Halkes C J M, van Dijk H, Verseyden C, de Jaegere P P Th, Plokker H W M, Meijssen S, Erkelens D W, Cabezas M Castro
Department of Vascular Medicine, University Medical Center Utrecht, The Netherlands.
Arterioscler Thromb Vasc Biol. 2003 Oct 1;23(10):1875-80. doi: 10.1161/01.ATV.0000092326.00725.ED. Epub 2003 Aug 21.
An increased hepatic flow of free fatty acids (FFAs) is associated with impaired peripheral FFA trapping by malfunctioning of the complement component 3 (C3)/acylation-stimulating protein system and overproduction of VLDL in familial combined hyperlipidemia (FCHL). Postprandial ketone bodies reflect FFA oxidation in the liver, but the postprandial changes in male and female patients separately have not been determined yet. Gender differences in postprandial ketone bodies and C3 changes were investigated in normolipidemic patients and patients with untreated FCHL.
Thirty-two normolipidemic patients (16 female and 16 male) and 19 patients with untreated normolipidemia (9 female and 10 male) underwent an oral fat-loading test. Total and incremental areas under the curves (AUC and dAUC, respectively) after the oral fat load were calculated. Triglyceride AUC was similar between genders in each group. Normolipidemic female subjects showed a higher levels of dAUC-hydroxybutyric acid than male subjects (1.37+/-0.49 and 0.98+/-0.43 mmol x h/L). In FCHL, a similar trend was observed in female (1.92+/-0.38) compared with male (1.55+/-0.87) subjects. In contrast to normolipidemia, FCHL did not show a postprandial increase in C3, although C3 was higher in FCHL.
Women have higher postprandial ketone bodies than men, probably reflecting enhanced postprandial hepatic FFA oxidation. In FCHL, both genders have higher postprandial ketone bodies and therefore higher hepatic FFA delivery. The higher fasting and postprandial C3 levels in FCHL may reflect resistance of the C3/acylation-stimulating protein system to promote peripheral fatty acid trapping.
在家族性混合性高脂血症（FCHL）中，肝脏游离脂肪酸（FFA）流量增加与补体成分3（C3）/酰化刺激蛋白系统功能异常导致外周FFA捕获受损以及极低密度脂蛋白（VLDL）过量产生有关。餐后酮体反映肝脏中的FFA氧化情况，但尚未分别确定男性和女性患者的餐后变化。本研究在血脂正常的患者和未经治疗的FCHL患者中调查了餐后酮体和C3变化的性别差异。
32名血脂正常的患者（16名女性和16名男性）以及19名未经治疗的FCHL患者（9名女性和10名男性）接受了口服脂肪负荷试验。计算口服脂肪负荷后的曲线下总面积和增量面积（分别为AUC和dAUC）。每组中两性之间的甘油三酯AUC相似。血脂正常的女性受试者的dAUC-羟基丁酸水平高于男性受试者（1.37±0.49和0.98±0.43 mmol·h/L）。在FCHL中，女性（1.92±0.38）与男性（1.55±0.87）受试者中观察到类似趋势。与血脂正常不同，FCHL尽管C3水平较高，但餐后C3并未升高。
女性餐后酮体水平高于男性，这可能反映了餐后肝脏FFA氧化增强。在FCHL中，两性的餐后酮体水平均较高，因此肝脏FFA输送量也较高。FCHL中空腹和餐后C3水平较高可能反映了C3/酰化刺激蛋白系统促进外周脂肪酸捕获的抗性。
