Summary
Insulin secretion has been evaluated after oral glucose loading and other stimuli (tolbutamide, glucagon, arginine and i.v. glucose) in a group of 3 patients with familial hyperchylomicronemia (Fredrickson’s Type I), 33 patients with primary hypercholesterolemia (Fredrickson’s Type II) and 89 patients with endogenous hypertriglyceridemia. In familial hyperchylomicronemia glucose tolerance and insulin secretion were normal. In patients with familial hypercholesterolemia the increased insulin secretion is conditioned by overweight. In hypertriglyceridemic patients no significant correlation has been observed after glucose loading between basal insulin and plasma triglycerides and between insulin response (insulin area) and plasma triglyceride levels. Mean insulin response to oral glucose was significantly increased in hypertriglyceridemic patients with normal glucose tolerance and still more in hypertriglyceridemic patients with chemical diabetes. A significant positive correlation has been found between overweight and insulin response after oral glucose in the hypertriglyceridemic patients with normal glucose tolerance. The insulin response after the other stimuli was not significantly different from that of the controls. In conclusion, in primary familial hypercholesterolemia, insulin secretion was increased after oral glucose, with normal glucose tolerance; overweight only partially explained the increased insulin response. In endogenous hypertriglyceridemia, plasma triglycerides were not related to the degree of insulin response after oral glucose. Overweight is related to insulin response only when glucose tolerance is still normal, but with the appearance of a diabetic state, insulin secretion seems to be conditioned by the reduced glucose tolerance. Increased insulin secretion seems to be the first alteration of glucose homeostasis, even in the presence of normal glucose tolerance.
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Abrams M. E., Jarrett R., Keen H., Boyns D. R., Crossley J. N.: Oral Glucose Tolerance and Related Factors in a Normal Population Samples. II. Interrelationship of Glycerides, Cholesterol and Other Factors with the Glucose and Insulin Response — Brit. med. J.1, 599, 1969.
Albrink M., Davidson P. C.: Impaired Glucose Tolerance in Patients with Hypertriglyceridemia — J. Lab. clin. Med.67, 573, 1966.
Avogaro P., Crepaldi G., Enzi G., Tiengo A.: Association of Hyperlipidemia, Diabetes Mellitus and Mild Obesity — Acta diabet. lat.4, 572, 1967.
Bagdade J. D., Bierman E. L., Porte D. Jr.: Influence of Obesity on the Relationship between Insulin and Triglyceride Levels in Endogenous Hypertriglyceridemia — Diabetes20, 664, 1971.
Beaumont J. L., Carlson L. A., Cooper G. R., Fejfar Z., Fredrickson D. S., Strasser T.: Classification of Hyperlipidemias and Hyperlipoproteinemias — Bull. Wld Hlth Org.43, 891, 1970.
Bierman E. L., Bagdade J. D., Porte D. Jr.: Obesity and Diabetes: the Odd Couple - Amer. J. clin. Nutr.21, 1434, 1968.
Bierman E. L., Porte D. Jr.: Carbohydrate Intolerance and Lipemia — Ann. intern. Med.68, 926, 1968.
Bottger I., Faloona G., Unger R.: Response of Islet Cell and Gut Hormones to Fat Absorption: an Enteroinsular Axis for Fat — Clin. Res.20, 542, 1972.
Brown D. F., Doyle J. T.: Pre-Beta Lipoproteinemia. Its Bearing on the Dietary Management of Serum Lipid Disorders as Related to Ischemic Heart Disease — Amer. J. clin. Nutr.20, 324, 1967.
Brown W. V., Greten H.: Type I Hyperlipoproteinemia — In:Rifkind B. (Ed.): Disorders of Lipid Metabolism — Clin. Endocr. Metab.2, 73, 1973.
Crespin S. A., Greenough W. B., Boynton D., Steinberg D.: Direct Stimulation of Insulin Secretion in Vivo by Free Fatty Acids — Diabetes18, 326, 1969.
Davidson P. C., Albrink M. J.: Abnormal Plasma Insulin Response with High Plasma Triglycerides Independent of Clinical Diabetes or Obesity — J. clin. Invest.45, 1000, 1966.
