Vessby B, Carlson L A
Eur J Clin Invest. 1975 Jul 29;5(4):359-64. doi: 10.1111/j.1365-2362.1975.tb00465.x.
Hyperlipoproteinaemia type III has been considered a clear cut clinical entity characterized by the presence of cholesterol rich "floating" beta very low density lipoproteins (VLDL) after ultracentrifugation. Carbohydrate inducibility is pronounced in type III. This study was undertaken to elucidate the effect of a high carbohydrate diet in type III as an effort to clarify a suggested association between type III and IV hyperlipoproteinaemia. On an isocaloric fat free carbohydrate rich diet the lipoprotein pattern changed as the VLDL triglycerides increased 31 per cent on average and LDL and HDL cholesterol decreased by 40 and 22 per cent. The high ratio cholesterol/triglycerides in VLDL was normalized. The lipoprotein levels in serum after carbohydrate induction showed all characteristics of a type IV with high VLDL triglycerides, normal cholesterol/triglyceride ratio in VLDL, subnormal cholesterol levels in LDL and HDL with changed relation between LDL1 and LDL2. On electrophoresis the floating beta band disappeared. It is probable that depending on the nutritional situation, the metabolic defect in type III may be expressed either as a type III or a type IV. An explanation of the effects of the carbohydrate rich diet on the lipoprotein pattern is suggested.
III型高脂蛋白血症一直被认为是一种明确的临床实体，其特征是超速离心后存在富含胆固醇的“漂浮”β极低密度脂蛋白（VLDL）。III型中碳水化合物诱导作用明显。本研究旨在阐明高碳水化合物饮食对III型的影响，以努力澄清III型与IV型高脂蛋白血症之间可能存在的关联。在等热量无脂肪富含碳水化合物的饮食中，脂蛋白模式发生了变化，VLDL甘油三酯平均增加31%，而LDL和HDL胆固醇分别下降40%和22%。VLDL中高胆固醇/甘油三酯比值恢复正常。碳水化合物诱导后血清中的脂蛋白水平呈现出IV型的所有特征，即VLDL甘油三酯高、VLDL中胆固醇/甘油三酯比值正常、LDL和HDL中胆固醇水平低于正常，且LDL1和LDL2之间的关系发生改变。电泳时，漂浮的β带消失。III型的代谢缺陷可能根据营养状况表现为III型或IV型。本文提出了富含碳水化合物饮食对脂蛋白模式影响的解释。
