Clinical and Population Studies |
From the Departments of Medicine and Physiology, Division of Endocrinology and Metabolism (M.P., R.V., H.D., C.X., L.S., G.F.L.), University of Toronto, Canada; and the Washington University School of Medicine (B.W.P.), St. Louis, Mo.
Correspondence to Dr Gary F. Lewis, Toronto General Hospital, 200 Elizabeth Street, EN12-218, Toronto, Ontario, M5G 2C4. E-mail gary.lewis{at}uhn.on.ca
Objective— Insulin resistant states are associated with increased fatty acid flux to liver and intestine, which stimulates the production of triglyceride-rich lipoproteins (TRL). ApoC-III production and plasma and TRL concentrations are increased in insulin resistance and may contribute to the hypertriglyceridemia of these conditions. The mechanism underlying that increase is not known, but because apoC-III and VLDL production are closely linked we hypothesized that FFAs may stimulate TRL apoC-III production.
Methods and Results— We used Intralipid/heparin (IH) to raise plasma FFA in 12 healthy men in the fed state, and stable isotopes to examine apoC-III metabolism. TRL apoC-III concentration was significantly higher in the IH study, and this increase was associated with higher production (PR) and fractional catabolic rate (FCR). The increase in production was greater than in FCR (90% versus 30%, respectively), accounting for the elevated concentration. Glycerol infusion had no effect on apoC-III concentration, PR, or FCR compared to saline, indicating that the effect was not attributable to glycerol released from intralipid.
Conclusion— These findings confirm that TRL apoC-III production is stimulated by an acute elevation of plasma FFAs, suggesting a novel regulatory pathway that may play a role in the overproduction of TRL apoC-III in insulin resistant states.
The mechanism of the increase in triglyceride-rich lipoprotein (TRL) apoC-III concentration and production in insulin resistant states is not known. We investigated this phenomenon in healthy men using stable isotope enrichment methodology, and demonstrated that TRL apoC-III production is stimulated by an acute elevation of plasma FFAs.
Key Words: apolipoprotein C3 free fatty acids insulin resistance lipoprotein
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