Debry G., Laurent L., Guisard D., Gonand J. P., Mejean L., Drouin P.: Étude de la glycorégulation au cours des hypertriglycéridémies essentielles — Journées Annuelles de Diabétologie de l’Hôtel-Dieu, Paris 1970. Flammarion Éd., Paris, 1970; p. 229.
De Gennes J.-L., Truffert J., Salmon D.: Place des troubles de la glycorégulation dans le différentes variétés d’hyperlipidémies idiopathiques — Journées Annuelles de Diabétologie de l’Hôtel-Dieu, Paris 1970. Flammarion Éd., Paris, 1970; p. 247.
Eaton R. P., Nye W. H. R.: The Relationship between Insulin Secretion and Triglyceride Concentration in Endogenous Lipemia — J. Lab. clin. Med.5, 682, 1973.
Eggstein M., Kreutz F. H.: Eine neue Bestimmung der Neutralfette in Blutserum und Gewebe. I. — Klin. Wschr.44, 262, 1966.
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, 1966.
Fedele D., Tiengo A., Muggeo M., Crepaldi G.: Insulin Secretion in Human Endogenous and Experimental Hypertriglyceridemia — 3rd Int. Symposium on Atherosclerosis, Berlin 1973; abstract # 189.
Ford S. Jr., Bozian R. C., Knowles H. C. Jr.: Interactions of Obesity, and Glucose and Insulin Levels in Hypertriglyceridemia — Amer. J. clin. Nutr.21, 904, 1968.
Fredrickson D. S., Levy R. I., Lees R. S.: Fat Transport in Lipoproteins — An Integrated Approach to Mechanisms and Disorders — New Engl. J. Med.276, 34, 94, 148, 215, and 273, 1967.
Glueck C. J., Levy R. I., Fredrickson D. S.: Immunoreactive Insulin, Glucose Tolerance and Carbohydrate Inducibility in Types II, III, IV, and V Hyperlipoproteinemia — Diabetes18, 739, 1969.
Gomez F., Jequier E., Chabot V., Buber V., Felber J.-P.: Carbohydrate and Lipid Oxidation in Normal Human Subjects: its Influence on Glucose Tolerance and Insulin Response to Glucose — Metabolism21, 381, 1972.
Hales C. N., Randle P. J.: Immunoassay of Insulin with Insulin-Antibody Precipitate — Biochem. J.88, 137, 1963.
Heinberg M., van Harken D. R., Brown T. O.: Hepatic Lipid Metabolism in Experimental Diabetes. II. Incorporation of 1-14C-Palmitate into Lipids of the Liver and of the D less than 1,020 Perfusate Lipoproteins — Biochem. biophys. Acta (Amst.)137, 435, 1967.
Huggett A. G., Nixon D. A.: Use of Glucose Oxidase, Peroxidase and O-Dianisidine in Determination of Blood and Urinary Glucose — Lancet2, 368, 1957.
Kane J. P., Longcope C., Pavlatos F. Ch., Grodsky G. M.: Studies of Carbohydrate Metabolism in Idiopathic Hypertriglyceridemia — Metabolism14, 471, 1965.
Kinsell L. W., Schlierf G.: Alimentary and Non-Alimentary Hyperglyceridemia — Ann. N. Y. Acad. Sci.131, 603, 1965.
Kuo P. T., Feng L.: Study of Serum Insulin in Atherosclerotic Patients with Endogenous Hypertriglyceridemia (Type III and IV Hyperlipoproteinemia) — Metabolism19, 372, 1970.
Levy R. I., Glueck C. J.: Hypertriglyceridemia, Diabetes Mellitus and Coronary Vessel Disease — Arch. intern. Med.123, 220, 1969.
Lewis B., Mancini M., Mattoch M., Niteckis N.: Studies on the Mechanism of Carbohydrate Induced Lipemia in Normal Man — Clin. Sci.38, 33, 1970.
Nestel P. J.: Turnover of Plasma Esterified Cholesterol: Influence of Dietary Fat and Carbohydrate and Relation to Plasma Lipids and Body Weight — Clin. Sci.38, 593, 1970.
Noble R. P.: Electrophoretic Separation of Plasma Lipoproteins in Agarose Gel — J. Lipid Res.9, 693, 1968.
