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PubMed1971

Stimulation of insulin secretion by medium-chain triglycerides in patients with cirrhosis.

Oral medium-chain triglycerides were given to 10 normal volunteers, 12 cirrhotics (group I) without and 28 cirrhotics (group II) with abnormal portal systemic communications (ascites, splenomegaly, oesophageal varices, or surgically-created portacaval shunts). After 30 ml of medium-chain triglyceride oil there was no appreciable change in serum glucose levels in any of the three groups nor in serum insulin levels in the normals and in cirrhotics in group I. However, there was a significant increase in serum insulin levels in the cirrhotic patients in group II. It is suggested that the rise in serum insulin levels after medium-chain triglycerides noted in the cirrhotics with shunts is due to shunting of insulin-containing portal blood around the liver (anatomical shunts) and to a diminished hepatic cell mass capable of extracting insulin (functional shunt). This differential response of serum insulin levels to medium-chain triglycerides may prove to be of value in detecting the presence of abnormal portal systemic communications in cirrhotic patients.

Adult↗
PubMed1972

Disappointment with triethers as markers for measuring triglyceride absorption in man.

Glycerol triethers were tried as non-absorbable, oil-phase markers for indirectly measuring triglyceride absorption in the human proximal jejunum. Tritium labelled 1-hexadecyl-2, 3-didodecyl glycerol, or 1,2,3-trioleyl glycerol, or 1,2,3-tridecyl glycerol was dissolved in linseed oil and egg yolk lipids; an aqueous emulsion of the lipid mixture was infused into the stomach. Unexpectedly, postprandial jejunal contents contained proportionately less triether than triglyceride compared with the test meals. These triethers were found to separate from an aqueous phase at a faster rate than the triglyceride. This dissociation occurred in the stomach and thwarted quantification of triglyceride absorption by this test system.

Egg Yolk↗
PubMed1998

Low molecular weight heparin reduces triglyceride, VLDL and cholesterol/HDL levels in hyperlipidemic diabetic patients on hemodialysis.

BACKGROUND: Low molecular weight heparin (LMWH) provides a safe and effective alternative for hemodialysis anticoagulation. While unfractionated (UF) heparin has been implicated in hyperlipidemia, the effect of LMWH on the lipid profile in nondiabetic patients is controversial in chronic hemodialysis. The effect of LMWH in diabetic patients, a high risk group of hyperlipidemia, has not been studied. METHOD: LMWH was tested for its safety and efficacy in 10 nondiabetic Taiwanese patients. To evaluate influence of lipid profile, a crossover study was carried out in 10 type II diabetic patients with poor blood sugar control associated with high triglyceride (430.4 +/- 101.1 mg/dl) and total cholesterol levels (219.2 +/- 12.7 mg/dl) using UF heparin for more than 1 year. These patients were subjected to Fraxiparine, an LMWH, for 6 months and then switched back to UF heparin for another 6 months. Lipid profiles were measured every 2 months without prescribing lipid-lowering agents and the blood sugar was maintained at stationary levels. RESULTS: LMWH is safe and effective in Taiwanese patients as a single bolus injection and maintains a 9.4% higher platelet count immediate postdialysis compared to UF heparin. With high HbA1c levels (9.6 +/- 0.6%), mean triglyceride and VLDL levels started to decrease at the 4th month after LMWH treatment and reached a 34% reduction in triglyceride, a 26.2% reduction in VLDL, and a 19% reduction of total cholesterol/HDL ratio at the 6th month. Increments of triglyceride levels were found at the 6th month after a switch back to UF heparin. The levels of total cholesterol, LDL-cholesterol, HDL-cholesterol, apolipoprotein A-1 and B remained unchanged. CONCLUSION: LMWH may be beneficial to lipid control in hyperlipidemic diabetic patients on hemodialysis.

Adult↗
PubMed2006

Higher serum triglyceride level in patients with acute ischemic stroke is associated with lower infarct volume on CT brain scans.

