Effect of medium-chain triglycerides on the postprandial triglyceride concentration in healthy men

This study compared the serum lipid concentrations after a single dose of medium-chain triglycerides (MCT) or long-chain triglycerides (LCT) between individuals grouped according to the body mass index (BMI). Twenty-five males participated as volunteers, the test diet containing 10 g of MCT or LCT. Blood samples were collected up to 6 h after the intake of a test diets. The LCT diet resulted in significantly greater increases in areas under the curves (AUCs) for serum and chylomicron triglyceride in the BMI > or = 23 kg/m2 group than those in the BMI < 23 kg/m2 group. The magnitude of response after intake of the MCT diet by the BMI > or = 23 kg/m2 group was significantly lower than that after the LCT diet. These results suggest that, in subjects with BMI > or = 23 kg/m2, the intake of MCT is preferable to that of LCT for maintaining postprandial triglyceride at a low concentration.     

Hyperlipidaemia in Asthmatic Patients Receiving Long-term Steroid Therapy

Plasma lipids were measured in 100 female asthmatic patients receiving long-term steroid therapy. A significant increase in the incidence of endogenous hypertriglyceridaemia but not of hypercholesterolaemia was found. The hypertriglyceridaemia was not due to obesity or diabetes. Neither the dose of steroid, duration of therapy, nor the addition of corticotrophin gel or depot tetracosactrin influenced the prevalence of hypertriglyceridaemia.     

Chronic intraperitoneal infusion of low doses of tumor necrosis factor alpha in rats induces a reduction in plasma triglyceride levels.

Single and repeated bolus injections of tumor necrosis factor alpha (TNF) in laboratory animals have been reported to result in hypertriglyceridaemia, suggesting that TNF is a mediator of hypertriglyceridaemia occurring during infection. However, as during infection production of TNF is probably chronically elevated, we determined the effects of continuous infusion of low doses of TNF on plasma levels of triglycerides and cholesterol. Male rats, bearing a venous catheter to allow repeated blood sampling, were intraperitoneally equipped with osmotic minipumps which continuously delivered TNF or saline for 7 days. Infusion of rats with doses of TNF as low as 4.0 and 8.0 micrograms/24 h resulted in significant decreases in plasma levels of triglycerides as compared with those after saline infusion. Although plasma triglyceride concentrations were persistently lower in TNF than in saline animals throughout the study period, the differences were most prominent during the first days and reached statistical significance at day 1, 3, 4 and 5 and of the 4.0 micrograms experiment and on day 1, 2 and 3 of the 8.0 micrograms experiment. This suppression of plasma triglyceride concentrations was not accompanied by changes in plasma cholesterol levels. No effects of chronic TNF treatment on food intake, body weight change and rectal temperature of the animals were observed. These findings indicate that chronic infusion of low doses of TNF induces hypotriglyceridaemia in rats. The role of TNF as a factor in mediating hypertriglyceridaemia during infectious diseases needs to be reconsidered.     

Lipid screening: is it enough to measure total cholesterol concentration?

