Selective measurement of two lipase activities in postheparin plasma from normal subjects and patients with hyperlipoproteinemia

Metabolic disorders of serum lipoproteins in endotoxin-poisoned mice: the role of high density lipoprotein (HDL) and triglyceride-rich lipoproteins

A study was performed to clarify the role of serum lipoproteins, especially high density lipoprotein (HDL) and triglyceride-rich lipoproteins in endotoxemic or endotoxin-poisoned animals. The level of HDL-cholesterol decreased markedly in mouse serum 18-24 hr postintoxication, while the amount of low density lipoprotein (LDL)-cholesterol in the sera of poisoned mice was about 175% of that of the controls. Serum lecithin-cholesterol acyltransferase activity in the poisoned mice decreased slightly for 3-6 hr after endotoxin injection, but became markedly increased at 18-24 hr as compared with that in the controls. The amount of serum very low density lipoprotein (VLDL) showed a marked increase in the poisoned mice 8-24 hr postintoxication. The HDL fraction in the electrophoretic patterns of serum was reduced according to the dose of endotoxin 18 hr postintoxication. The HDL fraction in mice injected with lead acetate plus endotoxin was markedly lower than that in the poisoned mice. When streptozotocin-diabetic mice were injected with endotoxin, the HDL fraction was higher than that in the endotoxin-poisoned mice. In endotoxin-poisoned mice a correlation was observed between the lipid peroxide and LDL levels in the serum. In disk electrophoretic patterns, the HDL fraction in mice given vitamin E-supplemented diet showed a higher level than that in mice given a normal diet. Lipoprotein lipase (LPL) activity in poisoned mice significantly decreased to 59% of the control value 18 hr postintoxication, but hepatic triglyceride lipase activity was only slightly increased in endotoxin-poisoned mice. In analysis of HDL apoprotein peptide in serum lipoprotein, the apo C-II peptide level was clearly lower in mouse serum 18 hr postintoxication than that in the controls. These results suggest that the decrease in LPL activity in endotoxin-poisoned mice may be closely related to a decrease in the apo C-II peptide level, and also that it plays an important part in HDL and triglyceride-rich lipoprotein metabolism in the poisoned mice.

Reversal of decreased hepatic lipase and lipoprotein lipase activities after treatment of hypothyroidism

Plasma lipoprotein concentrations, activities of hepatic lipase and lipoprotein lipase in post-heparin plasma, and the removal rate of exogenous triglyceride were measured in fourteen patients with severe primary hypothyroidism before and after 4 months substitution therapy with 1-thyroxine. Before treatment plasma LDL cholesterol concentrations were markedly increased while HDL cholesterol and plasma triglycerides were in the upper reference range. Thyroxine substitution led to a normalization of LDL cholesterol in all patients. Plasma triglycerides and HDL cholesterol decreased moderately. Hepatic lipase and lipoprotein lipase activities were initially reduced but increased significantly after treatment, by about 170% and 55%, respectively. The increase in hepatic lipase activities was significantly correlated to the increase in serum triiodothyronine levels and also to the reduction in LDL cholesterol concentrations. The decrease in LDL cholesterol was also significantly correlated to the increase in serum triiodothyronine concentration. In two patients initially treated with triiodothyronine, the activity of hepatic lipase, but not that of lipoprotein lipase, increased after 24 and 48 h, while LDL cholesterol levels decreased substantially. We suggest that the reduced activities of hepatic lipase as well as of lipoprotein lipase are important pathogenetic factors for the dyslipoproteinaemia occurring in hypothyroidism and that the low serum triiodothyronine concentration is of major importance for the alterations in lipid transport.

