Mostaza J M, Vega G L, Snell P, Grundy S M
The Center for Human Nutrition, Department of Clinical Nutrition, University of Texas South Western Medical Center, Dallas 75235-9052, USA.
J Intern Med. 1998 Apr;243(4):265-74. doi: 10.1046/j.1365-2796.1998.00298.x.
There is growing evidence that endogenous hypertriglyceridaemia is frequently accompanied by a state of insulin resistance. The present study was performed to determine whether patients with primary endogenous hypertriglyceridaemia commonly have abnormalities in plasma concentrations and turnover rates of free fatty acids (FFA), which could reflect a state of insulin resistance in adipose tissue and could account for raised plasma triglycerides.
Hypertriglyceridaemic and normotriglyceridemic control patients underwent measurements of plasma concentrations and turnover rates of FFA. Fat weights in both groups were determined by hydrodensitometry, and fat distribution was assessed by skin-folds and measurement of waist and hip circumferences. Other measurements included plasma glucose, insulin, lipids, and lipoproteins.
Fifteen men with normal plasma triglycerides and 21 men with primary endogenous hypertriglyceridaemia were studied. Men in both groups varied in body weights and total fat weights, but total fat weights were entirely overlapping for the two groups. Waist-to-hip ratios and waist circumferences also were similar for the two groups.
For any total body fat content or waist circumference, most hypertriglyceridaemia patients had higher mean plasma concentrations of FFA and higher turnover rates (flux) for FFA than did normotriglyceridemic patients. Hypertriglyceridaemic patients also had higher fasting insulin concentrations for a given body fat content. In general, both FFA flux and plasma insulin levels were positively correlated with plasma concentrations of triglyceride and inversely with high density lipoprotein (HDL) cholesterol.
These studies indicate that many patients with primary endogenous hypertriglyceridaemia have increased flux of FFA and hyperinsulinemia that cannot be explained either by increased total body fat content or by greater waist circumferences than observed in normotriglyceridemic patients.
越来越多的证据表明，内源性高甘油三酯血症常伴有胰岛素抵抗状态。本研究旨在确定原发性内源性高甘油三酯血症患者的游离脂肪酸（FFA）血浆浓度和周转率是否普遍存在异常，这可能反映脂肪组织中的胰岛素抵抗状态，并可解释血浆甘油三酯升高的原因。
对高甘油三酯血症和正常甘油三酯血症的对照患者进行FFA血浆浓度和周转率的测量。两组的脂肪重量通过水下密度测定法确定，脂肪分布通过皮褶厚度以及腰围和臀围测量进行评估。其他测量包括血浆葡萄糖、胰岛素、脂质和脂蛋白。
研究了15名血浆甘油三酯正常的男性和21名原发性内源性高甘油三酯血症的男性。两组男性的体重和总脂肪重量各不相同，但两组的总脂肪重量完全重叠。两组的腰臀比和腰围也相似。
对于任何总体脂含量或腰围，大多数高甘油三酯血症患者的FFA平均血浆浓度高于正常甘油三酯血症患者，且FFA周转率（通量）更高。对于给定的体脂含量，高甘油三酯血症患者的空腹胰岛素浓度也更高。一般来说，FFA通量和血浆胰岛素水平均与甘油三酯血浆浓度呈正相关，与高密度脂蛋白（HDL）胆固醇呈负相关。
这些研究表明，许多原发性内源性高甘油三酯血症患者的FFA通量增加和高胰岛素血症，这既不能用总体脂含量增加来解释，也不能用比正常甘油三酯血症患者更大的腰围来解释。
