Abstract. The i.v. fat tolerance test (IVFTT), in which the elimination rate of the fat emulsion Intralipid® is determined, has been performed in 60 patients with massive obesity. These patients were compared with a control group of matched subjects of normal weight with the same plasma TG concentrations. The hyperbolic correlations which were found between the plasma TG concentration and the IVFTT value did not differ between the two groups. The IVFTT value was correlated rather to the plasma TG value than to total body weight. The IVFTT values were higher in women of both groups. Twenty‐three obese patients were studied with IVFTT before and after a jejuno‐ileal bypass operation. Concomitant with a mean weight reduction from 129 to 104 kg, plasma TG was significantly reduced from 1.92 to 1.40 mmol/l. The IVFTT value rose significantly from 3.99 to 5.83 %/ min. However in the individual cases the pattern was highly variable, as some patients lost weight considerably without major effects on the IVFTT value, whereas others had a marked fall of plasma TG and rise of IVFTT value concomitant with a very moderate weight loss. The results suggest that the reduced IVFTT values in massive obesity are of the same order as seen in primary hyper‐lipidaemia and that the removal sites for the Intralipid® emulsion are not proportionate to the amount of adipose tissue. Other factors than weight loss, such as changes of blood flow in the splanchnic region, could possibly account for the increased IVFTT values after jejuno‐ileal bypass operations.
Read full abstract