Lipoprotein lipase activity of adipose tissue, skeletal muscle and post-heparin plasma in primary endogenous hypertriglyceridaemia: relation to lipoprotein pattern and to obesity

The lipoprotein lipase (LPL) activity was determined from heparin eluates of adipose tissue and skeletal muscle and from post-heparin plasma of sixty-five males with hypertriglyceridaemia and of seventy males with normal serum lipid levels. The patients were subgrouped by their lipoprotein concentrations into types 2b, 4 and 5. The mean LPL activity of adipose tissue (per tissue weight) of nonobese type 2b, 4 and 5 patients was reduced to 54%, 41% and 13%, respectively, of the corresponding value of normolipidaemic men. On the other hand, among obese hyperglyceridaemic men only those with type 5 showed a decreased LPL activity in adipose tissue (44%). The mean skeletal muscle LPL was subnormal in nonobese type 4 (55%) and in type 5 patients (34%) but was normal in type 2b and in obese type 4 patients. The post-heparin plasma LPL activity was significantly reduced in all nonobese hyperglyceridaemic groups but was normal in obese patients apart from cases with type 5 who had low values. One exceptional subject with type 5 had high post-heparin plasma LPL activity. It is concluded that a low LPL activity may be a crucial factor in the pathogenesis of hypertriglyceridaemia in nonobese subjects and in patients having type 5 disorder.

Roles of lipoprotein lipase and hepatic triglyceride lipase in the catabolism in vivo of triglyceride-rich lipoproteins

To define the roles, in vivo, of hepatic triglyceride lipase and lipoprotein lipase in the catabolism of triglyceride-rich lipoproteins, we investigated the relationship between the activities of the above enzymes in postheparin plasma and the fractional removal rates of very low density lipoproteins (VLDL) and VLDL remnant particles. In 22 patients, the fractional removal rates of VLDL and VLDL-remnant particles were determined from analyses of the disappearance of radioiodinated Sf 60-400 and Sf 12-60 lipoprotein B apoprotein. The maximal activities of hepatic triglyceride lipase and lipoprotein lipase were determined in plasma samples drawn 2-60 minutes after heparin injection (60 U/kg). A positive correlation was observed between the fractional removal rate of VLDL and postheparin plasma lipoprotein lipase activity (r = 0.65). When all 22 patients were considered together, no relationship was demonstrable between remnant fractional removal and postheparin plasma lipoprotein lipase activity. However, humans may be subdivided with respect to the way in which they catabolize remnants. In some, all remnant may be catabolized to form LDL. In others, some of the remnant may also be directly removed from the circulation. Those subjects in whom previous studies indicate that all remnant is converted to LDL demonstrated a positive correlation between remnant fractional removal rate and postheparin plasma lipoprotein lipase activity (n = 8, r - 0.83). No correlations between postheparin plasma hepatic triglyceride lipase activity and any of the fractional removal rates were found. These data are consistent with the following: 1) lipoprotein lipase plays a key regulatory role in the catabolism of triglyceride-rich lipoproteins; 2) this role applies only to those catabolic involving the formation of particles of higher density VLDL remnants and low density lipoprotein; and 3) hepatic triglyceride lipase plays no rate-limiting role in the catabolism of VLDL or VLDL-remnant particles.

Phenotype study of apolipoprotein E isoforms in hyperlipoproteinaemic patients

It has been suggested that apolipoprotein E (apoE) is inherited at a single genetic locus with three common alleles designated E2, E3, and E4. The products of these three alleles are apoE2, apoE3, and apoE4. The apoE phenotypes of 74 normal subjects and 226 hyperlipoproteinaemic subjects were ascertained by gel isoelectrofocusing. Patients with type I, type IIa, type IIb, and type IV hyperlipoproteinaemia had an apoE phenotypic distribution which was similar to that of normal subjects, with 40.0 to 60.0% being homozygous for E3. In contrast, 75% of type III patients had an E2 phenotype and 25% were E2/3 heterozygotes. Among type V patients 31.4% had an E4 phenotype, and 42.9% were E4 heterozygotes. No type III patient and only 5.7% of type V patients had E3 phenotype. The results suggest that apoE2 and apoE4 are associated with two distinctly different dyslipoproteinaemias and that apoE has at least two different physiological functions.

Increased prevalence of apolipoprotein E4 in type V hyperlipoproteinemia

Type V hyperlipoproteinemia (HLP) is characterized clinically by hepatosplenomegaly, occasional eruptive xanthomas, and an increased incidence of pancreatitis. These patients have striking hypertriglyceridemia due to increased plasma chylomicron and very low density lipoprotein concentrations in the fasting state, without a deficiency of lipoprotein lipase or its activator protein, apolipoprotein (apo) C-II. ApoE, a protein constituent of triglyceride-rich lipoproteins, has been implicated in the receptor-mediated hepatic uptake of these particles. ApoE has three major alleles: E2, E3, and E4, and the products of these alleles are apoE2, apoE3, and apoE4, respectively. ApoE phenotypes were determined in 30 type V HLP patients as well as in 37 normal volunteers. Among the type V patients, 33.3% were noted to be homozygous, and 40.0% heterozygous for E4 (normal, 2.7 and 21.6%, respectively). These data suggest that apoE4 may play a role in the etiology of the hyperlipidemia in a significant number of type V HLP patients.

