Hormonal and Metabolic Profiles in Patients with alcohol-induced, mixed hypertriglyceridemia before and after abstinence from ethanol and before and after a lipid-lowering diet

Abstract

The diurnal variation of intermediary metabolites and hormones was determined, as 24-h profiles, in a group of subjects with mixed hypertriglyceridemia while consuming a diet with excess alcohol and caloric intake (Hyp-I) or after a hypotriglyceridemic diet (Hyp-11), and in normal controls. Alcohol was excluded from the hypotriglyceridemic diet and on the days of the study. Hyp-I subjects showed higher 24-h levels of plasma triglyceride, glucose, insulin, lactate, pyruvate, free fatty acid and glycerol. After the hypotriglyceridemic diet the levels of pyruvate, free-fatty acids and glycerol in plasma were normalized, while triglyceride, insulin and glucose concentrations were significantly reduced but remained still higher than in controls. The elevated lactate concentration in Hyp-I subjects were unaffected by the diet. In Hyp-I subjects free-fatty acids and glycerol levels were not suppressed following the meal, in contrast to controls. After the diet this defect in the suppression of endogenous lipolysis was only partially reversed in Hyp-II subjects. Plasma alanine, total ketone body and glucagon concentrations were unaffected. In conclusion, in mixed hypertriglyceridemia high lactate concentration and a defect in the suppression of endogenous lipolysis after a meal could represent a factor enhancing triglyceride production.