OBJECTIVES--To determine whether measurement of total cholesterol concentration is sufficient to identify most patients at lipoprotein mediated risk of coronary heart disease without measurement of triglyceride and high density lipoprotein (HDL) cholesterol concentrations. DESIGN--Cross sectional screening programme. SETTING--Six general practices in Oxfordshire. PATIENTS--1901 Men and 2068 women aged 25-59. MAIN OUTCOME MEASURE--Cardiovascular risk as assessed by fasting venous plasma concentrations of total cholesterol, triglyceride, and HDL cholesterol. RESULTS--2931 Patients (74% of those screened) had a total cholesterol concentration of less than 6.5 mmol/l. If the triglyceride concentration had not been measured in these patients isolated hypertriglyceridaemia (greater than or equal to 2.3 mmol/l) would have remained undetected in 185. Among these 185 patients, however, 123 were overweight or obese and only 18 (0.6% of those screened) had an increased risk associated with both a raised triglyceride concentration (greater than or equal to 2.3 mmol/l) and a low HDL cholesterol concentration (less than 0.9 mmol/l). Conversely, in the 790 patients with predominant hypercholesterolaemia (cholesterol concentration greater than or equal to 6.5 mmol/l and triglyceride concentration less than 2.3 mmol/l) measurement of HDL cholesterol concentration showed that 348 (9% of those screened) had only a moderately increased risk with a ratio of total to HDL cholesterol of less than 4.5 and 104 had a low risk with a ratio of less than 3.5. CONCLUSIONS--Fasting triglyceride and HDL cholesterol concentrations identify few patients at increased risk of coronary heart disease if the total cholesterol concentration is less than 6.5 mmol/l. HDL cholesterol and triglyceride concentrations should, however, be measured in patients with a total cholesterol concentration exceeding this value. Total cholesterol concentration alone may overestimate risk in a considerable number of these patients, and measurement of HDL cholesterol concentration allows a more precise estimate of risk. Measurement of the triglyceride concentration is required to characterise the lipoprotein abnormality. A patient should not be started on a drug that lowers lipid concentrations without having had a full lipoprotein assessment including measurement of HDL cholesterol concentration.     

Metabolic effects of intravenous LCT or MCT/LCT lipid emulsions in preterm infants

Most lipid emulsions for parenteral feeding of premature infants are based on long-chain triacylglycerols (LCTs), but inclusion of medium-chain triacylglycerols (MCTs) might provide a more readily oxidizable energy source. The influence of these emulsions on fatty acid composition and metabolism was studied in 12 premature neonates, who were randomly assigned to an LCT emulsion (control) or an emulsion with a mixture of MCT and LCT (1:1). On study day 7, all infants received [13C]linoleic (LA) and [13C]alpha-linolenic acid (ALA) tracers orally. Plasma phospholipid (PL) and triacylglycerol (TG) fatty acid composition and 13C enrichments of plasma PL fatty acids were determined on day 8. After 8 days of lipid infusion, plasma TGs in the MCT/LCT group had higher contents of C8:0 (0.50 +/- 0.60% vs. 0.10 +/- 0.12%; means +/- SD) and C10:0 (0.66 +/- 0.51% vs. 0.15 +/- 0.17%) than controls. LA content of plasma PLs was slightly lower in the MCT/LCT group (16.47 +/- 1.16% vs. 18.57 +/- 2.09%), whereas long-chain polyunsaturated derivatives (LC-PUFAs) of LA and ALA tended to be higher. The tracer distributions between precursors and products (LC-PUFAs) were not significantly different between groups. Both lipid emulsions achieve similar plasma essential fatty acid (EFA) contents and similar proportional conversion of EFAs to LC-PUFAs. The MCT/LCT emulsion seems to protect EFAs and LC-PUFAs from beta-oxidation.     

Seasonal changes in plasma and aortic lipids in young rats

In young non-exercised rats, plasma triglyceride and plasma phospholipid levels increased in summer and low density lipoprotein cholesterol (LDL-C) increased in winter. As for lipids samples from the wall of the aorta, total cholesterol, cholesteryl ester and triglyceride decreased in summer and phospholipid decreased in winter. Exercise diminished the gain in body mass (delta m) and suppressed seasonal changes in the levels of LDL-C and plasma triglyceride. Seasonal changes in the aorta lipids in this case were similar to those found in non-exercised animals. The values of total energy intake (Q) and of delta m.Q-1 were found to change with season in both non-exercised and exercised rats. Seasonal changes in plasma and in aorta lipids observed in these animals ran in parallel with the respective levels of delta m.Q-1 and/or of Q. The training effect on the lipid values detected in summer and/or in winter was also found to be dependent on the reduction in delta m.Q-1 with exercise. In the non-exercised and in the exercised animals, plasma phospholipid was associated with aorta phospholipid and inversely related to aorta cholesteryl ester and aorta triglyceride. The relationship between these estimations suggests that an increase in the plasma phospholipid in summer would remove non-polar lipids from the walls of the aortae.     

The triglyceride content of adipocytes and plasma of patients with diabetes mellitus.

