The Effect of Glucose on the Clearing Mechanism of Postalimetary

Lipemia in Coronary Arteriosclerosis

Abstract

For the prevention and treatment of arteriosclerosis, control of diet is one of the most important factors. This study was attempted to elucidate the effect of carbohydrate on the clearing mechanism of postalimentary lipemia in normal subjects and in patients with coronary arteriosclerosis.
Results obtained were as follows:
1. After an overnight fast, 100g of raw cream containing 25% fat were orally administered to 16 patients with coronary arteriosclerosis and to 13 control subjects. In addition, 40ml of 50% glucose was injected intravenously 3 hours after oral fat intake in 9 patients and in 5 control subjects. Observations were made of serial changes of optical density (OD) indicating the chylomicron level and FFA content in plasma. In both groups, comparative investigations were made of patterns of OD and FFA. For both groups, a significant decrease in OD was noted after administration of glucose, but the decrease was relatively more pronounced in the control subjects than in the patient group. The pattern of FFA was similar to that of OD, respectively, in each group.
2. Seven control subjects were loaded with raw cream. Four of these controls were given 10mg of propranolol intravenously, and the other three were given the same volume of saline three hours after fat intake. The beta-blocker was demonstrated to lower OD significantly.
3. To three patients with coronary arteriosclerosis and three control subjects treated with raw cream, protamine was infused intravenously two and a half hours after fat loading. 30 minutes after the beginning of protamine infusion, 40ml of 50% glucose was also injected intravenously. It was revealed that OD was markedly elevated by the pretreatment with protamine in spite of the intravenous administration of glucose.
From these results it is postulated that the most basic factor of the clearing mechanism of postalimentary lipemia is the activity of lipoprotein lipase. By promoting the turnover rate of plasma FFA, glucose is postulated as having an augumentative effect on this mechanism.
The effect of glucose on the clearing mechanism of postalimentary lipemia was revealed to be disturbed in patients with coronary arteriosclerosis, compared with control subjects. Regarding its mechanism, lowered glucose tolerance in patients with coronary arteriosclerosis is suggested.