We investigated the relationship between serum triglyceride level and acute ischemic stroke severity using infarct volume on CT brain scans as a marker. A total of 121 consecutive acute ischemic stroke patients (53 males and 68 females, age 47-93 years) with anterior circulation (75%), posterior circulation (9%) or lacunar infarcts (16%) were examined. All patients were admitted within 24 h of the symptom onset, and CT scans were taken over the subsequent 24-72 h. With adjustment for the infarct type, age, sex, timing of CT imaging (24-36, >36-48 or >48-72 h since admission), atrial fibrillation, hypertension, fasting cholesterol and glucose levels, a higher (> or =1.70 mmol/l) fasting serum triglyceride level (within 24 h after admission) was associated with a lower infarct volume (p = 0.014). In line with a recent report on milder clinical symptoms in acute ischemic stroke patients with higher triglycerides, the results suggest an independent association between serum triglyceride level and stroke severity.

Aged↗
PubMed1994

Intestinal absorption of octanoic, decanoic, and linoleic acids: effect of triglyceride structure.

The influence of triglyceride structure on the intestinal absorption of specific triglycerides was investigated. A bolus of either a structured or a randomized oil was given to lymph-cannulated rats. The structured oil contained medium-chain fatty acids (MCFA) in the sn-1 and sn-3 position of the triglyceride, and linoleic acid (C18:2 n-6) in the sn-2 position, whereas in the randomized oil the same fatty acids were distributed randomly between the three positions. The absorption of MCFA was highest from the randomized oil, where approximately 33% of the MCFA were located in the sn-2 position. The absorption of C18:2 n-6 was highest from the structured oil, where C18:2 n-6 is located in the sn-2 position, indicating that the intestinal absorption is influenced by triglyceride structure, and that the absorption is enhanced for fatty acids located in the sn-2 position. Prior to lymph collection, the rats were fed either a fish oil or a vegetable oil diet. The absorption of C18:2 n-6 was highest in the rats previously fed the fish oil diet. The incorporation of the highly unsaturated fatty acids from the fish oil into the membrane phospholipids may thus influence the absorption of fat.

Animals↗
PubMed1996

Increased secretion of triglyceride and cholesterol following inhibition of long-chain fatty acid oxidation in rat liver.

The effects of emeriamine, a fungal metabolite and a potent inhibitor of mitochondrial fatty acid oxidation, on ketogenesis and lipid secretion were examined in isolated perfused livers from 2-day-fasted rats. Liver perfusion with increasing concentrations of emeriamine up to 3 mumol caused a dose-dependent inhibition of ketone body production. The hepatic uptake of exogenous oleic acid substrate was comparable in the control and emeriamine-treated livers. The addition of 2 mumol emeriamine to the perfusion medium at either the beginning of perfusion or 2 h later caused immediate and almost complete cessation of ketone body production, which was accompanied by a concomitant decrease in the beta-hydroxybutyrate: acetoacetate ratio, suggesting a decreased production of NADH via mitochondrial beta-oxidation. Conversely, both triglyceride and cholesterol secretions were elevated, indicating a reciprocal response in ketogenesis and lipid secretion by the livers. The proportion of oleate in the perfusate triglyceride obtained from emeriamine-treated livers was significantly higher than that from control livers. In the post-perfused liver triglyceride, oleate was progressively increased in the livers treated with the inhibitor 2 h after perfusion and at the beginning of perfusion, respectively. These results indicate that direct inhibition of fatty acid oxidation diverts the exogenous fatty acids to the esterification pathway, and subsequently stimulate the synthesis and secretion of triglyceride and cholesterol. The fatty acid oxidation rate in the liver is, therefore, a critical determinant for the synthesis and secretion of these lipid components.

3-Hydroxybutyric Acid↗
PubMed1979

Serum levels of retinol, retinol-binding protein, carotenoids and triglycerides in children with beta-thalassemia major.

Levels of retinol (vitamin A), carotenoids and triglycerides in the serum of 50 children with homozygous beta-thalassemia have been studied, as well as the ability of the small intestine to absorb a test meal containing retinol palmitate, triglyceride, d-xylose and glucose. On the other hand, 8 patients underwent a dark-adaptation test, and in 40 children with homozygous beta-thalassemia the levels of retinol-binding protein in the serum were estimated. The mean levels of retinol, carotenoids and triglycerides in the serum of the patients were: 23 +/- 4.1 micrograms/dl (controls: 36.3 +/- 4.9), 44 +/- 15.5 micrograms/dl (controls: 103 +/- 24), 117 +/- 20 (controls: 126 +/- 26), respectively. The absorption from the small intestine of retinol, triglycerides, glucose and d-xylose was normal. 6 out of 8 patients studied for visual function showed an abnormal dark-adaptation test, and these 6 children had low serum retinol levels. Finally, the mean serum levels of retinol-binding protein in the patients were 4.74 +/- 0.53 mg/dl (controls: 5.63 +/- 0.58). The low retinol levels were correlated with the low retinol-binding protein values which, in turn, could be due to the abnormal liver function of the patients.

