Carbohydrate-induced hypertriglyceridemia and glucose utilization in ischemic heart disease

Abstract

The frequency of carbohydrate-induced hypertriglyceridemia among male subjects with ischemic heart disease was studied in a sample of 9 subjects selected from a group of 26. Six of the 9 subjects had plasma triglyceride concentrations which were either normal or moderately raised and the remaining 3 had triglyceride levels greater than 300 mg. 100 ml . The 9 subjects were initially overweight and were placed on diets which were deficient in carbohydrate and total calories until their weights and plasma triglyceride concentrations were within normal limits. They were then given a diet rich in fats followed by an isocaloric diet which was rich in carbohydrate. Striking increments in plasma triglycerides were seen after the carbohydrate diet only in those subjects whose initial triglyceride levels exceeded 300 mg. 100 ml . Since in the whole group of 26 patients 4 had triglyceride levels greater than 300 mg. 100 ml. , it is estimated that approximately 1 of 7 males with ischemic heart disease suffers from carbohydrate-induced hypertriglyceridemia. The changes in blood glucose and plasma FFA concentrations after intravenous tolbutamide were studied in 14 of the 26 patients, 7 of whom were significantly heavier and had significantly higher plasma triglyceride levels than the other 7. The mean falls in blood glucose and FFA were significantly less in the group of overweight, hypertriglyceridemic subjects. In a further group of 8 overweight subjects, it was found that weight reduction was associated with improved glucose tolerance. Reductions in plasma triglyceride concentration were observed after intravenous tolbutamide.