Sheu W H, Shieh S M, Fuh M M, Shen D D, Jeng C Y, Chen Y D, Reaven G M
Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan, ROC.
Arterioscler Thromb. 1993 Mar;13(3):367-70. doi: 10.1161/01.atv.13.3.367.
Plasma glucose and insulin responses to oral glucose and mixed meals and the ability of insulin to stimulate glucose disposal were quantified in normal volunteer subjects and patients with types IIA, IIB, and IV hyperlipoproteinemia (HLP). The results indicated that patients with either type IIB or IV HLP had higher plasma glucose (p < 0.05-< 0.001) and insulin (p < 0.001) responses to both oral glucose and mixed meals compared with the normal subjects and patients with type IIA HLP. Steady-state plasma glucose concentrations (mmol/L) were also higher (p < 0.001) in patients with types IIB (13.3 +/- 0.6) and IV (12.8 +/- 1.2) HLP during a continuous infusion of somatostatin, glucose, and insulin than either the control group (volunteer subjects) (6.2 +/- 0.9) or patients with type IIA HLP (5.6 +/- 1.0). Because the steady-state plasma insulin concentrations were similar in all four groups, patients with either type IIB or IV HLP were resistant to insulin-mediated glucose uptake. These data indicate that patients with hypertriglyceridemia are insulin resistant, glucose intolerant, and hyperinsulinemic, irrespective of the plasma cholesterol concentration. The results further demonstrate that hypercholesterolemic patients with normal triglyceride concentrations do not have any abnormalities of glucose and insulin metabolism.
在正常志愿者以及IIA型、IIB型和IV型高脂蛋白血症（HLP）患者中，对口服葡萄糖和混合餐的血浆葡萄糖和胰岛素反应以及胰岛素刺激葡萄糖处置的能力进行了量化。结果表明，与正常受试者和IIA型HLP患者相比，IIB型或IV型HLP患者对口服葡萄糖和混合餐的血浆葡萄糖（p < 0.05 - < 0.001）和胰岛素（p < 0.001）反应更高。在持续输注生长抑素、葡萄糖和胰岛素期间，IIB型（13.3 ± 0.6）和IV型（12.8 ± 1.2）HLP患者的稳态血浆葡萄糖浓度（mmol/L）也高于对照组（志愿者受试者）（6.2 ± 0.9）或IIA型HLP患者（5.6 ± 1.0）（p < 0.001）。由于所有四组的稳态血浆胰岛素浓度相似，IIB型或IV型HLP患者对胰岛素介导的葡萄糖摄取具有抗性。这些数据表明，无论血浆胆固醇浓度如何，高甘油三酯血症患者都存在胰岛素抵抗、葡萄糖不耐受和高胰岛素血症。结果进一步表明，甘油三酯浓度正常的高胆固醇血症患者没有任何葡萄糖和胰岛素代谢异常。