Carotenoids↗
PubMed1988

Medium-chain triglycerides in parenteral nutrition in the newborn: a short-term clinical trial.

In order to study the effects of infusions of medium-chain triglycerides (MCTs) in newborns (2 to 4 weeks old), we administered these fats to patients requiring short-term (48 h) parenteral nutrition. The regimens provided glucose (10 g.kg-1 B.W..24 h), amino acids (1 g.kg-1 B.W..24 h), and, between 8.00 a.m. and 8.00 p.m. of each day, a 10% fat emulsion (1.5 g triglycerides.kg-1 B.W.). The one group (n = 10) received an emulsion containing long-chain triglycerides (LCTs), while the other group (n = 12) was given an MCT/LCT emulsion. No adverse reaction related to either emulsion occurred. Plasma Na, K, Ca and Cl levels and the capillary gasometry did not change during the trials. Plasma triglycerides, non-esterified fatty acids, and free glycerol were increased immediately at the end of the lipid infusion. Concerning triglycerides and non-esterified fatty acids, the increase was greater with the MCT/LCT emulsion than with the LCT emulsion but all values returned to normal within 12 h after the end of the fat infusion. The blood ketone body concentrations did not change and there was no ketonuria. Under our conditions, the MCT/LCT emulsion maintained the plasma glucose and urea levels better than the LCT emulsion.

Female↗
PubMed1984

A comparison of plasma cholesterol, triglycerides and high density lipoprotein cholesterol levels in women using contraceptive pills and a control group.

Plasma cholesterol, triglycerides and HDL cholesterol levels were compared in a group of 45 young, normotensive, nonobese and nondiabetic women who used modern combined minidose contraceptive pills, to a matched group of 39 women who did not use any hormonal preparations. Our results show an increase in triglyceride levels as well as significant increase in cholesterol level in the 'pill' users group. We failed to show a significant change in HDL cholesterol levels and HDL cholesterol to total cholesterol ratio between the two groups. Our results concerning triglyceride levels are in consent to previous studies in the medical literature, while the elevation in cholesterol levels has rarely been reported in contemporary papers about minidose pill users. It seems that the contradicting effect of estrogen and progesterone on plasma HDL levels neutralizes each other's effect on this lipoprotein fraction. The elevation in plasma triglycerides and cholesterol may have importance in the vascular abnormalities seen in such pill users.

Adult↗
PubMed1994

Complex segregation analysis provides evidence for a major gene acting on serum triglyceride levels in 55 British families with familial combined hyperlipidemia.

Familial combined hyperlipidemia (FCHL) was first described as an autosomal dominant inherited trait with primary action on triglyceride levels and secondary effects on cholesterol metabolism. This conclusion has since been questioned by several groups despite subsequent supportive biochemical and metabolic studies. To reexplore the genetics of FCHL, we assembled 55 families from the United Kingdom comprising 559 persons ascertained through probands with both hypercholesterolemia and hypertriglyceridemia. The results of univariate complex segregation analysis were consistent with a major gene acting on triglyceride and explaining two thirds of the genetic variability and 20% of the phenotypic variance in triglyceride levels. Univariate analysis did not identify a major genetic component acting on cholesterol levels. Bivariate segregation analysis rejected a major gene model. We also reexamined the original FCHL pedigrees collected by Goldstein et al and obtained results similar to those in the UK families. The prospects for mapping putative major genes determining triglyceride levels in FCHL patients by linkage analysis are discussed.

Family Health↗
PubMed1995

The lipoprotein lipase HindIII polymorphism modulates plasma triglyceride levels in visceral obesity.