In two groups of obese diabetic patients closely matched for age, glucose intolerance and indices of obesity, the group with hypertriglyceridaemia was found to have an increased triglyceride content of adipocytes (p less than 0.001) and raised fasting plasma insulin (p less than 0.02). Plasma insulin did not directly relate to the level of plasma triglyceride (r = +0.28, n = 36, p N.S.) but correlated with the triglyceride content of adipocytes (r = +0.59, n = 37, p less than 0.001). The results suggest that raised plasma insulin is not a primary determinant of the level of plasmatriglyceride but that it may be related by its effect on lipogenesis in adipose and other tissues.     

Kinetics of plasma triglycerides in rats with streptozotocin diabetes

Streptozotocin diabetes [45 mg/kg] in rats fed on a standard diet, with insulin substitutional therapy - 66 [nkat/kg]/d [[4 U/kg b.w.]d] for the first 3 days - led during an 8 days' experiment to marked hypertriglyceridaemia [4.86 mmol/l] and to triglyceride accumulation in the liver [22.35 mmol/kg]. The endogenous triglyceride secretion rate, studied by means of a Triton WR 1339 block of lipoprotein lipase, was almost 30 % lower in diabetic rats. The half-time of plasma 14C-triglycerides [labelled endogenously with 14C-1-palmitic acid] almost doubled and the fractional turnover rate fell to half the value in the control animals. Hypertriglyceridaemia in diabetic rats [60 % insulin deficiency] is caused by slower removal of lipoprotein triglycerides from the plasma space, owing to reduced lipolytic activity in the peripheral tissues.     

The antimicrobial properties of milkfat after partial hydrolysis by calf pregastric lipase

Studies on the kinetic characteristics of calf pregastric lipase (EC 3.1.1.3) have shown that it preferentially releases short chain fatty acids (SCFAs) from bovine milkfat. The released fatty acids form mixed micelle structures. The aim of this investigation has been to test whether hydrolysed milkfat is antimicrobial, and how the state of the emulsion alters the bactericidal or bacteriostatic effects. Partial hydrolysis of milkfat by pregastric lipase was carried out in two types of emulsion systems, containing either Triton X-100 or casein/lecithin, plus milkfat in citrate/phosphate buffer (pH 5.0-6.0). The concentrations and compositions of fatty acids were determined by gas chromatography. The minimum percentages of hydrolysed milkfat which affected growth and survival of selected Gram-positive and Gram-negative bacteria were measured. The bacterial experiments were repeated using pure fatty acids at similar concentrations. Lauric acid (C12:0) was found to be the most potent bactericidal fatty acid against Enterococcae (Gram-positive), and caprylic acid (C8:0) was the most potent against coliforms (Gram-negative). Use of Triton X-100 for milkfat emulsification provided a more compatible medium for studying bacterial growth in the hydrolysed milkfat than did use of casein/lecithin. The results also show that the antimicrobial effects of individual fatty acids released from hydrolysed milkfat were at least additive and suggest that hydrolysis of milkfat may be a significant factor in controlling growth of organisms imbibed with food in pre-weaned animals. The amount of pregastric catalyzed triglyceride hydrolysis in the digestive tract is sufficient to produce an antibacterial concentration of fatty acids and monoglycerides.     

The effect of chronic marginal vitamin C deficiency on the rate of secretion and the removal of plasma triglycerides in guinea-pigs

In guinea-pigs, chronic borderline vitamin C deficiency leads to hypertriglyceridaemia and to the accumulation of triglycerides in the liver. We investigated the triglyceride secretion rate by determining the rate of accumulation of triglycerides in the plasma following a Triton WR 1339 block of the their removal from the plasma (experiment 1) and the rate of the removal of triglycerides from the plasma by mathematical analysis of the specific plasma triglyceride activity - time curve after the administration of 3H-glycerol (experiment 2). In the 14th and 16th week of the experiment it was found that borderline vitamin C deficiency slowed down the triglyceride secretion rate, prolonged the half-time and reduced fractional plasma triglyceride turnover. The balance shift between the rate of the uptake and removal of very low density lipoprotein triglycerides (VLDL-TG) in the plasma compartment (greater retardation of the catabolic phase of kinetics) is probably the reason why triglycerides accumulate in the plasma and liver compartment of guinea-pigs with borderline vitamin C deficiency.     

