Diurnal changes in serum triglycerides as related to changes in lipolytic enzymes, lipoproteins and hormones in patients with primary endogenous hypertriglyceridaemia on a carbohydrate-rich diet.

Parameters of diurnal triglyceride (TG) metabolism were investigated in 5 subjects with primary endogenous hypertriglyceridaemia and compared with those of normal subjects studied previously. The patients were in a steady state on a carbohydrate-rich diet (meals at 9.00, 13.00 and 17.00 h). Serum TG showed a wavelike pattern with a maximum at around 17.00 h. Post-heparin lipoprotein lipase (LPL) activity in the fasting state was not different from that in normals, but failed to show the normal increase in the fed state (16.30 h). This was due to the inability of patients to increase their adipose tissue (AT)-LPL activity in the course of the day. AT-LPL activity was throughout the day lower than in normal subjects. Skeletal muscle LPL activity was low and showed no diurnal change, equalling our findings in normal subjects. Low density lipoprotein cholesterol and high density lipoprotein (HDL) cholesterol concentrations showed no diurnal change. However, HDL phospholipids increased significantly in the course of the day.

Diurnal course of the suitability of serum samples obtained from normal subjects and from patients with primary endogenous hypertriglyceridaemia to serve as substrate for milk lipoprotein lipase.

Serum samples, obtained at various times of the day from four normal subjects and five patients with primary endogenous hypertriglyceridaemia on a carbohydrate-rich diet (meals at 09.00, 13.00 and 17.00 h), were incubated with cows' milk lipoprotein lipase (LPL) to investigate the susceptibility of the triglyceride(TG)-rich lipoprotein fraction to hydrolysis. Mean KM and vmax of this reaction increased in patients between 09.00 and 13.00 h (p = 0.016 and 0.015, respectively) and decreased again thereafter, whereas no diurnal change was observed in normal subjects (p = 0.31 and 0.27, respectively). At 13.00 and 23.00 h patients showed a higher mean KM (p less than 0.02) at 23.00 h a higher mean vmax (p less than 0.03) than normal subjects. When the data were expressed as reaction rates (FFA formation rates) at TG-concentrations in the in vivo range, neither group showed a diurnal difference. Patients showed a significantly lower reaction rate than normal subjects only at 13.00 h at TG concentrations below 3 mmol X 1-1. This suggests that a defect in the suitability of TG-rich particles to serve as a substrate for LPL is not likely to play a role in the development of hypertriglyceridaemia.

Diurnal changes in serum triglycerides as related to changes in lipolytic enzymes, (apo) lipoproteins and hormones in normal subjects on a carbohydrate-rich diet.

Normal subjects in steady state on a carbohydrate-rich diet (three equivalent meals a day at 9.00, 13.00 and 17.00 h), show a wave-like serum triglyceride (TG) pattern with a peak at 14.00 h. Post-heparin lipoprotein lipase (LPL) activity increased from a mean value of 49 mU/ml +/- 13 (SD) in the fasting state to 127 mU/ml +/- 18 in the fed state (P less than 0.005). This was due to an increase in adipose tissue LPL activity which, at 16.30 and 21.30 h, was significantly higher than basal levels (128.3 +/- 81.5 and 87.7 +/- 23.2 v. 43.3 +/- 9.3 mU/g, P less than 0.05 and P less than 0.01, respectively). Skeletal muscle LPL activity was low (5.8 mU/g +/- 2.3, mean +/- SD) and showed no diurnal change. The observed changes in TG-hydrolysing capacity in the course of the day might explain the TG-pattern. High density lipoprotein (HDL) subfractions HDL2 and HDL3 were separated by density gradient ultracentrifugation and had mean hydrated densities of 1.088 and 1.135 g/ml, respectively. While HDL2 showed no diurnal change, HDL3-cholesterol and-phospholipid significantly increased during the day (P less than 0.005 and P less than 0.001 respectively), reaching their highest levels in the evening. Since te rise in HDL3-lipids follows the fall in serum TG, this provides further indication that the metabolism of these fractions in mutually related.

Diurnal levels of lipids, glucose and insulin in type IV hyperlipidemic patients on high carbohydrate and high fat diet: comparison with normals.

Diurnal levels of serum triglyceride (TG), cholesterol, free fatty acids (FFA), glucose and insulin were measured in three type IV hyperlipidemic patients on a fixed solid 65% carbohydrate and a 65% fat diet when in steady state conditions in a metabolic unit. The carbohydrate-rich food was divided into either three or eight equivalent portions, differently spaced over the day and night. The fat-rich food was given in three equivalent portions only. The diurnal TG profiles on these diets showed the same characteristics as those found in normals, but increments and mean levels were considerably higher. On the carbohydrate-rich diet, mean TG levels decreased during the study. This was not seen either on the fat-rich diet or in normals. In contrast to our findings in normals, chylomicrons formed the major contribution to the serum TG pattern. FFA levels were markedly higher on the high-fat than on the carbohydrate-rich diet, but not different from those in normals. Postprandial glucose responses did not differ significantly between the diets. Insulin responses were markedly higher on the carbohydrate-rich than on the fat-rich food. Glucose levels did not differ from those in normals. Insulin levels were significantly higher in the patients. Cholesterol showed minimal fluctuations, parallel to the TG pattern, which could be attributed to chylomicron cholesterol.