The aim of this study was to investigate the potential interaction between the lipoprotein lipase (LPL) HindIII polymorphism and visceral adipose tissue (AT) accumulation in the modulation of triglyceride levels in visceral obesity. The LPL-HindIII genotype was determined by polymerase chain reaction in 52 min. Twenty-three subjects were heterozygous (+/-) and 28 were homozygous (+/+) for the presence of the restriction site. One subject who was homozygous for the--allele was excluded from analysis. Body mass index (BMI), fasting insulin level, and visceral AT area as measured by computed tomography were positively correlated with triglyceride levels only in subjects homozygous for the + allele. Furthermore, whereas these variables were negatively correlated with plasma HDL2 cholesterol concentrations in the +/+ group, these associations were not found in +/- heterozygotes, with the exception of BMI. To further investigate the interaction of the LPL-HindIII polymorphism with visceral obesity and hyperinsulinemia, the two genotype groups were further subdivided on the basis of BMI (low versus high), fasting insulin level (low versus high), and visceral AT area (low versus high), and their lipoprotein profiles were compared. Elevated levels of abdominal visceral AT were significantly associated with increased triglyceride concentrations in +/+ homozygous men, suggesting that visceral obesity may lead to hypertriglyceridemia in the presence of the +/+ genotype. In the +/- group, variation in the amount of visceral AT was not associated with differences in triglyceride concentration. However, hypertriglyceridemia and an increased cholesterol-to-HDL cholesterol ratio were observed in the hyperinsulinemic state irrespective of LPL-HindIII genotype status.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMed1997

Therapeutic response to medium-chain triglycerides and omega-3 fatty acids in a patient with the familial chylomicronemia syndrome.

We have studied the underlying molecular defect in a patient presenting with recurrent pancreatitis, hypertriglyceridemia, and virtually undetectable postheparin plasma lipoprotein lipase (LPL) mass and activity, who normalized her triglycerides 3 to 6 months after initiation of either medium-chain triglyceride (MCT) oil or omega-3 fatty acid (omega-3-FA) therapy. After treatment, postheparin plasma LPL activity and mass ranged from 24% to 39% of normal and LPL specific activity was normal (1.0 nmol.ng-1.min-1). On discontinuation of MCT oil or omega-3-FA, plasma triglyceride increased to > 2000 mg/dL. Northern blotting revealed both normal size and abundance of LPL mRNA isolated from adipocytes as well as macrophages. Sequence analysis of the LPL gene, which included all 10 exons, intron-exon splice junctions, and 1.7 kb of the 5'-flanking region, and of LPL cDNA failed to identify any mutations. ApoC-II activity and mass assays revealed the presence of normal levels of a fully functional cofactor as well as the absence of circulating plasma inhibitors of lipase function. In summary, we describe a unique patient presenting with classical features of the familial chylomicronemia syndrome who manifests an unusually beneficial therapeutic response to MCT oil and omega-3-FA therapy. Unlike that in most patients with LPL deficiency, the chylomicronemia in this patient is not caused by a mutation in the structural LPL gene but possibly by a posttranscriptional defect. Thus, a subset of LPL-deficient patients with unique genetic defects respond to therapy by normalizing fasting plasma triglycerides; a therapeutic trial with MCT oil should be considered in all patients presenting with the familial chylomicronemia syndrome.

Adipose Tissue↗
PubMedDate not supplied

Hyperlipidemia in the Pacific Northwest Bell Telephone Company Health Survey. Part 1. Lipoprotein cholesterol and triglyceride concentrations.

Lipoprotein triglyceride and cholesterol concentrations and characteristics are described in normolipidemic and in three categories of hyperlipidemic subjects participating in the Pacific Northwest Bell Telephone Company Health Survey. For this study, 350 white participants 20 to 59 years of age with cholesterol or triglyceride values exceeding the age, sex, and hormone-use specific, population-based 90th percentile values were defined as having hypercholesterolemia, hypertriglyceridemia, or combined hyperlipidemia; 722 participants were classified as normolipidemic. In hypercholesterolemia, very low density lipoprotein cholesterol and triglyceride and high density lipoprotein cholesterol concentrations were higher than in normolipidemia. In hypertriglyceridemia, high density lipoprotein cholesterol was significantly lower in men and women not using sex hormones and low density lipoprotein triglyceride was significantly higher in men and women using hormones compared to normolipidemia. In combined hyperlipidemia, high density lipoprotein cholesterol concentrations were lower than in normolipidemia, but higher than in pure hypertriglyceridemia. The presence of beta migrating very low density lipoprotein and chylomicrons was seen primarily in hypertriglyceridemic or combined hyperlipidemic men. Sinking prebeta lipoprotein was equally common (20%) among all normolipidemic and hypercholesterolemic subjects, but was less common (5% to 10%) in hypertriglyceridemic and combined hyperlipidemic men and female hormone users. Quantitative and qualitative lipoprotein abnormalities associated with hyperlipidemia were found to vary by gender and by sex hormone use in women and were often, but not always, more marked in men.