Outcome of case finding among relatives of patients with known heterozygous familial hypercholesterolaemia

ObjectivesTo assess the feasibility of detecting new cases of heterozygous familial hypercholesterolaemia by using a nurse led genetic register.DesignCase finding among relatives of patients with familial hypercholesterolaemia.SettingTwo lipid clinics in central and south Manchester.Subjects259 (137 men and 122 women) probands and 285 first degree relatives.ResultsOf the 200 first degree relatives tested, 121 (60%) had inherited familial hypercholesterolaemia. The newly diagnosed patients were younger than the probands and were generally detected before they had clinically overt atherosclerosis. Concentrations of serum cholesterol were, respectively, 8.4 (1.7 SD) mmol/l and 8.1 (1.9 SD) mmol/l in affected men and women and 5.6 (1.0 SD) mmol/l and 5.6 (1.1 SD) mmol/l in unaffected men and women. Screening for risk factors as recommended in recent guidelines for coronary heart disease prevention would have failed to identify most of the affected relatives in whom hypertension, diabetes mellitus, cigarette smoking, and obesity were uncommon.ConclusionsBy performing cholesterol tests on 200 relatives, 121 new patients with familial hypercholesterolaemia were discovered. Because 1 in 500 people in the UK are affected by this condition, to detect a similar number by population screening over 60 000 tests would be required, and only a few of these patients would have been detected had cholesterol testing been restricted to those with other risk factors for coronary heart disease. A case exists for organising a genetic register approach, linking lipid clinics nationally.     

Central insulin sensitivity in male and female juvenile rats

The incidence of juvenile obesity is increasing at an alarming rate. In adults, central insulin administration decreases hypothalamic orexigenic neuropeptides, food intake and body weight more effectively in males than females. Mechanisms regulating energy balance in juvenile animals are inherently different from those in adults due to differences in growth rates and hormonal milieu. Therefore, we sought to determine if central insulin treatment in juvenile rats (4 wk) would have similar sex-dependent effects on food intake as those reported in adult rats. Twenty-four hour food intake was measured following icv saline or insulin (0.01 or 0.1 U) prior to the onset of dark phase of the light cycle. An additional set of animals was used to assess the effects of central insulin on hypothalamic orexigenic (NPY, AgRP) and anorexigenic (POMC) neuropeptide mRNA expression. In both males and females, insulin reduced meal size initially (first 4 h) and later decreased meal frequency (4-24 h) to reduce cumulative food intake. Consistent with this, central insulin decreased hypothalamic NPY and AgRP and increased POMC mRNA expression. In contrast to adult studies, there were no demonstrated sex differences. These studies indicate that juvenile females and males are equally sensitive to central insulin anorexigenic effects, perhaps due to a lack of circulating gonadal hormones. The anorexigenic responsiveness of both genders suggests a potential pharmacologic approach to childhood obesity.     

The effects of Triton WR-1339, protamine sulfate and heparin on the plasma removal of emulsion models of chylomicrons and remnants in rats

Protein-free lipid emulsions with compositions modelling chylomicrons (chylomicron-like emulsion) or chylomicron remnants (remnant-like emulsion) were injected intra-arterially into nonanesthetized rats. Compared with control untreated rats, treatment with Triton WR-1339, protamine sulfate or heparin strongly modified the plasma removal of triacylglycerols and cholesteryl ester moieties of chylomicron-like emulsions, but had little effect on removal rates of triacylglycerols or cholesteryl esters of remnant-like emulsions. The effects on chylomicron-like removal were similar to those on natural lymph chylomicrons. The relative lack of effects on remnant-like emulsion removal provides additional evidence that remnant-like emulsions are a metabolic model for natural chylomicron remnants.     