Human postheparin plasma hepatic lipase activity against triacylglycerol and phospholipid substrates

Recent evidence has suggested that the major physiological substrate of the heparin-releasable (postheparin plasma) hepatic lipase is HDL2-phospholipid. However, all the current assay methods for this enzyme are based on the use of triacylglycerol substrate. Even though both lipolytic activities of hepatic lipase are likely to be due to a single enzyme it is possible that the use of unphysiological lipid as a substrate may give misleading results. Therefore we did parallel assays of the activity of postheparin plasma hepatic lipase using triacylglycerol, monoacylglycerol and phospholipid substrates. The correlation coefficients between the three lipolytic activities were 0.95-0.98, indicating that identical results are obtained using any of these three lipids in the assay of postheparin plasma hepatic lipase.

Effect of cardiopulmonary bypass on the pharmacokinetics of drugs

The cardiopulmonary bypass apparatus must temporarily substitute for the cardiac and pulmonary function of the patient undergoing heart surgery. In order to meet the metabolic needs of the patient and the technical demands of the surgeon, within the limits of engineering technology, a number of major alterations are made in normal physiology. The patient is typically cooled to 27 degrees C and perfused with a non-pulsatile flow of blood which has been diluted with saline to a haematocrit in the mid-20s. Blood flow and pressure are often considerably less than normal. Blood coagulation is prevented by administration of a massive dose of heparin. Central redistribution of blood flow, elaboration of stress-reactant hormones, and fluid and electrolyte shifts occur in response to these changes. In the postoperative period, these alterations are reversed, and normal physiology is restored. Effects upon the pharmacokinetics of drugs are anticipated. The clearance of many drugs may be reduced. Protein binding is diminished by haemodilution, but may rise above normal in the postoperative period for basic drugs which bind to alpha 1-acid glycoprotein. Changes in volume of distribution depend upon the opposing influences of protein binding and reduced peripheral perfusion. Previous studies on the pharmacokinetics of drugs during and after cardiopulmonary bypass illustrate many of these effects. The clearance of digoxin, fentanyl, and the cephalosporins is reduced after cardiopulmonary bypass, and the volume of distribution of cefazolin is increased during cardiopulmonary bypass. Studies of digitoxin and propranolol are also reviewed. Many of the investigations in this area of study have been limited by logistical and methodological factors. Thus, the effects of cardiopulmonary bypass on the pharmacokinetics of drugs are incompletely understood, and the subject merits further attention.

Influence of native and randomized peanut oil on lipid metabolism and aortic sudanophilia in the vervet monkey

Vervet monkeys (Cercopithecus aethiops pygerethrus) were fed cholesterol-free, semipurified diets containing 40% sucrose, 25% casein, 15% cellulose and 14% peanut oil (PNO), randomized peanut oil (RPNO) or corn oil (CO). After 4 months, serum cholesterol and triglyceride levels, serum lecithin-cholesterol acyl transferase (LCAT) activity and plasma lipoprotein lipase (LPL) activity were similar in all groups. Livers of monkeys fed CO converted 156% more acetate and 24% more mevalonate to cholesterol than those of monkeys fed RPNO. Cholesterogenesis in RPNO-fed monkeys was enhanced compared to PNO (68% from acetate; 62% from mevalonate). Incidence of atherosclerosis was 33% in monkeys fed RPNO, 80% in those fed CO and 90% in those fed PNO. Extent of sudanophilia was lowest in aortas of monkeys fed RPNO. Incidence of arteriosclerosis was 40% in monkeys fed CO, 56% in those fed RPNO and 70% in those fed PNO. Extent of aortic surface showing arteriosclerosis was highest in monkeys fed RPNO.

Regulation of high density lipoprotein levels

Current concepts of the structure and metabolism of high density lipoproteins are presented and factors that influence their levels in human beings are surveyed.

