Immunoreactive insulin, glucose tolerance, and carbohydrate inducibility in types II, 3, IV, and V hyperlipoproteinemia.

Abstract

The elevation of plasma glycerides by a high carbohydrate diet (carbohydrate induction) has been systematically correlated with glucose tolerance, insulin output and ponderal index in normals and in patients with different types of hyperlipoproteinemia. Carbohydrate inducibility (ΔTG) was similar in normals and patients with Type II hyperlipoproteinemia. Delta TG was nearly always much greater than normal in Type III, and was quite heterogeneous in type IV. The scatter in ΔTG values in Type V patients was extremely great. The basal triglyceride and ΔTG were positively correlated only in Type IV. Abnormal glucose tolerance was present in approximately one third of Types II and III, one half of Type IV and 80 per cent of Type V patients. Hyperinsulinemia was present in most Type V patients, while a majority of Type II and III patients had relatively normal insulin levels. Approximately one third each of the Type IV patients had low, normal, and abnormally high insulin levels. Increasing insulin and insulinogenic indices were correlated with increased ATG in the normal, but not in any of the patient groups. In the specific groups of hyperglyceridemic patients in this study, plasma insulin levels did not appear to be a primary determinant of the degree of carbohydrate induction.