The uptake of oleic acid by rat small intestine: a comparison of methodologies

The interaction between long-chain and medium-chain lipids during intestinal absorption was examined using several model systems. A decrease in steady-state triolein (LCT) output in thoracic duct lymph after addition of trioctanoin (MCT) to the duodenal infusion confirmed previous studies in unanesthetized rats which demonstrated inhibition of steady-state LCT uptake from the small intestinal lumen by MCT. In slices of everted rat jejunum octanoic acid reduced incorporation into triglyceride and initial uptake of (14)C-labeled oleic acid from micellar solutions. Inhibition of uptake did not occur at 0 degrees C, when triglyceride synthesis was blocked. Incubation of slices at low pH (5.8) or in the presence of dimethyl sulfoxide also reduced uptake of oleic acid and its incorporation into triglyceride. However, when everted sacs of jejunum were similarly incubated, octanoate, dimethyl sulfoxide, or low pH caused no inhibition of oleic acid uptake or esterification. The results indicate that the significance of kinetic data describing intestinal fatty acid absorption which were obtained from experiments conducted in vitro is highly questionable, and that suitable models for in vivo uptake kinetics have yet to be developed. However, analysis of the in vitro kinetic data suggests that the intestinal mucosal membrane does not function as a simple lipid interface with respect to fatty acid absorption.     

The hypertriglyceridaemia of the cobalt chloride-treated rat: A possible mechanism

The cobalt chloride-treated rat is an animal model of induced hypertriglyceridaemia. Associated with the hyperlipaemia is an increase in hepatic triglyceride and decrease in total body lipid content. Lipoprotein lipase (EC.3.1.1.3), the enzyme responsible for regulation of the rate of uptake of triglyceride by adipose tissue was investigated and its activity shown to be reduced by cobalt treatment. Plasma post-heparin lipoprotein lipase activity was also reduced in the cobalt chloride-treated rat and plasma clearance of exogenous triglyceride was halved. The heavy metal ions, Zn⁺⁺, Cu⁺⁺ and Fe⁺⁺, reduced post-heparin lipoprotein lipase activity. These findings suggest a possible mechanism for production of the hypertriglyceridaemia by cobalt chloride involving a decrease in plasma triglyceride clearance coupled with a possible increase in hepatic triglyceride production.     

Effect of pectin on cholesterol distribution in the lipoproteins of streptozotocin-diabetic rats fed cholesterol diet

In rats fed a semisynthetic diet, streptozotocin-induced diabetes [45 mg/kg, 17 days] led to hypertriglyceridaemia [6.4 mmol/l], to a marked increase in the proportion of plasma cholesterol present in the very low density lipoproteins [VLDL] [to 40 %] and to a decrease in the amount present in the high density lipoproteins [HDL] [to 34 %]. The addition of 0.25 % cholesterol to the above diet led in healthy rats to hypercholesterolaemia [4.3 mmol/l] and to similar changes in the distribution of cholesterol in the lipoproteins. In diabetic rats, the same diet led to pronounced hypertriglyceridaemia [13.8 mmol/l] and hypercholesterolaemia [18.9 mmol/l], while the proportion of HDL-borne plasma cholesterol fell still further to 6 % and rose in the VLDL to 70 %. The addition of pectin to the diet in 6 % concentration markedly inhibited triglyceridaemia [3.3 mmol/l] and cholesterolaemia [4.4 mmol/l] and raised the proportion of HDL plasma cholesterol to 47 %.     

Characterization of Obese Phenotypes in a Small Nonhuman Primate,the Common Marmoset (Callithrix jacchus)