Plasma lipid alterations in patients with chronic renal disease

Hyperlipidemia is common in patients with renal disease. This fact may be of great clinical relevance in view of the overwhelming evidence associating disturbed lipid metabolism and atherogenesis. Thus, hyperlipidemia may predispose to vascular disease in patients with chronic renal disorders and premature atherosclerosis could be an important risk in renal disease and a major factor limiting survival of patients on long-term maintenance hemodialysis. The aim of the present review is to present a brief but clinically relevant description of lipoprotein physiology and then to survey the now considerable literature concerned with lipoprotein and thus lipid abnormalities in patients with renal disease. A particular emphasis is placed on the role of the plasma lipoproteins in forming an integrated and controlled pathway for lipid metabolism, and how altered regulatory control within the pathway may be associated with pathogenic mechanisms. Finally, the evidence for accelerated development of vascular disease associated with these lipid abnormalities is briefly considered.

Pharmacological studies on tiadenol in type IV patients. Evidence for a mechanism of action different from other lipid-lowering drugs

Tiadenol [bis(hydroxyethylthio) 1-10 decane], a new absorbable hypolipidemic agent differing in chemical structure from clofibrate and related compounds, was tested in hypertriglyceridemic patients, both responsive and nonresponsive to dietary treatment. Tiadenol administration was remarkably effective in inhibiting fructose induced hypertriglyceridemia in diet responsive type IV patients; it was ineffective in patients with stable, diet refractory, hypertriglyceridemia. The significant reduction of plasma triglycerides (-42%) in sensitive patients, was not accompanied in this study, by the activation of plasma lipoprotein and hepatic lipases. In a second, longer term investigation of stable type IV patients, tiadenol administration resulted in significant triglyceride decreases in the very low density lipoproteins (VLDL) (-45%), as well as in the low and high density lipoproteins (LDL and HDL) (both -25%). The cholesterol content of LDL and HDL was not modified. In VLDL a significant reduction of apoprotein E was observed (from 15.2 +/- 4.9 to 11.9 +/- 5.9% of VLDL proteins). The reported observations are consistent with a difference in the mode of action of tiadenol from that of other lipid lowering agents, particularly of the clofibrate type.

Combined deficiency of apolipoprotein C-II and lipoprotein lipase in familial hyperchylomicronemia

The underlying pathophysiological defect was studied in four siblings with familial hyperchylomicronemia. Deficiency of apolipoprotein C-II and E-3 was identified. In addition, these subjects had markedly decreased LPL activity in postheparin plasma. Addition of normal plasma to the assay as source for apoC-II enhanced LPL activity only to a limited extent. In contrast with previously reported patients with apoC-II deficiency, a far less pronounced effect of intravenous infusion of normal plasma was seen in one of the siblings, probably due to the combined deficiency of apoC-II and LPL. Plasma VLDL-TG turnover rate was not decreased in one of the siblings with apoC-II and LPL deficiency, suggesting different metabolic pathways for chylomicrons and VLDL. Family study confirmed an autosomal recessive mode of inheritance both for apoC-II and for apoE-3 deficiency. The mode of inheritance for LPL deficiency could not be established exactly.

Minor dietary effects of HDL in physically active men

In a preceding prospective study an increased high-density lipoprotein (HDL)-cholesterol and apolipoprotein (apo) A-I concentration occurred in healthy, non-obese, initially sedentary men, aged 30--44 years, after 3 months of physical training. Dietary history data revealed an increase in the absolute amount of fat-intake. In the present study we investigated whether a changed fat intake would influence the levels of lipoproteins, especially the HDL fraction, in twenty-three regularly conditioning men, aged 30--44 years, with a maximal aerobic capacity of 53.4 ml/kg x min--1 +/- 0.8, mean +/- SE. Ten subjects participated in an experimental group and thirteen in a control group. The experimental group studied before, after 4 weeks on a fat-rich diet (fifty-four energy-% fat, twenty-nine energy-% carbohydrate) and after 4 weeks on a fat-poor diet (twenty-nine energy-% fat, fifty-three energy-% carbohydrate). The data reveal that these large dietary changes did not influence HDL-cholesterol concentrations (1.71 +/- 0.10, 1.69 +/- 0.12, 1.59 +/- 0.13 mmol/l, mean +/- SE, during ordinary, fat-rich and fat-poor diet, respectively) and only influenced apo A-I levels to a minor degree after the fat-poor diet (134 +/- 6.1, 134 +/- 7.1 and 123 +/- 4.7 arbitrary units, mean values +/- SE) during ordinary, fat-rich and fat-poor diet, respectively). No changes were observed in the controls before and after 8 weeks. During the study training habits and body weight were constant. These findings show that large variations in the intake of dietary neutral fat only to a minor extent influence the level of HDL-cholesterol and apo A-I in physically active subjects.