Adult↗
PubMed1976

Serum cholesterol and triglyceride levels in 3,446 children from a biracial community: the Bogalusa Heart Study.

Serum lipid profiles of 3,446 (91% of population) children, ages 5-14 years, were determined in a biracial community (Bogalusa, Louisiana) as part of a program investigating the early natural history of atherosclerosis. Black children had significantly higher mean levels of serum cholesterol than white children (170 mg/dl vs 162 mg/dl, P less than 0.0001). On the other hand, significantly lower levels of triglycerides were found in blacks than in whites (61 mg/dl vs 73 mg/dl, P less than 0.0001). Girls had higher levels of triglycerides than boys in both races (blacks, 64 mg/dl vs 59 mg/dl, P less than 0.001; whites, 77 mg/dl vs 69 mg/dl, P less than 0.001). The racial differences in serum cholesterol and triglyceride levels were even more apparent at the 95th percentile. The serum cholesterol level remained relatively constant in all children until ages 11 and 12 years, after which a slight reduction occurred. This reduction was more pronounced in boys than in girls. In contrast, a significant increase in the level of triglycerides with age was observed in all children except black girls, the increasing slope being most pronounced in white girls.

Adolescent↗
PubMed1983

Plasma and lipoprotein cholesterol and triglyceride concentrations in the Pima Indians: distributions differing from those of Caucasians.

Plasma and lipoprotein cholesterol and triglyceride concentrations were measured in Pima Indians, a genetically homogeneous population with a high prevalence of obesity and diabetes and a low frequency of coronary heart disease. The data for nondiabetic Pima Indians were compared with those of U.S. Caucasians measured during the Lipid Research Clinics Prevalence Study. Plasma total and low-density lipoprotein (LDL) cholesterol levels in Pima men older than 30 years of age and in women over 25 were lower than those of U.S. Caucasians, and in men the total and LDL cholesterol levels did not increase with age. In Pima male subjects of all ages high-density lipoprotein (HDL) cholesterol levels were lower than that in Caucasian male subjects, and in Pima female subjects HDL cholesterol levels averaged 11 mg/dl lower than those in female Caucasian subjects. On the other hand, plasma triglyceride levels in Pima male subjects up to 35 years of age and in female subjects up to 55 years old were higher than those of Caucasians. Comparison of plasma cholesterol and triglyceride levels in Pima male and female subjects showed the same relationships as those in Caucasians (i.e., higher in male subjects until the older age groups), but Pima male and female subjects had similar HDL cholesterol levels. There was a strong negative correlation between obesity and HDL cholesterol levels in Pimas. Obesity appeared to account for the lower HDL cholesterol levels in Pima male subjects compared with that in Caucasian male subjects, but obesity could not explain the lack of differences between the sexes in HDL levels in the Pimas. Triglyceride levels correlated positively with obesity in the Pimas, but the relationship was not as strong as that reported for Caucasians. The results indicate that there are differences in lipoprotein distributions between Pimas and U.S. Caucasians; the relationship between lipoprotein levels and the incidence of coronary disease in the Pimas must be determined.

Adolescent↗
PubMed1997

Plasma triglycerides and red cell ion transport alterations in genetically hypertensive rats.

