Dissociation of apoprotein B and triglyceride production in very-low-density lipoproteins

As a first step toward understanding the regulation of apoprotein B (apoB) secretion in man, we have simultaneously studied the production of very-low-density lipoprotein (VLDL) apoB and VLDL triglycerides (TG) in six subjects with plasma TG levels of 153-344 mg/dl, during consumption of control and high-carbohydrate diets. 125I-labeled VLDL and [3H]glycerol were injected intravenously, and blood samples obtained over a 48-h period were used to isolated VLDL 125I-labeled apoB and VLDL 3H-labeled TG. The complex radioactivity curves obtained were analyzed by a multicompartmental model of VLDL metabolism. In accord with previous data, plasma VLDL TG levels were increased in five of six subjects (mean increase of 76% for the group), and in four of the six subjects the VLDL apoB concentrations were increased significantly during the high-carbohydrate period. The estimated rate of secretion of VLDL TG was higher in all six subjects, from 9.4 to 23.5 mg/kg-1 X h-1 on the control diet to 14.0-65.5 mg X kg-1 X h-1 on the carbohydrate diet (P < 0.001). In contrast, there was no increase in the rate of secretion of VLDL apoB in any of the subjects compared to their control period with values ranging from 0.60 to 1.59 mg X kg-1 X h-1 during the control period to 0.63-1.47 mg X kg-1 X h-1 after carbohydrate induction. These results indicate that physiological perturbations of VLDL TG production need not be accompanied by an alteration in VLDL apoB production.

Order of polyadenylic acid addition and splicing events in early adenovirus mRNA formation

A study of the processing of mRNA from two early adenovirus type 2 transcription units (regions 2 and 4 of adenovirus type 2 genome; [J. Flint, Cell 10:153--166, 1977]) revealed that polyadenylic acid [poly(A)] was added in most if not all cases to an unspliced nuclear RNA molecule whose coordinates extended from the apparent initiation site for RNA synthesis to the single poly(A) site in each transcription unit. An intermediate RNA molecule in the processing of the mRNA for the 72,000-M, single-stranded DNA binding protein showed that the first of the two intervening sequences, the one closest to the 5' end of the molecule, was removed first at least in the majority of the processed molecules. Finally, in cells labeled for 10 min and then treated with actinomycin D to stop further RNA synthesis, the majority, if not all, of the poly(A)-terminated nuclear RNA specific for region 2 was successfully processed and transported to the cytoplasm.

Induction of hypertriglyceridemia by a low-fat diet

We have studied the effects of moderate dietary fat restriction on plasma triglyceride, cholesterol, glucose, and insulin response in 27 subjects. Compared with a control diet (45% fat, 40% carbohydrate [CHO], 15% protein) the low fat (higher CHO) diet (30% fat, 55% CHO, 15% protein) produced a 41% increase in fasting triglyceride level (155 +/- 17 to 219 +/- 23 mg%) with no change in fasting plasma cholesterol level. Furthermore, this increase in triglyceride levels; induced by the higher CHO content of the low fat diet, was seen in 26 out of 27 subjects. Postprandial triglyceride, glucose, and insulin levels were also higher on the low fat (higher CHO) diet. Since hypertriglyceridemia is a significant risk factor for the development of coronary heart disease, and since our data indicate that the moderate increase in dietary CHO associated with a low fat diet will elevate plasma triglyceride levels, we believe that more caution is necessary before recommending the wide-spread use of low fat diets for heart disease prevention.

Quantification of plasma cholesterol and triglyceride levels in hypercholesterolemic subjects receiving ascorbic acid supplements

In order to assess the possible effects of ascorbic acid on plasma cholesterol and triglyceride levels and plasma lipoprotein composition, nine hypercholesterolemic subjects were treated with oral ascorbic acid (4 g/day) for 2 months. The data demonstrate: 1) no significant change in plasma cholesterol or triglyceride levels; 2) no significant change in the cholesterol or triglyceride concentrations of the major lipoprotein classes; and 3) the unexpected appearance of extra pre-beta bands on lipoprotein electrophoresis by the end of the ascorbic acid treatment period.