Familial hypo-alpha-lipoproteinemia

A familial syndrome with hypo-alpha-lipoproteinemia is described. The affected propositus and his relatives have low levels of high density lipoprotein-cholesterol and apolipoprotein A, without any other lipid and lipoprotein abnormalities. Lipase activity and lecithin:cholesterol acyltransferase activity are also normal. A high prevalence of premature cardiac events was observed in this kindred, without any other established coronary risk factors present. The longevity analyses showed a shortening of life expectancy. The biochemical data and the pedigree are compatible with an autosomal dominant mode of inheritance.

Effect of probucol on the activity of postheparin plasma lipoprotein lipase and hepatic lipase

The effect of discontinuation of long term (34-56 months) probucol treatment on serum lipids, lipoproteins and on the activity of postheparin plasma lipoprotein and hepatic lipase ahs been studied in 10 healthy males participating in a primary prevention programme of coronary heart disease. A significant increase was observed in the activity of postheparin plasma lipoprotein lipase, in the total serum cholesterol concentration and in the serum concentrations of high density lipoprotein (HDL) cholesterol, HDL phospholipids and apoprotein AI after withdrawal of the drug No changes were seen in the serum triglyceride levels or in the activity of postheparin plasma hepatic lipase. The activity of postheparin plasma hepatic lipase tended to correlate with the serum concentration of HDL. No correlations were present between the individual changes in the serum levels of HDL and in the activity of postheparin plasma triglyceride lipases.

Role of the liver in the degradation of very low density lipoproteins: a study of lipolysis by heparin releasable liver lipase and uptake during isolated rat liver perfusion

The role of the liver and of a heparin-releasable liver lipase in the metabolism of very low density lipoprotein (VLDL) was investigated in vitro and during recycling rat liver perfusion. Rat plasma VLDL and nascent hepatic VLDL were labelled biosynthetically in their lipid moieties. Incubation in vitro of VLDL with the lipase caused hydrolysis of VLDL-triglycerides (greater than 80%) and VLDL-phosphatidylcholine (greater than 30%). Nascent VLDL was a better substrate for the enzyme. The hydrolytic activities were inhibited by 70--90% when rat plasma (10--30 vol%) was added to the incubation mixture. VLDL-triglycerides and cholesterol esters were taken up by the liver during 180 min recycling perfusion. The rate of disappearance of nascent VLDL was faster than that of plasma VLDL (half-life times of 56.2 +/- 13.9 and 125.0 +/- 24.8 min respectively). Injection of heparin into the perfusion medium caused accelerated uptake of the hydrolysed VLDL-triglyceride by the liver. Addition of plasma (d greater than 1.006 g/ml) to the perfusion at a concentration of 10 vol% delayed the rate of disappearance of VLDL from the perfusate by about 50--75%. These studies have established the capacity of the hepatic lipase to hydrolyse VLDL-lipids and the ability of the liver to degrade nascent and plasma VLDL particles. These two activities, however, are depressed by plasma and therefore previous studies of VLDL metabolism may have to be re-examined when based on incubations or perfusions in the absence of plasma.