Ion transport abnormalities in essential hypertension are often associated with concomitant changes of lipid metabolism, but this information is missing in rats with genetic hypertension. We therefore studied the alterations of red cell Na+ and K+ transport and their relationship to blood pressure and plasma lipids (cholesterol and triglycerides) in Prague hereditary hypertriglyceridemic (HTG) rats, Lyon hypertensive (LH) rats, and HTG x Lewis F2 hybrids. In both hypertensive models and F2 hybrids, red cell Na+ content (Na+(i)) was positively related to plasma triglycerides but not to plasma cholesterol levels. Na+(i) elevation was more pronounced in HTG than in LH rats, probably due to higher plasma triglycerides in the former strain. The two hypertensive strains differed in bumetanide-sensitive Na+ transport, which was augmented in HTG rats with low plasma cholesterol but suppressed in LH rats characterized by high cholesterol levels. In the two genetic models, there was a positive association of blood pressure with Na+ leak, and this was also confirmed by the cosegregation of these parameters in F2 hybrids. We conclude that the enhancement of Na+ leak represents the major ion transport abnormality in rats with genetic hypertension. The alterations in plasma lipids are important determinants of abnormal red cell ion transport in hypertensive models studied. Although the detailed mechanism of their participation in ion transport regulation is still not completely understood, triglyceride-dependent changes in membrane microviscosity seem to be responsible for the modulation of particular ion transport pathways.

Animals↗
PubMed1978

Age-related changes in the concentration of plasma cholesterol and triglycerides in two groups of rats with inherited widely different levels of spontaneous physical activity.

The plasma concentration of cholesterol and triglycerides was determined in two groups of rats with inherited widely different levels of spontaneous physical activity. Active as well as passive rats of each sex were divided into two subgroups, one with free access to wheel running activity (exercising group), and another for which admittance to the drum was closed (nonexercising group). Plasma concentrations of cholesterol and triglycerides were followed from the age of 3-8 months in females and 3 months to 1 year in males. A pronounced increase with age in the plasma concentration of these lipids was observed in the active male rats. In the passive male rats and in all females, there were no major changes in plasma levels of cholesterol and triglycerides. Corresponding groups of exercising and nonexercising rats had similar plasma levels of these components. The data for male rats show a positive association between the inherited tendency to perform spontaneously a high level of physical activity and an age-related increase in plasma lipids. However, running activity per se does not seem to have any influence on the level of plasma cholesterol and triglycerides in these rats.

Age Factors↗
PubMed2006

Triglycerides and the risk of coronary heart disease: 10,158 incident cases among 262,525 participants in 29 Western prospective studies.

BACKGROUND: Many epidemiological studies have reported on associations between serum triglyceride concentrations and the risk of coronary heart disease, but this association has not been reliably quantified. In the present study, we report 2 separate nested case-control comparisons in 2 different prospective, population-based cohorts, plus an updated meta-analysis of 27 additional prospective studies in general Western populations. METHODS AND RESULTS: Measurements were made in a total of 3582 incident cases of fatal and nonfatal coronary heart disease and 6175 controls selected from among the 44,237 men and women screened in the Reykjavik and the European Prospective Investigation of Cancer (EPIC)-Norfolk studies. Repeat measurements were obtained an average of 4 years apart in 1933 participants in the EPIC-Norfolk Study and an average of 12 years apart in 379 participants in the Reykjavik study. The long-term stability of log-triglyceride values (within-person correlation coefficients of 0.64 [95% CI, 0.60 to 0.68] over 4 years and 0.63 [95% CI, 0.57 to 0.70] over 12 years) was similar to those of blood pressure and total serum cholesterol. After adjustment for baseline values of several established risk factors, the strength of the association was substantially attenuated, and the adjusted odds ratio for coronary heart disease was 1.76 (95% CI, 1.39 to 2.21) in the Reykjavik study and 1.57 (95% CI, 1.10 to 2.24) in the EPIC-Norfolk study in a comparison of individuals in the top third with those in the bottom third of usual log-triglyceride values. Similar overall findings (adjusted odds ratio, 1.72; 95% CI, 1.56 to 1.90) were observed in an updated meta-analysis involving a total of 10,158 incident coronary heart disease cases from 262,525 participants in 29 studies. CONCLUSIONS: Available prospective studies in Western populations consistently indicate moderate and highly significant associations between triglyceride values and coronary heart disease risk. Because these associations depend considerably on levels of established risk factors, however, further studies are needed to help assess the nature of any independent associations.

Case-Control Studies↗