two studies in which glucose turnover rate was measured by a continuous infusion of3H-2-glucose. The first study was performed under conditions of basal insulin secretion, and the second carried out at steady state exogenous insulin levels of approximately 100 μU/ml. The results indicated that basal hepatic glucose production was the same in both groups, and was suppressed to an equal degree by physiological levels of insulin. These data demonstrate that hepatic glucose production can be suppressed to an equal degree in normal and hypertriglyceridaemic subjects at comparable circulating insulin levels, at the same time that resistance to insulin-stimulated glucose uptake is observed in the hypertriglyceridaemic individuals.

Key words

Hypertriglyceridaemia insulin resistance hyperinsulinaemia hepatic glucose output triglyceride metabolism 


  1. 1.
    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.45, 1648–1565 (1966)Google Scholar
  2. 2.
    Reaven, G.M., Lerner, R.L., Stern, M.P., Farquhar, J.W.: Role of insulin in endogenous hypertriglyceridemia. J. Clin. Invest.46, 1756–1767 (1967)Google Scholar
  3. 3.
    Olefsky, J.M., Farquhar, J.W., Reaven, G.M.: Reappraisal of the role of insulin in hypertriglyceridemia. Am. J. Med.57, 551–560 (1974)Google Scholar
  4. 4.
    Salans, L.B., Reaven, G.M.: Effects of insulin pretreatment on glucose and lipid metabolism of liver slices from normal rats. Proc. Soc. Exp. Biol. Med.122, 1208–1213 (1966)Google Scholar
  5. 5.
    Letarte, J., Fraser, T.R.: Stimulation by insulin of the incorporation of U14C-glucose into lipids released by the liver. Diabetologia5, 358–359 (1969)Google Scholar
  6. 6.
    Topping, D.L., Mayes, P.A.: The immediate effects of insulin and fructose on the metabolism of the perfused liver. Biochem. J.120, 295–311 (1972)Google Scholar
  7. 7.
    Tulloch, B.R., Dyal, K., Fraser, T.R.: Increased lipid synthesis by liver slice in a superfusion system following raised glucose or insulin concentration. Diabetologia8, 267–273 (1972)Google Scholar
  8. 8.
    Havel, R.: Lipid transport and insulin resistance. Excerpta Med.20, 353–359 (1973)Google Scholar
  9. 9.
    Kissebah, A.H., Alfarsi, S., Adams, P.W., Wynn, V.: Role of insulin resistance in adipose tissue and liver in the pathogenesis of endogenous hypertriglyceridaemia in man. Diabetologia12, 563–571 (1976)Google Scholar
  10. 10.
    Desbuquois, B., Aurbach, G.D.: Use of polyethylene glycol to separate free and antibody-bound peptide hormones in radioimmunoassay. J. Clin. Endocrinol. Metab.33, 732–738 (1971)Google Scholar
  11. 11.
    Kessler, G., Lederer, H.: Fluorometric measurement of triglyceride. In: L.T. Skeggs, Jr. (Ed.): Automation in Analytic Chemistry, pp. 341–344. New York: Med. Incorp. 1976Google Scholar
  12. 12.
    Katz, J., Dunn, A.: Glucose-2-T as a tracer for glucose metabolism. Biochemistry6, 1–5 (1967)Google Scholar
  13. 13.
    Wahren, J., Felig, P., Ahlborg, G., Jorfeldt, L.: Glucose metabolism during leg exercise in man. J. Clin. Invest.50, 2715–2725 (1971)Google Scholar
  14. 14.
    Owen, O. F., Patel, M. S., Reichle, F. A., Block, B. S. B., Kreulen, T. H., Mozzoli, M. A.: Gluconeogenesis in the normal, diabetic, and cirrhotic human. In: Gluconeogenesis: Its Regulation in Mammalian Species, pp. 553–554 (1976)Google Scholar

Copyright information

© Springer-Verlag 1978

Authors and Affiliations

  • R. M. Bernstein
    • 1
  • B. M. Davis
    • 1
  • J. M. Olefsky
    • 1
  • G. M. Reaven
    • 1
  1. 1.Department of MedicineStanford University School of Medicine and Veterans Administration HospitalPalo AltoUSA

Personalised recommendations