Changes in serum lipids, lipoproteins, and heparin releasable lipolytic enzymes during moderate physical training in man: a longitudinal study

Serum lipids, postheparin plasma lipoprotein lipase (LPL) and hepatic lipase (HL) activity, and furthermore adipose tissue LPL activity were studied in 20 middle-aged men undergoing a moderate training program of 15-wk. These same parameters were also measured in 7 nontraining control subjects. The training caused a significant (P less than 0.001) increase in physical fitness, and also considerable changes in serum lipid levels and lipolytic enzymes activities. In the trainers, serum HDL cholesterol increased by about 7% (P less than 0.01 and HDL/total cholesterol ratio by 11% (P less than 0.001). Decreases were observed in serum total (P less than 0.10 and LDL (P less than 0.05) cholesterol levels and in insulin values (P less than 0.05). No changes in these parameters occurred in the reference group. Postheparin plasma and adipose tissue LPL activity increased by 33% (P less than 0.001) and 56%, respectively, in the trainers. Postheparin plasma HL activity remained essentially the same in both groups, although a trend towards decreased values was seen in the trainers. On the other hand, postheparin plasma HL activity correlated negatively with serum HDL cholesterol levels both before and after the training period. The present results suggest that even with a moderate training program, beneficial effects on serum lipids in middle-aged men can be accomplished. There is also reason to believe that these changes are, at least in part, mediated by changes in the activities of lipolytic enzymes involved in lipoprotein metabolism, namely LPP and HL.

Postheparin lipolytic activity and Intralipid clearance in very low-birth-weight infants

The effect of heparin (10 U/kg) on serum lipolytic activity, triglyceride and FFA levels, during four hours infusion of 0.5 gm/kg Intralipid was measured in 18 AGA infants, 25 to 32 weeks' gestational age. PHLA, TG, and FFA were measured at 0, 10, 30, 120, and 240 minutes of infusion of Intralipid, before and following a bolus of 10 U/kg heparin iv. Lipolytic activity, measured by hydrolysis of activated tri-3H-oleate and expressed in mumol FFA released per milliliter serum per hour, was not detected in serum before heparin administration. Ten minutes after heparin administration peak PHLA was significantly higher in infants of 27 to 32 weeks' gestation than in infants of 25 to 26 weeks' gestation. There was no significant difference in peak PHLA between infants of 27 to 28 and 29 to 32 weeks' gestation. PHLA returned to baseline (zero) two hours after heparin administration in all infants. Infants of 25 to 26 weeks' gestational age had significantly higher concentrations of serum triglycerides before and during Intralipid infusion than in infants of 27 to 32 weeks' gestational age. Although there was a transient rise in FFA 10 and 30 minutes after heparin administration, the levels of FFA and triglycerides were not different at the end of infusion with or without heparin in either group, suggesting that a single bolus of heparin has only a transient effect on Intralipid clearance.

Hemodialysis vs. peritoneal dialysis: results of a 3-year prospective controlled study

A prospective comparison of peritoneal dialysis to hemodialysis was undertaken to identify advantages and disadvantages of either treatment relative to the other. Hematologic, biochemical, lipid, and neurobehavioral parameters were followed. Careful controls were imposed to assure that the treatment groups were comparable. Patients on peritoneal dialysis proved to have more normal concentrations of BUN, hemoglobin, potassium, bicarbonate, and high-density lipoproteins. Hemodialysis patients had more normal concentrations of albumin, total protein, and calcium. Hypertriglyceridemia was only minimally greater in peritoneal patients. Neurobehavioral results documented multiple abnormalities in both. The profile of results obtained provides preliminary criteria for selecting either form of dialysis for a particular patient.

Influence of two non-steroidal anti-inflammatory drugs on lipolysis and on plasma post-heparin lipoprotein lipase activity in normal man

Indomethacin 50 mg i.v. or p.o. and diclofenac sodium 50 mg p.o. produced a prompt and significant increase in plasma free fatty acid concentration. In 10 subjects who took indomethacin 150 mg/d p.o. for 3 days, plasma post-heparin lipoprotein lipase activity was also significantly increased. The same effect occurred in 9 subjects treated for 3 days with diclofenac sodium 50 mg t.d.s. Since both indomethacin and diclofenac sodium are potent inhibitors of prostaglandin synthetase, these findings are consistent with the hypothesis tht prostaglandins are involved in the feed-back regulation of lipolysis, and mediate the inhibitory effect of lipolysis on lipoprotein lipase activity.

Increase in lipolysis and decrease in plasma-heparin lipoprotein lipase activity and alpha 1 lipoprotein level after aminophylline in man

Intravenous aminophylline 0.48 g produced a sharp increase in plasma free fatty acids. After three days of treatment with aminophylline 0.96 g/day i.v., plasma post-heparin lipoprotein lipase was significantly reduced, and post-heparin hepatic triglyceridase remained unchanged. alpha 1 lipoprotein was reduced by treatment, in parallel with lipoprotein lipase, while other lipoprotein fractions, serum cholesterol and triglycerides were unaffected.