Olefsky J., Reaven G. M., Farquhar J. W.: Effects of Weight Reduction on Obesity. Studies of Lipid and Carbohydrate Metabolism in Normal and Hyperlipoproteinemic Subjects — J. clin. Invest.53, 64, 1974.
Owen W. C., Kreisberg R. A., Siegal A. M.: Carbohydrate-Induced Hypertriglyceridemia: Inhibition by Phenformin — Diabetes20, 739, 1971.
Patrassi G., Crepaldi G.: Le iperlipoproteinemie — Pozzi Ed., Roma, 1971.
Pin-Sunyer F. X., Hashim S. A., van Itallie T. B.: Insulin and Ketone Responses to Ingestion of Medium and Long-Chain Triglycerides in Man — Diabetes18, 96, 1969.
Raskin P., Siperstein M. D.: Hyperlipidemia and Diabetes Mellitus: Can Electron Microscopy Help in the Diagnosis? — Mt. Sinai J. Med.40, 350, 1973.
Reaven G. M., Lerner R. L., Stern M. P., Farquhar J. W.: Role of Insulin in Endogenous Hypertriglyceridemia — J. clin. Invest.46, 1756, 1967.
Sailer S., Bolzano K., Sandhofer F., Spath P., Braunsteiner H.: Triglyceridespiegel und Insulinkonzentration im Plasma nach oraler Glukosegabe bei Patienten mit primärer kohlenhydratinduzierten Hypertriglyceridämie — Schweiz. med. Wschr.98, 1512, 1968.
Sailer S., Sandhofer F., Braunsteiner H.: Overweight and Triglyceride Level in Normal Persons and Patients with Diabetes Mellitus — Metabolism15, 135, 1966.
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. (N. Y.)122, 1208, 1966.
Sandhofer F., Bolzano K., Sailer S., Braunsteiner H.: Quantitative Untersuchungen über den Einbau von Plasmaglucose-Kohlenstoff in Plasmatriglyceride und die Veresterungsrate von freien Fettsäuren des Plasmas zu Plasmatriglyceriden wahrend oraler Zefuhr von Glucose bei primärer kohlenhydratinduzierter Hypertriglyceridämie — Klin. Wschr.47, 1086, 1969.
Schnatz J. D., Borse R. J., Frohman L. A.: Endogenous Hypertriglyceridemia: Effects of Altering Insulin Secretion with Diazoxide and Tolbutamide — Clin. Res.16, 555, 1968.
Seyffert W. A. Jr., Madison L. L.: Physiologic Effects of Metabolic Fuels on Carbohydrate Metabolism. Acute Effect of Elevation of Plasma Free Fatty Acids on Hepatic Glucose Output, Peripheral Glucose Utilization, Serum Insulin and Plasma Glucagon Levels — Diabetes16, 765, 1967.
Tiengo A., Crepaldi G., Muggeo M., Avogaro P., Enzi G., Trisotto A., Federspil G.: Insulin Response after Oral Glucose Load and Intravenous Tolbutamide in Patients with Fat-Induced and Carbohydrate-Induced Hyperlipemias — Acta diabet. lat.4, 591, 1967.
Tiengo A., Fedele D., Muggeo M., Crepaldi G.: Diabetic-Like Behaviour of Glucagon Secretion in Primary Endogenous Hypertriglyceridemia — 8th Congr. Int. Diabetes Fed., Bruxelles 1973. Excerpta Medica Foundation, Amsterdam, 1973; p. 47, abstract # 110.
Tzagournis M., Chiles R., Herrold J., Skillman T. G.: The Role of Endogenous Insulin in Different Hyperlipidemic States — Diabetologia8, 215, 1972.
Tzagournis M., Chiles R., Ryan J. M., Skillman T. G.: Interrelationship of Hyperinsulinism and Hypertriglyceridemia in Young Patients with Coronary Heart Disease — Circulation38, 1156, 1968.
Watson D.: A Simple Method for the Determination of Serum Cholesterol — Clin. chim. Acta5, 637, 1960.
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Tiengo, A., Muggeo, M., Fedele, D. et al. Insulin secretion in hyperlipoproteinemias. Acta diabet. lat 11, 149–164 (1974). https://doi.org/10.1007/BF02581314
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DOI: https://doi.org/10.1007/BF02581314