Metabolic effects of increased caloric intake in man

In order to determine if increased caloric intake could be responsible for the insulin resistance and elevated plasma glucose, insulin, and triglyceride levels commonly associated with obesity, hypercaloric diets were fed for 3 wk to eight normal subjects, and the metabolic consequences of this diet were assessed before significant weight gain had occurred. One wk of increased caloric intake led to statistically significant increases in fasting plasma insulin (22 per cent), glucose (5 per cent), and triglyceride (30 per cent) levels, as well as an increased insulin response (20 per cent) to oral glucose. Since the average weight gain during this period was only 1.6 kg, the observed changes appear to be secondary to increased caloric consumption, not obesity. Most of these changes returned toward baseline values during the succeeding 2 wk of increased caloric intake, but statistically significant elevations of fasting plasma glucose (10 per cent), insulin (8 per cent) and cholesterol (15 per cent) levels were still seen at the end of the hypercaloric dietary period. On the other hand, insulin resistance, as estimated by direct measurement of insulin responsiveness, did not change as a result of 3 wk of increased caloric intake. These results indicate that acute increases in caloric intake can lead to elevated plasma glucose, insulin, cholesterol, and triglyceride levels. These changes occurred before significant weight gain had taken place, and raised the possibility that at least some of the abnormalities of carbohydrate and lipid metabolism attributed to obesity may be due to increased caloric intake. However, this conclusion would not seem to apply to the insulin resistance associated with obesity, as 3 wk of increased caloric intake did not produce any change in the responsiveness of these subjects to insulin's action.

Demonstration of insulin resistance in untreated adult onset diabetic subjects with fasting hyperglycemia

We have used a continuous intravenous infusion of glucose (6 mg/kg/min), insulin (80 mU/min), epinephrine (6 mug/min), and propranolol (0.08 mg/min) to directly assess insulin resistance in 14 untreated adult onset diabetics with a mean (plus or minus SE) fasting plasma glucose level of 217 plus or minus 17 mg/100 ml. During the infusion endogenous insulin secretion is inhibited and steady-state plasma glucose and insulin levels are achieved after 90 min. Since similar steady-state levels of plasma insulin are achieved in all subjects, the plasma glucose concentration observed during the steady-state period is a measure of an individual's insulin resistance. Under these conditions, the mean (plus or minus SE) steady-state plasma glucose level of the 14 diabetic patients was 350 plus or minus 16 mg/100 ml, while that of 12 normal subjects was 121 plus or minus 4 mg/100 ml. Additional studies were performed in which control subjects and patients with diabetes had their fasting plasma glucose levels acutely raised or lowered to comparable levels before receiving the basic infusion mixture of glucose, insulin, epinephrine, and propranolol. The results of these studies indicated that differences in initial plasma glucose levels could not account for the different glucose responses of the two groups to the basic infusion. Finally, the mean (plus or minus SE) steady-state plasma glucose level of 104 plus or minus 17 mg/100 ml observed during the same basic infusion in five patients with fasting hyperglycemia (mean plus or minus SE, 142 plus or minus 12 mg/100 ml) secondary to chronic pancreatitis suggested that neither chronic hyperglycemia nor hypoinsulinemia per se necessarily lead to insulin resistance. These results demonstrate that marked insulin resistance exists in adult onset diabetics with fasting hyperglycemia. Since previous studies have documented the presence of insulin resistance in patients with chemical diabetes, the possibility exists that insulin resistance may be characteristic of adult onset diabetes mellitus.

Further evidence that insulin resistance exists in patients with chemical diabetes

Insulin resistance was estimated in fifty nonobese subjects who were classified as normal (thirty subjects) or as having chemical diabetes (twenty subjects) on the basis of a standard oral glucose tolerance test. Insulin resistance was determined by administering a constant intravenous infusion of epinephrine, propranolol, glucose and exogenous insulin to each subject for 150 minutes and by measuring the resultant steady state plasma glucose levels attained during the last sixty minutes. Under these conditions, endogenous insulin secretion and hepatic glucose output are suppressed, and similar steady state plasma levels of the exogenously infused insulin are achieved in all subjects. Since all patients are challenged with comparable glucose loads, the height of the steady state plasma glucose response becomes a direct measure of an individual's resistance to insulin-mediated glucose uptake. With this approach we found that the mean (± S.E.) steady state plasma glucose level in patients with chemical diabetes was 224 ± 15 mg. per 100 ml. as compared to 126 ± 12 mg. per 100 ml. in control subjects. This difference was statistically significant (p &lt;.001) and could not be attributed to differences in degree of obesity between the two groups. Furthermore, when individual values were examined it was apparent that relatively little overlap existed between steady state plasma glucose levels in normal and diabetic subjects. These results indicate that resistance to insulin-mediated glucose uptake is a characteristic of nonobese patients with chemical diabetes.