Impaired plasma triglyceride clearance as a feature of both uremic and posttransplant triglyceridemia

After accurate plasma volume calculation, endogenous plasma very-low-density-lipoprotein (VLDL)-triglyceride turnover rates were measured in 20 undialyzed patients with chronic renal failure (CRF) and in 16 renal transplant recipients with stable graft function. When kinetic criteria were based on a group of healthy subjects (Vmax = 36.7 mumoles/hr/kg), it was clear that, on the whole, CRF patients had a reduced capacity for VLDL-triglyceride removal (Vmax = 14.0 mumoles/hr/kg), as did graft recipients (Vmax = 19.5 mumoles/hr/kg). In transplant recipients with impaired graft function, however, extremes of both under removal and over production of VLDL-triglycerides were observed. In CRF, defective clearance was accompanied by a reduction in postheparin lipoprotein and hepatic lipase activities, although there was no statistical relationship. Enzyme activities were not reduced, however, after transplantation, and the metabolic factors responsible for defective clearance were not clearly identified.

Evaluation of the roles of lipoprotein lipase and hepatic lipase in lipoprotein metabolism: in vivo and in vitro studies in man

The roles of lipoprotein lipase (LPL) and hepatic lipase in very low density lipoprotein (VLDL) and VLDL remnant metabolism were investigated by (1) in vivo studies where the kinetics of VLDL-apo B removal were measured in patients with non-functioning lipoprotein lipase systems, and (2) in vitro studies where the relative capacities of hepatic lipase and LPL to hydrolyse the triglyceride (TG) of different lipoprotein substrates was measured. The results indicated that VLDL-apo B removal was not impaired in patients with non-functional LPL, nor ws there any apparent abnormality in the conversion of VLDL-apo B to intermediate- (IDL) and low (LDL) density lipoprotein-apo B. Post-heparin plasma hepatic lipase activity against VLDL was normal in these subjects. Purified normal hepatic lipase had a similar Km for VLDL-TG hydrolysis (1.57 mmol/l) to that of LPL (1.49 mmol/l). However, at equal lipoprotein TG concentration, hepatic lipase had increasing activity with lipoproteins of decreasing particle size, in the order chylomicrons much less than VLDL of Sf 100-400 less than VLDL of Sf 60-100 less than VLDL of Sf 20-60 less than IDL. The mean contribution of hepatic lipase to VLDL-TG hydrolysis by post-heparin plasma was 35% in normal controls, but the contribution to IDL-TG hydrolysis was significantly higher (mean - 58%). It is concluded that hepatic lipase plays a significant role in VLDL and, especially, IDL metabolism, at least in patients with non-functioning lipoprotein lipase.

Fat clearance before and after heparin in chronic renal failure--haemodialysis reduces post-heparin fractional clearance rates of intralipid

The effect of heparin on the kinetics of fat removal was studied in 15 subjects and it became apparent that the fat tolerance test could be performed after the administration of heparin. Therefore, fractional clearance rates of Intralipid were determined before and after heparin in three groups of patients: 18 in chronic renal failure, 11 on peritoneal dialysis and 17 on haemodialysis. Patients on peritoneal dialysis and on haemodialysis had similar serum triglyceride concentrations and comparable fractional clearance rates of Intralipid before heparin was given. However, the latter had significantly smaller increases in fractional rates of Intralipid clearance after the administration of heparin. Either gradual diminution of releasable releasable enzymes by regular heparinisation or activator concentrations becoming rate-limiting could be responsible for the low post-heparin fractional clearance rates observed in haemodialysis patients.

