Diabetes, Vol 29, Issue 11 899-905, Copyright © 1980 by American Diabetes Association
Resistance to insulin but not to glucagon in lean human hypertriglyceridemics
G Steiner, S Morita and M Vranic
Glucose kinetics were studied in a group of nonobese humans with endogenous
hypertriglyceridemia before, during, and after an infusion of graded
increments of glucagon. The tracer methods employed permitted glucose
turnover to be quantitated under non-steady state conditions. The rates of
glucose production, disappearance, and fractional disappearance were
related to the range of glucagon and insulin levels in each individual. The
findings in hypertriglyceridemics were compared with those in lean normals
of the same relative body weight and the same extracellular fluid volume
per kg, as reflected by their apparent glucose space. Glucose production
and serum insulin were each positively correlated to plasma glucagon
concentrations in both hypertriglyceridemics and normals. Thus, with
respect to these parameters, the hypertriglyceridemics were not resistant
to glucagon. During the glucagon infusion, the glucose concentration rose
more in the hypertriglyceridemics than in ther normals because of a reduced
total rate of glucose disappearance in the hypertriglyceridemics. In the
normals the fractional disappearance rate of glucose was positively related
to serum levels of insulin, whereas in the hypertriglyceridemics it was
lower than normal and did not change in relation to insulin concentration.
This demonstrated that, at least with respect to glucose utilization, lean
hypertriglyceridemics can be resistant to insulin even in the absence of
obesity.