This report explores aspects of developing obesity in two captive populations of common marmosets (Callithrix jacchus), a small primate with a short lifespan that may be of value in modeling chronic aspects of obesity acquisition and its lifetime effects. Two populations were examined. In study 1, body composition, lipid parameters, and glucose metabolic parameters were measured in a population of 64 adult animals. Animals classified as obese (>80th percentile relative fat based on sex) displayed both dyslipidemia (higher triglyceride and very low–density lipoprotein (VLDL)) and altered glucose metabolism (higher fasting glucose and HbA_1c). Using operational definitions of atypical values for factors associated with metabolic syndrome in humans, five subjects (7.8%) had at least three atypical factors and five others had two atypical factors. A previously unreported finding in these normally sexually monomorphic primates was higher body weight, fat weights, and percent fat in females compared to males. In a second study, longitudinal weight data for a larger population (n = 210) were analyzed to evaluate the development of high weight animals. Differences in weights for animals that would exceed the 90th percentile in early adulthood were evident from infancy, with a 15% difference in weight between future‐large weight vs. their future‐normal weight litter mates as early as 4–6 months of age. The marmoset, therefore, demonstrates similar suites of obesity‐related alterations to those seen in other primates, including humans, suggesting that this species is worthy of consideration for obesity studies in which its fast maturity, high fertility, relatively short lifespan, and small size may be of advantage.     

Pharmacological Inhibition of Monoacylglycerol O-Acyltransferase 2 Improves Hyperlipidemia,Obesity, and Diabetes by Change in Intestinal Fat Utilization

Monoacylglycerol O-acyltransferase 2 (MGAT2) catalyzes the synthesis of diacylglycerol (DG), a triacylglycerol precursor and potential peripheral target for novel anti-obesity therapeutics. High-throughput screening identified lead compounds with MGAT2 inhibitory activity. Through structural modification, a potent, selective, and orally bioavailable MGAT2 inhibitor, compound A (compA), was discovered. CompA dose-dependently inhibited postprandial increases in plasma triglyceride (TG) levels. Metabolic flux analysis revealed that compA inhibited triglyceride/diacylglycerol resynthesis in the small intestine and increased free fatty acid and acyl-carnitine with shorter acyl chains than originally labelled fatty acid. CompA decreased high-fat diet (HFD) intake in C57BL/6J mice. MGAT2-null mice showed a similar phenotype as compA-treated mice and compA did not suppress a food intake in MGAT2 KO mice, indicating that the anorectic effects were dependent on MGAT2 inhibition. Chronic administration of compA significantly prevented body weight gain and fat accumulation in mice fed HFD. MGAT2 inhibition by CompA under severe diabetes ameliorated hyperglycemia and fatty liver in HFD-streptozotocin (STZ)-treated mice. Homeostatic model assessments (HOMA-IR) revealed that compA treatment significantly improved insulin sensitivity. The proximal half of the small intestine displayed weight gain following compA treatment. A similar phenomenon has been observed in Roux-en-Y gastric bypass-treated animals and some studies have reported that this intestinal remodeling is essential to the anti-diabetic effects of bariatric surgery. These results clearly demonstrated that MGAT2 inhibition improved dyslipidemia, obesity, and diabetes, suggesting that compA is an effective therapeutic for obesity-related metabolic disorders.     

Hepatic uptake of chylomicrons and triglyceride emulsions in rats fed diets of differing fat content

The hepatic removal of plasma chylomicrons was determined for rats fed the following diets: a) containing no triglyceride, b) regular chow diet with 4.5% of its mass as lipid and, c) a corn oil-supplemented chow with triglyceride accounting for 20% of the mass. The fractional hepatic uptake of either radiolabeled chylomicrons or a triglyceride emulsion was reciprocally related to the amount of lipid in the diet. The animals receiving only carbohydrate and protein calories had the most active hepatic uptake of particulate triglyceride and were observed to have a significant decrease in the plasma concentration of the C apolipoproteins. The addition of either C-I, C-II, or C-III apoproteins to the triglyceride emulsion prior to intravenous injection produced a significantly lower hepatic triglyceride recovery of emulsions containing apoC-III. When the plasma of animals fed a fat-free diet was supplemented with human C-III-1 apolipoprotein, the distribution into the liver of either enterally administered fatty acid or parenteral triglyceride was diminished. The triglyceride content in the liver of the rats fed fat-free or corn oil-supplemented diets was significantly greater than that of the control rats and composition was somewhat similar to that of lymph triglyceride. The studies indicate an important influence of dietary lipid on both the partition of plasma triglyceride into the liver and the steady state hepatic triglyceride content.