Lipoprotein lipase of human postheparin plasma and adipose tissue in relation to physical training

Adipose tissue lipoprotein lipase and postheparin plasma triglyceride lipase activities were measured in 28 men differing in their physical training activity. They were divided into 4 subclasses based on their training intensity. The two most active classes (17 subjects) having regular heavy exercise at least 4 times a week were considered as the actively training group, and the other two (11 subjects) classes not training regularly as the control group. In postheparin plasma, the lipoprotein lipase activities were not different between the two groups, whereas training subjects had significantly (P less than 0.02) lower hepatic lipase activities. Adipose tissue lipoprotein lipase activity was in the training group at about 70% higher level on an average than in the controls (P less than 0.10). A significant positive correlation (r = 0.38, P less than 0.05) was obtained between the adipose tissue lipoprotein lipase activity and the level of physical activity. Our data suggest that even moderate inter-group differences in the physical training activity are reflected as measurable alterations in the adipose tissue lipoprotein lipase activity in man.

The validation and use of specific methods for the estimation of lipoprotein lipase and hepatic lipase activities in post-heparin plasma of children with hyperlipidaemia

The methods proposed by Nilsson-Ehle and Ekman [8] for the specific estimation of lipoprotein lipase and hepatic lipase activities in post-heparin plasma were investigated. The procedure for hepatic lipase was found to be specific, but the lipoprotein lipase assay required modification to abolish hepatic lipase interference. The modified procedures were fully validated and found to be relatively simple, rapid and specific and were used to investigate children with primary and secondary hyperlipidaemic states.

A selective decline of postheparin plasma hepatic triglyceride lipase in hypothyroid rats

The present study aimed to define the effect of thyroid status on two postheparin plasma lipases, i.e., lipoprotein lipase and hepatic triglyceride lipase. Rats with hypo- and hyperthyroidism were used for this purpose. Separate measurement of these two lipases was done by an immunochemical method utilizing antiserum specific to hepatic triglyceride lipase. The 5-wk thyroidectomized, hypothyroid rats had normal plasma concentrations of both triglyceride and cholesterol. These rats showed a selective decline in the activity of postheparin plasma hepatic triglyceride lipase with normal lipoprotein lipase activity. The rats made thyrotoxic by thyroxine treatment had normal plasma levels of both triglyceride and cholesterol. These rats showed normal activities of both hepatic triglyceride lipase and lipoprotein lipase. The observed finding of a selective decline of hepatic triglyceride lipase in hypothyroid rats is discussed in connection with the possible function of this enzyme in lipoprotein metabolism.

Decline of postheparin plasma lipoprotein lipase in acromegalic patients

Lipoprotein lipase and hepatic triglyceride lipase in postheparin plasma were measured in seven patients with active acromegaly by an immunochemical method utilizing antiserum prepared against hepatic triglyceride lipase. A mild or moderate hypertriglyceridemia was shown, with plasma triglyceride concentrations between 156 and 544 mg/dl. Lipoprotein lipase was found to be decreased in all patients (p less than 0.001). Hepatic triglyceride lipase was also low in these patients (p less than 0.001). We speculate that acromegalic hypertriglyceridemia is mediated, at least in part, by the decline in lipoprotein lipase and possibly by the decline in hepatic triglyceride lipase activities.

Lipoprotein lipase and adipose tissue and plasma triglyceride clearance in patients with primary hypertriglyceridaemia

1. The activity of lipoprotein lipase (E.C.3.1.1.3) extracted and released from adipose tissue has been measured in obese subjects with mild or severe hypertriglyceridaemia. The Intralipid tolerance test has been studied as a measure of in vivo clearance of exogenous triglyceride from plasma. 2. Plasma triglyceride clearance was reduced in patients with severe hypertriglyceridaemia (> 4 mmol/l) and this was associated with reduced activities of extracted lipoprotein lipase in adipose tissue compared to patients with mild hypertriglyceridaemia (2--4 mmol/l). 3. A course of insulin therapy (20 u/day) for 1 week increased the extracted, but not the released component of the enzyme from adipose tissue of hypertriglyceridaemic patients. 4. Serum (25% v/v) potentiated the release of lipoprotein lipase from adipose tissue of normo- but not hypertriglyceridaemic patients. 5. The effect of serum on enzyme release was abolished if lipoprotein-deficient serum was used. Addition of very low density lipoprotein (VLDL) or high density lipoprotein (HDL) restored the ability of delipidated serum to augment release of enzyme from adipose tissue, but this was not observed with low density lipoprotein (LDL). 6. It is suggested that a defect in the release of lipoprotein lipase activity in adipose tissue may contribute to the development of hypertriglyceridaemia in this group of patients.